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Palliative and End of Life Care services and resources for patients and carers living in the Greater Glasgow and Clyde area can be accessed through NHS Inform.

NHS Inform – Scotland’s Service Directory

NHS Inform – Palliative Care – General Information

Telephone enquiries on community services including Palliative Care should be made through your local HSCP contacts or directed to NHSGGC Support and Information Service.

Out of Hours or Urgent Health enquires should be made through your GP or NHS 24

Leaving Hospital

Community Services following discharge from hospital for patients with life limiting conditions, their families and carers.

Hospices

Hospices in NHSGGC and surrounding area

News

Palliative Care National Strategy

Palliative Care Matters for All: palliative care strategy 2025 to 2030
“Supporting people with life-shortening conditions and their families. “

View the Palliative Care Strategy

NHSGGC Palliative Care Accelerated Design Event

In early 2025 NHSGGC began the next stage of its journey towards improving palliative and end of life care within NHS Greater Glasgow and Clyde Read the full news item on the Accelerated Design Event

Social Media

Our X account links palliative and end of life care news, resources & organisations across the Greater Glasgow and Clyde area, Scotland and the UK. www.twitter.com/palliativeggc

Additional Social Media on Palliative Care and Bereavement

Further information and related information

Planning Your Care

Macmillan Information And NHS Bereavement Centre

Adult Disability Payment

Adult Disability Payment, which replaces Personal Independence Payment (PIP), is launching nationally across Scotland on 29 August 2022.

This means Scotland’s new terminal illness definition, based on clinical judgement, will apply to adults (aged 16 to state pension age) who become terminally ill. This moves away from the current DWP time limited ‘6 month’ definition.

From 29 August 2022, BASRiS forms instead of DS1500 forms should be completed to support applications for disability assistance for the following groups:

  • Children: for all children living in Scotland age 0 to 16 years: complete a BASRiS form and return it to Social Security Scotland
  • Adults: age 16 to state pension age: complete a BASRiS form and return it to Social Security Scotland
  • Adults over state pension age: please continue to use a DS1500 and return to DWP. The date for when you will be able to use a BASRiS form for adults over state pension age is still to be announced.

Your Health Care Professional should be able to access the relevant resources to support applications.

More information for the public is available at Social Security Scotland

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Bereavement – NHSGGC Services and Resources

For additional bereavement information and the latest advice relating to Covid-19 please check updates on

NHSGGC Home Page


Macmillan Information and NHS Bereavement Centre

The Macmillan Information and NHS Bereavement Centre is a new service based at Glasgow Royal Infirmary.

Further Information and access this service

Coronavirus: dealing with bereavement and grief – Cruse Bereavement Care

Further Information

NHSGGC Bereavement Support for Parents, Siblings and Staff

Child Bereavement UK has been commissioned by NHS Greater Glasgow and Clyde with funding from Glasgow Children’s Hospital Charity to provide bereavement support for families bereaved of a baby or child, and training to support NHSGGC staff.

Child Bereavement UK is a national charity which supports families and educates professionals when a baby or child dies or is dying, or when a child is facing bereavement.

Contact NHSGGC Service
Telephone. 0141 370 4747
Email. GHsupport@childbereavementuk.org

Bereavement Support for Parents, Siblings and Staff – Leaflet

Renfrewshire Bereavement Network

New grief and bereavement service for families in Renfrewshire.

http://www.renfrewshire.gov.uk/renfbn

What Can Happen When Someone is Dying

This leaflet provides information to family and friends when someone is dying. It discusses food and fluids, medicines, breathing, communication and other changes.

View or download this booklet at NHS Greater Glasgow and Clyde Public Health Resources Directory

When Someone Has Died – information for you

The NHSGGC Booklet ‘When Someone Has Died, Information and Support for Relatives & Friends’ has been replaced by the new National Booklet ‘When someone has died – information for you’.

View or download this booklet at NHS Inform

NHSGGC Spiritual Care and the Chaplaincy Service

An NHS Healthcare Chaplain is always on-call and ward staff can arrange for them to be paged. 

Further Information and access this service

Other Local and National Services and Resources

Richmond’s Hope – service to help bereaved children in Glasgow 
http://www.richmondshope.org.uk/

LifeLink

Lifelink offers a range of stress services for adults and young people in communities and schools across Glasgow City.

Living Life

Living Life is a free telephone service available to anyone over the age of 16 who is suffering from low mood, mild to moderate depression and/or anxiety.

NHS Inform 

NHS Inform Bereavement area can help you find answers to your questions and guide you through the early days of your bereavement. It can also help you understand more of the experience of loss in the days that lie ahead.’

Good Life, Good Death, Good Grief

Good Life, Good Death, Good Grief is working to make Scotland a place where there is more openness about death, dying and bereavement so that:

  • People are aware of ways to live with death, dying and bereavement
  • People feel better equipped to support each other through the difficult times that can come with death, dying and bereavement

EQUIPU

EQUIPU is a service responsible for providing, delivering and installing a range of disability equipment supplied by health and social work services to disabled people living at home.

For further information or to arrange uplift contact:

Telephone. 0141 287 6300

Website: www.equipu.org.uk

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Arrangements for Death Certification may have changed due to Covid-19. Local Authority websites linked below should have the latest information from your area. The latest National information can also be found on the following websites.

National Records of Scotland latest information on registering a death during the COVID-19 pandemic
https://www.nrscotland.gov.uk/registration/registering-a-death

NHS Inform Medical certificate of cause of death
https://www.nhsinform.scot/care-support-and-rights/death-and-bereavement/practical-advice-after-a-death

Local Authority websites provide information about burial services, registering a death and other related advice.

Glasgow City Council – Registering a death
https://www.glasgow.gov.uk/article/16018/Registering-a-Death

Renfrewshire Council – Registering a death
http://www.renfrewshire.gov.uk/article/2233/Register-a-death

East Renfrewshire Council – Registering a death
https://www.eastrenfrewshire.gov.uk/register-death

Inverclyde Council – Registering a Death
http://www.inverclyde.gov.uk/environment/registrars/registrations/registering-a-death

West Dunbartonshire Council – Registering a Death
http://www.west-dunbarton.gov.uk/birth-marriage-death/bereavement/death-registration/

East Dunbartonshire Council – Registering a Death
https://www.eastdunbarton.gov.uk/residents/registration-services/registering-death

North Lanarkshire Council – Registering a Death
https://www.northlanarkshire.gov.uk/index.aspx?articleid=2093

South Lanarkshire Council – Bereavement Services
http://www.southlanarkshire.gov.uk/info/200209/deaths/394/registering_a_death

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The Macmillan Information and NHS Bereavement Centre is based at Glasgow Royal Infirmary.

The Centre is located on ground floor of the centre block of Glasgow Royal Infirmary.
You can drop in between 9.30am and 4.30pm Monday to Friday.
For more information call 0141 451 5373 or email macinfoandnhsbereavement@ggc.scot.nhs.uk

The service provides patients, families, carers and staff access to information materials on various types of cancer, long term conditions and their treatment. The team can provide a listening ear and signpost you onto other support services such as benefits advice, a dedicated one-to-one support worker through Macmillan’s Improving the Cancer Journey, or help to get active. Please visit us and see if we can offer you any assistance. We can also visit you on the ward.

We can provide:

  • time to listen and talk in a comfortable, friendly environment
  • leaflets and booklets on all aspects of living with and beyond cancer
  • access to additional cancer support
  • leaflets and booklets about living with long term conditions

We also offer:

  • help to arrange counselling and free complimentary therapy appointments if you are affected by cancer
  • support to access practical help, such as help at home and travel insurance
  • referral to other available support services.

We will be working in partnership with Palliative and Spiritual Care to offer people the right support at the right time.

The team can also provide emotional and practical advice around end of life care, including information about power of attorney, wills and funeral planning. We also offer support with complex bereavement issues, bereavement counselling and benefits advice to help cover the cost of the funeral.

We can offer information and signposting including:

  • what you need to do when someone dies
  • information about carers support for people looking after someone for example a partner, a patient, a relative with cancer or another long term condition
  • access to other organisations that can help, including local support groups
  • assisting with repatriation
  • discussing organ and tissue donation
  • face to face training for staff
  • end of life care

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Our Pelvic Floor Physiotherapy service in NHS Greater Glasgow & Clyde (NHSGGC) supports people experiencing bladder and bowel problems, urinary incontinence, pelvic organ prolapse, pelvic pain and post-surgical issues.

All appointments are conducted by HCPC-registered specialist pelvic health physiotherapists with advanced training in pelvic floor assessment and treatment. Our approach follows evidence-based guidelines to ensure safe and effective care.

At your appointment, a specialist pelvic health physiotherapist will:

  • Take a detailed history
  • Discuss your symptoms and concerns
  • If appropriate, carry out an examination

Some questions may feel personal. However, your physiotherapist will explain everything clearly at the start of your consultation. In addition, you can ask questions at any time.

This page explains:

  • What the pelvic floor muscles are and how to exercise them
  • The conditions treated by pelvic floor physiotherapy
  • How pelvic floor physiotherapy can help bladder, bowel and prolapse symptoms
  • How to access our pelvic floor physiotherapy service
  • Frequently asked questions
  • Where our pelvic health clinics are located across Glasgow and Clyde

What are your pelvic floor muscles?

The pelvic floor muscles are a hammock of muscles that lie beneath your pelvis. They support the bladder, bowel, and the uterus (in women). These muscles help keep the bladder and bowel openings closed to prevent unwanted leakage (incontinence) and they relax to allow normal bladder and bowel emptying.

How to exercise your pelvic floor muscles

To exercise the pelvic floor muscles, lie, sit or stand with your knees slightly apart. First, tighten your back passage as though you are trying to stop yourself from passing wind. Then, at the same time, tighten the muscles you would use to stop yourself from passing urine. As you do this, focus on the sensation of “squeeze and lift,” gently closing and drawing up both the back and front passages.

There are two ways to exercise your pelvic floor muscles. 

Short squeezes 

  • Quickly tighten up your pelvic floor muscles 
  • Hold for 1 second and relax 
  • Repeat this up to 10 times

Long squeezes 

  • Tighten your pelvic floor muscles for up to 10 seconds 
  • Relax fully for 4 seconds
  • Now tighten again for the same time 
  • Relax fully for 4 seconds
  • Repeat this up to 10 times

Conditions treated by pelvic floor physiotherapy

Bladder problems

Bladder dysfunction affects how urine is stored or passed. It can affect people of all ages and may significantly impact daily life.

Pelvic floor physiotherapy offers non-surgical treatment for many bladder problems. It can improve bladder control, reduce leakage, and restore confidence.

Common bladder issues include:

Stress urinary incontinence 

Stress urinary incontinence is when urine leaks during activities like coughing, sneezing, laughing, or exercising. It happens when the pelvic floor muscles are weak and cannot fully support the bladder. Although more common in women, it can also affect men.

Urinary urgency

Urinary urgency is a sudden, strong need to urinate that may be hard to control. It can be caused by overactive bladder muscles or nerve signals that trigger the bladder too often and may make you feel anxious about finding a bathroom in time.

Urinary urge incontinence

Urinary urge incontinence occurs when urine leaks due to a sudden, strong urge to empty the bladder. You may not reach the toilet in time. It is often caused by overactive bladder muscles that contract too frequently or without warning.

Overactive bladder

Overactive bladder is a condition that may include:

  • A strong, sudden need to urinate (urinary urgency)
  • Going to the bathroom more than 6 to 8 times during the day (frequency)
  • Waking up more than once at night to urinate (nocturia)
  • Sometimes leaking urine before reaching the toilet (urinary urge incontinence)
Common causes of bladder problems

Bladder problems can develop for many reasons. Understanding the cause helps your specialist pelvic health physiotherapist provide the right treatment. Common causes include:

  • Life stages: Pregnancy, childbirth, ageing, menopause
  • Weight and lifestyle: Obesity, high-impact exercise
  • Medical procedures: Pelvic or prostate surgery
  • Bladder and bowel issues: Overactive bladder muscles, constipation, urinary tract infections
  • Medications and diet: Water tablets, caffeine, alcohol, fizzy drinks, spicy or acidic foods
  • Bladder habits and fluid intake: High fluid intake, frequent “just in case” toilet visits, anxiety
  • Neurological conditions: Stroke, Multiple Sclerosis, Parkinson’s disease, spinal injury, diabetes
What can help
  • Pelvic floor exercises: Strengthening the muscles that support the bladder can improve bladder control and help reduce leakage. These exercises are a core part of pelvic floor physiotherapy
  • Bladder training: Structured bladder training helps increase the time between toilet visits and reduces urgency, frequency and improves overall bladder function
  • Lifestyle advice: Guidance on fluid intake, diet, and healthy toileting habits can support long-term bladder health and complement pelvic floor exercises
  • Electrical stimulation: A gentle electrical current may be used to activate weak pelvic floor muscles, particularly when they are difficult to contract voluntarily. This can help improve muscle strength over time
  • Biofeedback: Sensors provide visual or audio feedback on how your pelvic floor muscles are working. This helps you learn to contract and relax the muscles correctly, enhancing the effectiveness of your exercises
  • Squeezy app for women: This app guides you through pelvic floor exercises and tracks your progress. Using it regularly supports consistent practice and helps maintain long-term bladder control

Bowel problems

Good bowel function is important for overall health. When things aren’t working properly, it can quickly affect quality of life. Bowel problems affect around 10% of the population, and pelvic floor physiotherapy can help you manage these issues.

Common bowel issues include:

Constipation

Constipation occurs where there are changes to how you move your bowels. This may include not opening your bowels as often as normal and finding it hard to get your stool (poo) out. Often the stool is hard and lumpy and difficult to pass and most people will experience constipation at some point, but this is usually temporary. However, for some people constipation can become a long term issue.

What can help

  • Fluids: Aim for 1.5–2 litres of water-based fluids daily
  • Diet: Eating more fibre can help keep stools soft and easier to pass
  • Toilet positioning: Using the right posture can make bowel movements easier. Your specialist pelvic health physiotherapist can advise on this and watch this video for tips
  • Helpful guides: Resources like POGP good bowel health and POGP improving your bowel function provide additional support
Faecal incontinence

Faecal incontinence is the unwanted leakage of stool or wind from the back passage. This condition can be distressing and diarrhoea can make it worse. It can occur suddenly without any warning and may be linked to an urgent need to have a bowel movement which may lead to accidental leakage.

What can help

  • Pelvic floor muscle exercises: Strengthening the muscles around the back passage can improve control
  • Healthy diet: Eating enough fibre helps keep stools well-formed
  • Toilet positioning: Using the right posture can make bowel movements easier. Your specialist pelvic health physiotherapist can advise on this and watch this video for tips
  • Medication: Some people may benefit from medication. Speak to your healthcare professional
  • ‘Just can’t wait’ card: Gives quicker access to public toilets. Applications are available online here
  • RADAR key: Provides access to locked accessible toilets across the UK for people with mobility or continence needs. You can order one online via Disability Rights UK
Obstructive defecation

Obstructive defecation is a term used to describe having difficulty opening your bowels. It is often associated with frequent toilet visits and a feeling of being unable to fully empty the bowel. This can result in excessive straining, which can increase the risk of vaginal or rectal prolapse. 

In a normal bowel movement, the muscles around the back passage relax to allow stool to pass. In obstructive defecation, these muscles may not relax fully or may even tighten, making bowel movements difficult.

What can help

  • Fluids: Aim for 1.5–2 litres of water-based fluids daily
  • Healthy diet: Eating enough fibre helps keep stools well-formed
  • Stay active: Aim for 30 minutes of physical activity daily to support bowel movement
  • Belly breathing: A relaxation technique that helps release the pelvic floor. Your specialist pelvic health physiotherapist can teach you how to do it correctly
Faecal urgency

Faecal urgency is a sudden, strong urge to empty your bowels. You may reach the toilet in time, but it can also lead to accidental leakage.

What can help

  • Healthy diet: Eating enough fibre helps keep stools well-formed
  • Holding on programme: This programme trains your bowel to delay the urge to go. A specialist pelvic health physiotherapist can guide you through it
  • Pelvic floor muscle exercises: Strengthening the muscles around the back passage improves control and confidence, helping you reach the toilet on time
  • ‘Just can’t wait’ card: Gives quicker access to public toilets. Applications are available online here
  • RADAR key: Provides access to locked accessible toilets across the UK for people with mobility or continence needs. You can order one online via Disability Rights UK

Pelvic organ prolapse

Pelvic organ prolapse (POP) occurs when one or more of the vaginal walls, or the uterus, move downwards, causing a bulge or a feeling of heaviness in the vagina. This can lead to pressure or discomfort, and sometimes you may notice a bulge inside or at the vaginal opening. Prolapse can also affect bladder or bowel function, as well as sexual function.

What can help
  • Pelvic floor exercises: Strengthening the muscles can help support the pelvic organs and reduce prolapse symptoms. These exercises are a core part of pelvic floor physiotherapy
  • Lifestyle changes: Maintaining a healthy weight, avoiding heavy lifting, and practicing safe toileting habits can support pelvic health
  • Supportive devices: In some cases, a vaginal pessary may be recommended by a healthcare professional to provide additional support
  • Helpful guides: Resources like POGP pelvic organ prolapse – a guide for women. This guide provides information and practical advice on managing prolapse

Pelvic pain

Pelvic pain can have many different causes. It is important to have the underlying cause assessed by your GP, advanced nurse practitioner, sexual health clinic or consultant. Depending on the diagnosis, pelvic floor physiotherapy may help to manage and reduce your symptoms.

Common types of pelvic pain issues include:

Bladder pain syndrome

This condition causes pelvic pain and difficulty urinating. As there is no single test to confirm it, diagnosis can take time.

Vaginismus

Repeated difficulty allowing vaginal entry of a penis, finger, or other object. It may lead to involuntary tightening of the pelvic floor muscles, along with fear or pain.

Dyspareunia

Dyspareunia is painful sex. This can be pain or discomfort at the opening to the vagina or felt deeper into the pelvis.

Vulvodynia

Vulvodynia is ongoing pain, burning, or discomfort in the vulva (the external female genital area) that lasts for 3 months or more and does not have a clear cause, such as an infection or skin condition. It can affect daily activities, including sitting, exercise, and sexual activity, but support and treatment are available.

Tight or overactive pelvic floor muscles

Pelvic floor muscles may be tense or overactive. This can contribute to pelvic pain.

What can help

Gynaecology surgery

After your gynaecology surgery, you will be seen by a specialist pelvic health physiotherapist on the ward. They will advise you on:

  • How to stay comfortable during your hospital stay.
  • How to get up and move safely after surgery.
  • Ways to support your recovery and gradually return to your usual activities.

If you need ongoing physiotherapy after your surgery, your consultant or GP can refer you to the NHSGGC pelvic health team.

What can help

Prostate surgery

After your prostate cancer diagnosis and the decision to have Robotic Assisted Removal of Prostate (RARP) surgery, your consultant or clinical nurse specialist will inform the NHSGGC pelvic health team.

You will be invited to attend a pre-surgery appointment at one of the NHSGGC hospitals. This may be offered individually or as part of a group session. The appointment aims to provide information on:

  • How to stay comfortable during your hospital stay.
  • How to get up and move safely after surgery.
  • Education on pelvic floor muscle exercises to help manage any urinary incontinence after surgery.
  • Ways to support your recovery and gradually return to your usual activities.

Post-surgery follow-up

A follow-up appointment will be arranged from six weeks after surgery to monitor your progress. Any additional appointments will depend on your recovery and symptoms.

What can help

How to access our pelvic floor physiotherapy service

A referral letter is required from:

  • Your GP
  • A hospital consultant

FAQs

What is pelvic floor physiotherapy?

Pelvic floor physiotherapy is a specialist NHS service. It helps people with problems affecting the pelvic floor muscles.
These muscles support the bladder, bowel and womb. They help with bladder and bowel control, pelvic organ support and sexual function.

Treatment aims to:

  • Reduce symptoms
  • Improve daily function
  • Help you manage your condition long term
What problems can pelvic floor physiotherapy help with?

Pelvic floor physiotherapy can help people with:

  • Leaking urine
  • Feeling a sudden, urgent need to use the toilet
  • Difficulty controlling your bowels
  • Difficulty emptying your bowels (constipation)
  • A feeling of heaviness, bulging or pressure in the vagina or pelvic area
  • Pain in the pelvis, vagina or between the legs
  • Pain during sexual activity
  • Ongoing problems after pelvic or gynaecological surgery
How do I access pelvic floor physiotherapy?

You usually need a referral. This can be made by:

  • Your GP
  • A hospital consultant
  • Another healthcare professional
Is pelvic floor physiotherapy available on the NHS?

Yes. Pelvic health physiotherapy is an NHS service. Appointments are offered to people who meet the referral criteria.

What happens at my appointment?

Your physiotherapist will:

  • Ask about your symptoms.
  • Ask how your condition affects daily life.
  • Review any relevant medical history.

Your physiotherapist will explain everything clearly. You can ask questions at any time.

Will I need an internal examination?

An internal vaginal or rectal examination may be offered, but it is not required.

  • It only happens with your full consent
  • You can say no
  • You can ask to stop at any time

Your comfort, dignity and privacy will always be respected.

Is pelvic floor physiotherapy painful?

Treatment should not be painful. Some assessments or exercises may feel unfamiliar. Your physiotherapist will work at a pace that feels comfortable for you.

Will I be given exercises?

Many people are given personalised exercises or advice. This may include:

  • Pelvic floor exercises
  • Breathing exercises
  • Bladder or bowel management advice
  • Movement or posture guidance

Your physiotherapist will explain what to do and why it may help.

How many appointments will I need?

This depends on your symptoms and progress. Your physiotherapist will discuss a plan with you and review it regularly.

What should I wear to my appointment?

Wear comfortable clothing that allows you to move easily. You do not usually need a full bladder.

Is pelvic floor physiotherapy confidential?

Yes. All appointments are confidential. Your information is handled in line with NHS confidentiality policies.

I feel embarrassed talking about pelvic floor problems

Many people feel like this. Pelvic floor problems are very common. Physiotherapists are trained to talk about sensitive issues in a respectful and supportive way.

Pelvic floor physiotherapy clinic locations and contact details

Inverclyde Royal Hospital – Pelvic Floor Physiotherapy

Physiotherapy Department
Level C
Inverclyde Royal Hospital 
Larkfield Road
Greenock PA16 0XN

Call: 01475 504 373

New Stobhill Hospital – Pelvic Floor Physiotherapy

Physiotherapy Department
Ground Floor
The New Stobhill Hospital
Balornock Road
Glasgow G21 3UW

Call: 0141 355 1642

New Victoria Hospital – Pelvic Floor Physiotherapy

Physiotherapy Department
Ground Floor
New Victoria Hospital
Grange Road
Glasgow G42 9LF

Call: 0141 347 8685

Princess Royal Maternity Hospital – Pelvic Floor Physiotherapy

Physiotherapy Department
Level 2
Princess Royal Maternity Hospital 
16 Alexandra Parade
Glasgow G31 2ER

Call: 0141 201 3432

At present we can only accept referrals from up to 6 months post-natal patients who have had their deliveries at this hospital.

Queen Elizabeth University Maternity Hospital – Pelvic Floor Physiotherapy

Physiotherapy Department
Room 3, 1st Floor Admin Corridor
Maternity Unit
1345 Govan Road
Glasgow G51 4TF

Call: 0141 201 2324

Royal Alexandra Hospital – Pelvic Floor Physiotherapy

Physiotherapy Department
Ground Floor
Maternity Unit
Royal Alexandra Hospital
Corsebar Road
Paisley PA2 9PN

Call: 0141 314 6765

Vale of Leven Hospital – Pelvic Floor Physiotherapy

Physiotherapy Department
Vale of Leven Hospital
Main Street 
Alexandria G83 0UA

Call: 01389 817 531

Further Information

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The Obstetrics, Gynaecology and Pelvic Floor Physiotherapy service is based in hospitals and health-centres across Greater Glasgow and Clyde.

About Us

We’re a team of highly specialised, dedicated staff who provide a comprehensive physiotherapy service for:

  • People during and after pregnancy.
  • People with pelvic floor dysfunction.

Access further information on…

NHS Greater Glasgow and Clyde’s Did Not Attend and Cancellation Policy

If you fail to answer a telephone or video appointment or fail to attend any face-to-face appointment and don’t contact us within 24 hours, we will discharge you.

If you cancel an appointment on more than 2 occasions, we will discharge you.

To cancel or change your appointment please contact your Obstetrics, Gynaecology and Pelvic Floor Physiotherapy Department with as much notice as possible.

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What is Sex

In the Equality Act 2010 ‘sex’ means a woman or a man or a group of women or men. Sometimes it is hard to understand exactly what is meant by the term ‘sex’ , and how it differs from the closely related term ‘gender’.

Our sex is determined by the sexual organs we are born with – men are born with a penis, women a vagina.

Gender relates to the types of behaviours society expects of men and women. We learn these behaviours as we grow through a range of images and messages given to us by parents, schools, friends and the media. For example, young girls might be given dolls to play with and princess outfits to play in, while boys may be given guns and soldier uniforms.

Society has a set of gender expectations of women and men that differ for each sex. Currently, masculine characteristics are more highly valued than feminine characteristics and world-wide, this ascribes more power and wealth to men than to women. This in turn reinforces sets of behaviour, which have significant implications for the pathways into poor health.

In terms of gender, some people describe themselves as gender fluid or non- binary The difference between gender fluidity and non-binary people is the fact that gender fluidity is one aspect of the non-binary spectrum. A range of people on the gender identity spectrum do not see themselves as male or female. They could be agendered, trans or simply identify as non-binary

Sex and Discrimination

Sex discrimination exists when a person (man or woman) or group of people (men or women) are treated unfairly solely on the basis of their sex. An understanding of gender is important to understanding inequality between women and men. Discrimination on the basis of gender is both subtle and persistent.

Women are expected to be ‘natural carers’ which has led to a huge imbalance in the types of jobs women do, how much they earn, how much housework/ caring they do and disapproval of society if they do not conform to this stereotype.

Men are expected to be ‘strong’ and unemotional, and they can often experience barriers when seeking jobs that require a degree of caring or empathy. Their masculinity can single them out for additional duties that rely on physical capacity rather than capacity to care.

There is a very serious side to this imposed difference. It means that women consistently earn less than men throughout their lives and often live in poverty when they are older. This lack of economic power has also meant that women have less power in society and less access to positions of power in politics.

In most cases we grow up feeling a sense of comfort or acceptance with our gender (as prescribed by biological sex at birth). However, a small number of us (around 1 in 11,500) find as we grow our prescribed gender is so different from our internal sense of where we exist in relation to being a boy/girl, man/women that we express a wish to live in the opposite, more appropriate gender. In Scotland, those of us experiencing this are referred to as ‘transgender people’ also covered by the Equality Act 2010.

Some people describe themselves as non-binary – not seeing themselves as male or female. In recognition that non-binary people experience extreme levels of discrimination in Scotland, the Scottish Government set up a working grouo in 2021

What is sex discrimination? – a short film by the Equality & Human Rights Commission

Sex and Other Protected Characteristics

Sex differences cut across all the other protected characteristics such as age, race and social class.

For example:

  • Male life expectancy is six years lower than for females across NHSGGC
  • In NHSGGC, there is a nine-year gap in male life expectancy between East Dunbartonshire (77.7 years) and North Glasgow (68.6 years)
  • Asian women aged between 15-35 are two to three times more vulnerable to suicide and self harm than their non-Asian counterparts
  • Retired women and lone parents are most at risk of poverty and average incomes of women in work are lower

Other inequality issues can prevent people from receiving health services and treatment appropriate to their sex. For example, some disabled women have been told that they do not need cervical smear tests because of assumptions about their sexual behaviour.

Why sex matters to health

NHS evidence has shown that treating women and men the same, without considering the differences between them, means that underlying sex-related links to health problems are ignored and patients’ health needs are not met. 

The National Advisory Council on Women and Girls recognises that gender discrimination affects women and their health and actions are outlined in government policy. The health and societal differences for women and men are shown in the examples below-

  • Women are more likely to live in poverty, be lone parents, experience abuse and  have less access to citizenship opportunities than men, due to historical gender stereotyping in society. This affect health differently during the life course.
  • One in four women are likely to experience domestic abuse over their life course and that prevalence rates for child sexual abuse are estimated at around 21% of girls and 7% of boys.
  • Men are more likely to participate in risk-taking behaviour which leads to premature mortality and to use their power to commit acts of violence and abuse which affect themselves and women and children of both sexes.
  • Men are also less likely than women to participate in health improvement activity or to present to primary care in the early stages of illness.
  • Where men have experienced abuse in childhood, this experience can manifest itself in a range of health and social problems in both childhood and adulthood but is often not identified as part of medical presentations.
  • Women still tend to have multiple social roles as employees, as carers and as the primary managers of households. This imposes stresses that can have physical and psychological impacts on their health.
  • Some diseases have been seen solely as ‘women’s’ or ‘men’s’ diseases due to gendered biases in medical research, leading to delays in diagnosis and treatment (e.g. heart disease – leading cause of mortality in UK women but still seen as a ‘male disease’)

Other examples of where gender expectations affect health are:

  • In NHSGGC, like the whole of Scotland, women are between two and two and a half times more likely to report experiencing depression and anxiety than men.
  • Suicide rates are almost three times higher in men than in women.
  • Men are more likely than women to die of injuries outside the home.
  • The gap between women’s and men’s smoking rates is changing, with more young girls taking up the habit than boys.
  • Young men aged 16-24 are most at risk of becoming a victim of violent crime
How we are addressing sex issues

‘A Fairer NHSGGC 2025-29 – Meeting the requirements of Equality Legislation’ sets out what the organisation is doing to ensure it meets its responsibilities to promote gender equality and remove sex discrimination across all its services and functions. Most actions in this document involve addressing issues around sex. In addition, actions on closing the health gap between affluent and deprived communities in NHSGGC take into account the different needs of women and men.

Some examples of actions include:

  • Equality Impact Assessments undertaken throughout NHSGGC has a strong gender element
  • An NHSGGC Gender-based Violence Action Plan has been in place for a number of years
  • Sex issues are key within Human Resources workforce equality actions (e.g. Equal Pay Audit, