Women's Health Plan: Phase Two (2026 - 2029)

2 Women’s Health Plan: Priority Programmes

Ambition

Our ambition is for all women and girls to enjoy the best possible health throughout their lives.

The Scottish Government will undertake four priority programmes as part of this second phase of the Women’s Health Plan. These programmes are in addition to, and complement, the 40 actions with the aim of driving forward progress in women’s health.

2.1 Transformation of Gynaecology Services

Aim

For all women and girls in Scotland to have timely access to gynaecological care.

Priority Programme One

The Scottish Government will develop, and NHS Boards will implement, a National Plan for Gynaecology.

This programme of service transformation will ensure the timely provision of high-quality gynaecological care which is sustainable for the future.

A National Gynaecology Plan will initially focus on addressing waiting times challenges, moving towards sustainable change, redesign and improvement for gynaecology services across Scotland.

Gynaecology was not identified as an area in need of specific and additional focus during the development of the first phase of the Women’s Health Plan in 2020-21. However, waiting lists in gynaecology have grown rapidly since the start of the COVID-19 pandemic. Women are now waiting too long for new outpatient appointments and inpatient or day-case treatment, with evidence that many are resorting to accessing emergency medicine and/or private care for urgent treatment.

As of November 2025, there were 64,535 waits for a gynaecology appointment or procedure in Scotland although waits of more than a year have fallen in recent months. 18.1% for new outpatients and down 3.9% for inpatient and day-case procedures between July and November 2025.. This has a significant impact on the quality of life of the women waiting for treatment, living with symptoms including extreme and chronic pain, heavy menstrual bleeding, incontinence and poor mental health. This affects their ability to work, to provide care, to access education, to enjoy life, and for some it will affect their fertility.

“Tackling gynaecology waiting times was seen as a critical area of focus for [Lived Experience] Group members. Group members urged that actions around reducing waiting times should also take into consideration demographic pressures and differences… a restructure, although a large undertaking, would make care more efficient.” Lived Experience Development Day – ALLIANCE – March 2025

Addressing excessively long waiting times is our primary focus in the immediate term. The growth in waiting lists reflects sustained pressures on theatre capacity, outpatient infrastructure and specialist workforce availability, alongside increasing clinical complexity. Reducing the overall waiting times for gynaecology and focussing on longer-term service sustainability will impact other priority areas of the Women’s Health Plan including waiting times for endometriosis or fibroid diagnosis and treatment as well as access to specialist menopause care. Primary care plays a crucial role in early identification and timely referral, yet access to diagnostics and primary care management of common gynaecological symptoms varies across Scotland. Strengthening support for assessment in primary and community settings, alongside clearer referral pathways, will be important to reduce avoidable delays.

In the financial year 2025-2026, over £10.5 million was allocated to Health Boards to target long waits for gynaecology, through waiting list initiatives and recruitment.

But we know more must be done.

Our ambition for gynaecology will align with those of the SRF, and in particular its focus on reducing long waits for planned care, working to ensure that women and girls live longer, healthier and more fulfilling lives. We want gynaecology services for women that are accessible in a timely manner. This should include support for prevention and early intervention and should ensure services are designed around the needs of women and girls, where there is more access to care and support in the community and where services are planned on the basis of the best possible care. Gynaecology care should enable rapid detection of gynaecological cancers and the detection of conditions such as endometriosis, PCOS or fibroids as early as possible. Women should be effectively supported to manage chronic gynaecology conditions and women and girls should no longer have to attend multiple appointments or experience years of healthcare interaction before they receive the treatment and care they need.

The national plan will explain how women will increasingly receive high quality and effective care closer to home. It will improve support and treatment for women with gynaecological and urogynaecological conditions, including postmenopausal bleeding, heavy menstrual bleeding and urinary incontinence. The plan will describe how, in the longer term, these improvements would move more services into the community and enable women to self-refer, where appropriate, for timely access to examination, scanning, biopsy and smaller procedures.

As we redesign services, we will work to reduce inequalities in access and outcomes, particularly for women in deprived communities, disabled women, minority ethnic women and those in rural and island areas. Achieving this requires coordinated improvement to ensure women receive the right support at the earliest opportunity.

2.2 Elimination of Cervical Cancer

Aim

For cervical cancer to be eliminated in Scotland by 2040.

Priority Programme Two

The Scottish Government will develop, publish and implement an Action Plan for the Elimination of Cervical Cancer.

In 2024, the Scottish Government established an Elimination of Cervical Cancer Expert Group to consider how Scotland can reach the World Health Organisation (WHO) targets for the elimination of cervical cancer. WHO recommends that at least 90% of girls are fully vaccinated against HPV by the age of 15, at least 70% of eligible women have cervical screening by age 35 and again by age 45, and at least 90% of women diagnosed with cervical disease should be treated. While WHO has established specific targets, the Expert Group and the three subgroups (covering vaccination, screening and treatment) have made specific recommendations to ensure that efforts in Scotland are equitable and inclusive for all.

