SEEN in Health
@SEENinHealth
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SEEN in Health is a staff network representing the protected characteristic of sex. We are committed to promoting sex equality and equity in all NHS settings.
Seeninhealth.org
Joined April 2024
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Welcome to SEEN in Health, the Sex Equality and Equity Network for NHS staff. We focus on the protected characteristic of sex. We're open to anyone who works in the NHS who shares our aims and values. Find out more or sign up for updates here
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SEEN in Health's mission is to create an environment in the NHS where staff feel safe and encouraged to discuss issues related to the protected characteristic of sex, so that they can speak up for themselves as employees and on behalf of patients
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Let’s talk about ovaries
These are the female gonad which produces large human gametes: ova and female hormones. Only women have ovarian diseases such as polycystic ovarian syndrome (PCOS) and ovarian cancer. Only women go through the menopause when the ovaries stop releasing ova
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We are seriously concerned by the multiple incorrect claims made in
@TheLancet
Information for Authors (June 2024) 🧵
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NHS communications must be, at a minimum, factually accurate.
This poster is misleading for 2 of the 9 legally protected characteristics
Sex is protected, not ‘gender’
Gender reassignment is protected, not ‘trans’
These errors undermine public & staff confidence in the
#NHS
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Sex-based rights are protected under the Equality Act 2010, staff who raise concerns about safety, privacy and dignity should not be ignored, belittled or advised to “broaden your mindset”.
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We are growing! As the NHS staff network we can do so much to help our employers understand and respect the protected characteristic of sex.
Capturing the right information on IT systems is vital. We would love more colleagues working in IT to join us:
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Let’s talk about sex.
Sex is a protected characteristic. It is a characteristic shared by 100% of the population. NHS data collection, EDI training, policy and patient pathways should all refer to sex.
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The 2024 NHS staff survey findings indicate a concerning trend that female healthcare staff are experiencing unwarranted sexual approaches at a disproportionate rate
1 in every 26 NHS workers report sexual harassment from their work colleagues /1
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SEEN in Health is seeing some disappointing examples of discriminatory policies in various trusts around the country, highlighted by the experiences of the nurses in Darlington.
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It’s clear from the Adams V ERCC case that women have an explicit right to same-sex intimate care.
This is applicable in healthcare too.
Staff & all patients who believe in same-sex care must not be punished for this belief.
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It is vital to know the sex of an individual when they present to a health care setting and we encourage the NHS to ensure accurate recording of sex in the electronic record, with recording of gender separately as appropriate.
Join us here at
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Thank you to those of you who have engaged positively with our tweets.
We have noted your comments, either on here or on the "Join us" form on our website, and your views are helping shape our next steps as a staff network.
To join us, go to
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What are the consequences of desexed / ambiguous language in healthcare?
@DrKarleenG
details her findings in this peer reviewed paper (free access)
We’ve summarised them in this thread:
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As NHS staff we are disappointed when the word ‘woman’ is removed as only women are at risk of ovarian cancer. It is crucial that we use clear language so that women from all parts of society are aware of their risks, and to avoid confusion among men and women.
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Today is World Blood Donor Day
Donors rightly take pride in being able to help others in this way. Without regular blood donations, thousands of people every day would not be able to receive vital emergency or ongoing medical treatment.
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It’s deeply concerning that one of the leading medical journals has chosen to express these untruths whilst encouraging prospective authors to follow suit
The accuracy and clarity of future medical publications involving sex-based findings are at risk. In healthcare, sex matters
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Let’s talk about the cervix
This is the Macmillan cervical screening awareness week.
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It was a pleasure to talk with
@WomensRightsNet
this evening to explain why we felt the need to set up SEEN in Health.
We exist because sex inequality exists in NHS workplaces across the four nations. Once we have achieved our mission we will gladly disband.
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(1) The guide claims that 'Sex and gender are often incorrectly portrayed as binary, concordant and static'.
There are only two sexes and they are immutable. 'Gender' is the socially constructed stereotypical behaviours applied to people based on sex.
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The NHS is a key election battleground. NHS staff alone account for nearly 2M votes.
