Women’s health hubs are now at the centre of Wales’ approach to improving women’s health. The Welsh Government says there is a hub in every health board area, making them one of the most visible commitments in the NHS Wales Women’s Health Plan 2025-2035. They are intended to make care easier to access, more joined up and closer to home. They also reflect the Plan’s wider ambition to redesign services around women’s needs.
Hubs are being presented as part of the answer to long-standing problems in women’s healthcare. This includes fragmented services, delayed diagnosis, pressure on gynaecology pathways and women feeling that symptoms are not always heard or taken seriously. But the scale of those expectations raises a scrutiny question. Are women’s health hubs being asked to solve too many problems?
What are women’s health hubs supposed to achieve?
The term “women’s health hub” does not describe one standard service. In Wales, each hub is designed locally. Some are physical clinics, some operate across more than one site, and others provide online portals or signposting services. That flexibility may help health boards respond to local need, but it also makes it harder to compare services or define what a hub should consistently offer.
Despite this variation, the broad aims are similar. Hubs are expected to bring together support for issues such as menstrual health, contraception, menopause and some gynaecology pathways. In England, national guidance and evaluations describe hubs as a way to improve access, reduce unnecessary referrals, join up care and improve patient experience.
The appeal of hubs is easy to understand. They fit with several policy ideas that are now common across health systems: prevention, community care, earlier intervention and services organised around people rather than institutions.
What could limit the impact of women’s health hubs?
Evaluations from England, where hubs have been operating for longer, have identified several challenges.
The University of Birmingham/BRACE evaluation reviewed how women’s health hubs in England were being implemented. It found that fragmented commissioning could lead to disjointed services that did not always reflect local needs. It also identified workforce capacity as a major constraint and concluded that more consistent outcome measures were needed to assess impact.
Another study, published through the National Institute for Health and Care Research programme, found there was no single model of a women’s health hub. Many areas had only partial provision, and hubs differed widely in their services, staffing and delivery models. The study raised concerns about equity, consistency and whether hubs met national expectations.
The Royal College of Obstetricians and Gynaecologists raised a further concern. It noted that progress on the wider Women’s Health Strategy in England remained uneven, with delivery dependent on local capacity and national follow-through. It warned that wider women’s health issues could be overlooked if delivery focused too narrowly on selected service areas.
The lesson for Wales may not be simply whether hubs work, but under what conditions they work. The English cost-benefit analysis suggests hubs may offer value, but the benefits depend on implementation.
Wales also has relevant experience of community-based redesign. The Bevan Exemplar/Ceredigion community gynaecology model has been cited as a Welsh precursor to the hub approach. It shows how consultant-led community services and access to diagnostics can shift some care closer to home. The question is whether lessons from a local model can be applied consistently across all health boards, especially where workforce, estate and diagnostic capacity differ.
Counting hubs is straightforward. Showing that they have changed access, experience, outcomes or value for money is harder. The Welsh Government has said an evaluation of the pathfinder hubs has been commissioned, including feedback from women using services.
That is why the Welsh evaluation matters. It could help distinguish between three different questions: whether hubs exist, whether they are reaching the women who need them, and whether they are changing outcomes. Those questions are related, but they are not the same. A hub could be open and active without yet reducing waits, improving experience or narrowing inequalities.
Which priorities risk being overlooked?
Hubs in Wales are strongly associated with menstrual health, contraception, menopause and some gynaecology pathways. These are important priorities, especially given pressure on gynaecology services. But they are not the whole of women’s health policy.
The Women’s Health Plan is broader. It includes preconception health, pelvic health, violence against women, ageing well, long-term conditions, research, education and the wider need to listen to women’s experiences. Some of these priorities cannot be delivered through a hub model alone. They require action across primary care, specialist services, public health, social care and wider government policy.
If success is judged mainly by hub activity, broader questions may receive less attention. These include whether research gaps are closing, and whether services are improving for conditions that affect women across the life course, including osteoporosis, heart disease, dementia and other long-term conditions.
From implementation to accountability
The debate that led to the Women’s Health Plan focused on recognition: listening to women, acknowledging gaps in care and giving women’s health a clearer place in NHS planning. Wales now has a national plan and a dedicated women’s health website. Although the previous Welsh Government said hubs were open in every health board area, the website currently lists none for Betsi Cadwaladr or Hywel Dda University Health Board.
The next phase is about accountability; whether they can deliver the improvements expected of them. This includes easier access, more joined-up care, better experiences and clearer evidence of impact.
Women’s health hubs are both practical services and symbols of wider reform. They may help bring care closer to home and make services easier to navigate, but England’s experience shows that promise depends on funding, workforce, clear pathways, shared outcome measures and realistic expectations.
The new Welsh Government has continued to frame women’s health around listening to women. That creates a useful benchmark for scrutiny. If the Plan is to remain rooted in women’s experience, evaluation should not only count hubs, appointments or activity. It should also show whether women find care easier to navigate, whether they feel listened to, whether access improves for those facing barriers, and whether the wider Women’s Health Plan is progressing beyond the hub model.
Article by Sarah Hatherley, Senedd Research, Welsh Parliament