The Scottish Government aims to eliminate cervical cancer as soon as possible. Modelling using Scottish data, including cancer incidence, HPV vaccination rates, vaccine effectiveness estimates, and cervical screening coverage suggests that, with current levels Scotland could eliminate cervical cancer as a public health problem within the next 25 years (between 2046 and 2050). However, the projections indicate stark inequalities:

• women residing in the least deprived areas may meet this target as early as 2036-2040
• women residing in the most deprived areas, may never reach elimination without targeted interventions.

To achieve earlier elimination and reduce inequalities, higher HPV vaccine uptake and increased screening at all ages are needed, particularly in the most deprived groups.

Mathematical modelling also shows possible elimination of cervical cancer in Scotland by 2040. That would require reaching equitable vaccine uptake of 90%; equitable screening coverage of 90%; and equitable coverage of 90% for catch-up vaccination with an extended age range (15-39 – an extension which would need to be approved by the JCVI).

This is a challenging and ambitious target, and we are committed to pursuing innovation and investment while driving collaborative efforts across healthcare and beyond to achieve elimination at a population level by 2040.

Even so, we know that women in our most deprived communities face significant challenges and barriers. Modelling tells us that successful elimination in these areas will take longer, likely until around 2045. Addressing the needs of women in these communities now is vital, and self-sampling in the cervical screening programme will therefore begin in some of Scotland’s most deprived areas in Spring 2026, as part of the Scottish Government’s concerted efforts to tackle these inequalities.

Evidence shows that there have been no cases of cervical cancer caused by HPV types targeted by the vaccine in fully vaccinated women who were given their first dose at aged 12 or 13 years old since the HPV programme was first introduced in 2008.^[9] To achieve earlier elimination and reduce inequalities, higher HPV vaccine uptake and increased screening at all ages are needed, particularly in the most deprived groups. Taking by far the most optimistic scenario – achieving 90% vaccine uptake and screening coverage in the most deprived women and extending the age range for catch-up vaccination for women^[10] – overall elimination could be brought forward to 2036-40 at a population level but would still take until 2045 in the most deprived parts of Scotland.

The Expert Group’s recommendations will be used to develop an Action Plan for the Elimination of Cervical Cancer.

2.3 Women’s Brain Health

Aim

For women’s brain health to be better understood and supported.

Priority Programme Three

Women’s Brain Health will be an early priority for the work of the Brain Health and Dementia Risk Group, led by the Chief Medical Officer (CMO), which is setting national priorities in response to emerging evidence around risk factors for dementia.

It is estimated that up to 90,000 people in Scotland are living with dementia, around 65% of whom are women. Dementia is the leading cause of death for women in Scotland^[11]. Women are also more likely to assume the burden of caring for someone with a diagnosis of dementia, accounting for 60-70% of caregivers in Scotland. We also know that women are more likely to care for someone for more than five years than men. The Scottish Government is responding to this growing evidence around the impact of dementia on women.

Members of our Lived Experience Group highlighted the importance of brain health for women. Women who took part in focus groups with Age Scotland, particularly participants in their 50s and 60s, also raised brain health as an area which is important to them as they get older.

“The needs of older women, including brain health and dementia, need to be considered in the next phase of the Women’s Health Plan ... particularly relevant given Scotland’s ageing population” Lived Experience Development Day – ALLIANCE – August 2025

With the number of people living with this condition likely to increase by up to 50% by 2044, work is needed now to improve the experiences of women with dementia, to reduce the risk of dementia in later life and to consider how to support unpaid carers, caring for people with dementia.

It is estimated that dementia costs the Scottish economy around £4 billion every year (based on overall UK figures). Demands on Scotland’s health and social care systems, as well as the significant contribution of unpaid carers, are only set to increase as our population ages.

Through the CMO’s group on Brain Health, and with the support of the Women’s Health Champion, the Scottish Government will look in detail at the particular needs and experiences of women from prevention to end of life care, and including how to better support those who are unpaid carers for loved ones with dementia.

2.4 Innovation to Support Women and Girls

Aim

That innovation will have a pivotal role in ensuring women and girls have access to the best-quality care.

Priority Programme Four

We recognise the transformative impact of innovation and its pivotal role in ensuring women and girls have access to the best-quality care.

To support the testing, adopting and scaling of innovations to support women and girls we will explore the innovation opportunities, working with our three NHS Scotland Innovation Hubs and partners across Scotland, around three key priority areas:

• menopause care and support;
• gynaecological care and support; and
• data to enable effective design and development of innovation.

The transformative potential of innovation is undeniable. We recognise, and want to harness, the transformative impact of Innovation and its pivotal role in ensuring women and girls have access to the best-quality care.

“Within the next phase of the Women’s Health Plan, the [Lived Experience] Group wished to see a commitment to prioritising research into women’s health, and investing in innovation.” Lived Experience Development Day – ALLIANCE – March 2025

We will seek to work collaboratively with partners across the UK, academia, industry and the third sector to identify opportunities to transform the care women and girls receive.