At long last, a National Endometriosis Framework is being developed in Ireland

Coinciding with the launch of the second annual Women’s Health Week here in Ireland, the Minister for Health Stephen Donnelly has announced the development of the National Endometriosis Framework, which sets out — for the first time — a defined clinical care pathway for women with endometriosis.

Since the Women’s Health Action Plan strategy was launched last year, we’ve seen the introduction of a free contraception scheme for women aged 17-26, the establishment of Regional Fertility Hubs, investment in the National Maternity Strategy, investment in two supra-regional endometriosis specialist centres for complex care, and five interdisciplinary teams to support the holistic treatment of endometriosis in each of the maternity networks, as well as Specialist Menopause Clinics.

Developed by the HSE’s National Women and Infants Health Programme (NWIHP), the National Endometriosis Framework will be implemented on a phased basis, commencing this year, and is built around the principle of “right care, right place, right time”. The framework’s Model of Care proposes that women with symptoms of endometriosis be treated on the basis of presumed diagnosis, which marks a significant step away from the approach taken in the past.

This development in the approach to endometriosis care ensures women will receive timely, effective treatment at the appropriate level of intervention, meaning that the vast majority of cases can be managed successfully at primary care level with the assistance of GPs, though some patients will require additional multi-disciplinary support at secondary care level. This is being facilitated with the setting up of five interdisciplinary teams to support the holistic treatment of endometriosis in each of the maternity networks.

A small number of women with more complex cases will require expert treatment in two supra-regional endometriosis specialist centres which are currently in development.

Speaking on this step to address an area of women’s health that has historically been under-recognised, Minister Donnelly said: “Since 2019, the Women’s Health Taskforce has heard testimony from women with endometriosis, who have described their experiences of the disease as ‘painful, isolating, misdiagnosed, lonely and dismissed.’ This Framework, along with investment in holistic treatment teams and in two supra-regional hubs for complex cases are important steps towards improving their experiences and outcomes.”

Clinical Director for the National Women and Infants Health Programme Dr Cliona Murphy said: “Together with the establishment of other specialist women’s health services such as ‘see and treat’ Ambulatory Gynaecology Services, Specialist Menopause Clinics and Regional Fertility Hubs, we are delivering tangible improvements in women’s healthcare.”