All parties must understand the importance of the protected characteristic of sex, sex equality & equity in healthcare; not least for patient and staff safety
SEEN & voters are watching
#GE24
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It is vital to know the sex of an individual when they present to a health care setting with abdominal or genitourinary symptoms and we encourage the NHS to ensure accurate recording of sex in the electronic record.
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@SEENinHealth
acknowledges the immutable characteristic of sex. Sex is not an assignation at birth, rather an observed fact.
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It was a pleasure to meet with the Rt Hon.
@EstherMcVey1
& other Sex Equality and Equity Network (SEEN) representatives from across the country, in Parliament yesterday. We are grateful for the opportunity and it is encouraging to know we are not alone and are being heard.1/3
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Women who have been pregnant can have antibodies in their blood that could cause harm to a recipient when receiving platelets and plasma, so men’s donations are easier to use than blood from women:
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It is deeply offensive to suggest that they are somehow a third sex and that their medical conditions are an 'identity'.
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It is incredulous that an NHS Trust denied the rape of a patient for a year because the trust reprehensibly prioritised the gender-identity of the alleged attacker over the female victim
These are just a few examples that have allegedly occurred in NHS Hospitals /7
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(2) “…these constructs exist along a spectrum that includes additional sex characterisations and gender identities, such as people who are intersex/ have differences of sex development”
Sex is not a spectrum. People with differences of sex development are still male or female:
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🧵
@SEENinHealth
welcomes the legislation passed before government dissolves for the election, which is prohibiting the private UK or overseas prescribing of puberty blockers for under 18s (subject to consultation to make permanent)
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SEEN in Health is run by volunteers. If you’d like to know more about what we do, check out our website and sign up to be on our mailing list.
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(3)“In any given person, sex and gender might not align, and both can change”
As we have said, gender is socially constructed. Sex, however, is immutable and absolutely cannot change.
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We have just published our response to the consultation on the NHS Constitution. We encourage everyone who works in the NHS or uses its services to submit a response.
See our submission here:
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REMINDER
If you've got any examples of public bodies with policies or guidance that wrongly suggest that people can access single sex spaces based on self-identified gender, you can still submit them, despite the election.
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The requirements for donating blood are different to ensure that women are not put as health risks. Women with a shorter stature under 65kg might not be able to donate, and women can only donate every 16 weeks minimum while men can donate every 12 weeks as they recover faster.
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Women of childbearing potential requiring blood components need to be matched for Rhesus factor and Kell factors, to help prevent haemolytic disease of the newborn in future pregnancies. Men, however, can receive a wider range of blood types.
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Additionally,
@TheLancet
advises authors to use the phrase “sex assigned at birth” rather than “biological sex” or “natal sex”; claiming this is more “accurate”.
However, there is no single, universally agreed-upon set of guidelines reporting sex-based findings.
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Michelle Russell, an experienced, specialist nurse was one such female sexually harassed by a male work colleague. Her own Trust’s investigation into these allegations were deemed ‘catastrophically flawed’ by NHS England: /2
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@SEENinHealth
are aware of many more.
These incidents depict the sobering reality facing UK healthcare staff and patients, these are the real life consequences of failing to safeguard the protected characteristic of sex in health
#BeSEEN
/8
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Ovarian Cancer Action website has lots of great information on the condition and we support their clear sex based language. Ovarian cancer can present with persistent symptoms of bloating, stomach pain, feeling full more quickly and needing to wee more frequently.
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Welcome to the SEEN community
@LocalAuthSEEN
👏🏼 👏🏼 🚹🚺
We’re a growing network of staff groups committed to sex equality and equity in all areas of society.
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Again, the concerns raised by a group of female nurses were repeatedly ‘brushed aside’ by
@CDDFTNHS
when they were forced to share their changing room with a male colleague /3
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But did you know that there are very important differences in the way that blood donations from men and women are handled?
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Similarly, provision to single-sex wards is fundamental in safeguarding patients from sexual assault too: /6
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It is vital to know the sex of an individual when they present to a health care setting and we encourage the NHS to ensure accurate recording of sex in the electronic record.
Join us here at
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Vulnerable women who have experienced sexual abuse and international staff with protected religious beliefs were amongst this group of nurses /5
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These are also symptoms of common and much less serious conditions. See here for more information:
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#MentalHealthWeek
In 2022
@ONS
reported that males continued to account for 3/4 of suicide deaths.
Accurate sex recording in healthcare is crucial to ensure services are supporting the appropriate demographic
@SEENinHealth
is committed to achieving sex equality in healthcare 🚻
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It is important that all NHS bodies are aware of their legal responsibilities to review their policies in light of legislation which balances the rights of different groups.
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Sex matters and is protected under the Equality Act 2010 yet this is not universally recognised, nor supported in practice, across our NHS employers, professional bodies or public sector unions.3/3
#SEEN
#strongertogether
#SexMatters
#NHS
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SiH believes that clear language is important for communication, accuracy and dignity of women and men when we talk about female and male anatomy.
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We believe the misguided attempts of inclusivity at the expense of women must end. Sex is a protected characteristic and mustn’t be erased or replaced with the term ‘gender’
@SEENinHealth
is committed to sex equality in healthcare and we support the use of accurate sexed language
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The cervix of the uterus is not synonymous with front hole: anatomically a front hole, a ventral orifice, is the urethral meatus, very different from the unique structure of the cervix, being the internal structure sitting at the top of the vagina that forms part of the uterus.
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“I support
@SEENinHealth
because sex matters” 🧵
The NHS needs to be more sex considerate, and so do our patients. I am relieved Constitutional changes are proposed to support this but more needs to be done at operational, strategic and policy level 1/9
#BeSEEN
#NHS
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The cervix is the neck of the uterus, an extraordinary structure is unique to females with no similar male structure, as it develops from the Mullerian structures which are suppressed in male development.
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After years of progress in which the public in general and women specifically have become more knowledgeable about their own anatomy we are disappointed that there is now a regression to using inaccurate terms.
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@SEENinHealth
looks forward to the newly elected Labour Govt ensuring the protected characteristic of sex is upheld in healthcare.
Patients and staff both have sexed based rights which must be respected./1
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@seeninhealth
are committed to protecting the sex-based rights of all healthcare staff - we encourage all staff involved and those who are concerned to join our network for support:
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The goal of Men’s Health Week is to raise awareness around the health challenges faced by men and reducing stigma around those challenges.
Men are less likely to discuss or seek help for their physical or mental health and many men find it difficult to open up and reach out.
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We discussed the negative impact of poorly implemented EDI policies and practices, the current culture of fear in our professional and personal communities and the importance of impartiality in the NHS.2/3
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@SeenStem
If you work in healthcare and believe in representing the specific sex-based needs of different staff and patient groups, please join us:
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SiH is aware that words other than anatomically correct terms are being used to describe female body parts.
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SEEN in Health would like to wish
@England
the best of luck in Berlin tonight.
True equality is winning both the women's and men's Euros! ⚽️🏆
#ESPENG
#EUROS2024
#EurosFinal
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Cervical cancer can develop in women, particularly if they have been infected with certain types of HPV virus. It is important to have screening for this infection and for abnormal cells in the cervix as this cancer is very treatable if caught early.
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@SEENinHealth
is a staff network representing the protected characteristic of sex in healthcare.
We’re a small part of a wider
#SEEN
community that promotes sex equality and equity
Here’s some of our colleagues who are doing great work in their field 🧵 1/11
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Let’s talk about prostates. This is a gland only found in men, and it is retained even if a trans identified male has had surgery to remove male genitalia.
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The cervix is short thick, mostly tightly closed except during labour when it thins, stretches and dilates up to 10cm to allow that passage of the baby’s head and body. Miscarriage can be caused by cervical insufficiency if it is unable to keep tight closed in pregnancy.
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Although different approaches to terminology in healthcare remaining respectful may be required depending on the context,
@DrKarleenG
suggests inclusivity statements or definitions in circumstances where desexing language isn’t appropriate because of the confusion it introduces.
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There has been an incremental creep of desexed language within healthcare communications. For example, replacing ‘Mothers’ & ‘Women’ with ‘Birthers’ & ‘Menstruators’, respectively. Desexing language in relation to males occurs less frequently.
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In 2022 the Women's Health Strategy was launched.
@lregan7
was appointed the first women's ambassador for England.
The strategy can help organisations promote sex equality and equity by improving training, policies and services for women. 1/9
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Referring to ‘chests’ rather than ‘breasts’ regarding breastfeeding is medically inaccurate. Chest = everything within the ribcage, breast = mammary glands.
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There have been a number of such cases that have come to court, and Trusts risk public money when they don’t abide by the law.
#BeSEEN
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The ambiguous alternative terms used involving body parts e.g. ‘cervix havers’ is perceived as dehumanising and ‘invisiblising women’. Women have unique experiences, needs and rights in relation to pregnancy, birth and breastfeeding that are not, and cannot, be shared with others
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New mothers, pregnant & birthing women have unique vulnerabilities and also require protection.
Each day, approx 810 women die during pregnancy worldwide (WHO).
Postpartum psychosis affects 1-2/1000 mothers and is a leading cause of maternal death through suicide
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Who are ‘postnatal people’? Are they the mothers who’ve just given birth or the healthcare staff providing postnatal care?
Who are ‘breastfeeding people’? Are they the mother or the infant, or both?
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The intention behind this is to acknowledge women with a gender identity alternative to their natal sex, a strategy championed by EDI departments. However, the unintended consequences of this on other women are often not deliberated resulting in sex-based rights being overlooked
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Misleading language introduces inaccuracies and creates confusion. E.g.
“1 in every 8 people develop breast cancer”.
“1 in every 10 people have endometriosis”
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Today is National ODP (Operating Department Practitioners) Day, thank you to our amazing ODPs, our theatres cannot run without you. Registrants are increasingly female (64%) in this allied health profession
#ODPday
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Join us here at
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It is vital to know the sex of an individual when they present to a health care setting with genitourinary symptoms, and we encourage the NHS to ensure accurate recording of sex in the electronic record.
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It is vital to know the sex of an individual when they present to a health care setting and we encourage the NHS to ensure accurate recording of sex in the electronic record
Join us here at
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We at
@seeninhealth
support the Women’s Health Strategy to achieve much needed change and improvement in healthcare provided to girls, women and mothers. 9/9
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We look forward to the clarification of sex based rights within the health sphere which is for the safety and dignity of all patients and staff./3
Join us here:
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The protected characteristic of sex follows on from the Sex Discrimination Act 1975, important in addressing the inequalities seen between men and women, and was the first time women could claim discrimination in law, based on sex./2
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All NHS services MUST operate to the same standards, including provision of evidence-based treatment. Prescribing practitioners MUST have full confidence in any psychopharmacological treatments prescribed
#FirstDoNoHarm
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Medical ethics directs staff to ‘do no harm’ and safe prescribing is essential. NHS prescribing will now be restricted to clinical trials only, providing much needed research to inform the future healthcare provision to vulnerable children
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Join us here at
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Oestrogens may increase the risk of prostate cancer, and treatment can be more difficult with poorer outcomes in trans identified males:
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Recognising sex matters means respecting sex as a protected characteristic. The NHS is not inclusive without this.
“I joined
@SEENinHealth
to help NHS leaders be Equality Act and Public Sector Equality Duty compliant. Our workforce deserves no less.” 9/9
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@SEENStem
For sex realists in STEM who believe reality matters for continuing scientific and technological discoveries 11/11
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Trans identifying males remain at risk of prostate diseases such as benign prostate hypertrophy, prostatitis and prostate cancer, but symptoms of these could be missed due to surgery and opposite sex hormones.
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@SEENinSchools
A collaborative support network for teachers, non-teaching school staff and school governors who hold gender critical and sex-realist beliefs. We aim to promote and support sex equality and equity in schools 4/11
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Sex matters and is a protected characteristic under the Equality Act 2010. It should not be undermined by poorly drafted policies and guidance that do not reflect the law. Collecting evidence is crucial to addressing this issue.
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In healthcare it is vital to use accurate sex specific language to avoid misleading ambiguous information. Words such as "mother", "woman" and "girl" are clear, unambiguous and accurate, describing those people directly affected by this strategy. 2/9
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The call for evidence received 110,123 responses, detailing women’s experiences at every stage of their interactions with the healthcare system. 5/9
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The need for healthcare professionals to receive better education and training on women’s health conditions, and to be better supported to deliver the best health and care possible was highlighted. 6/9
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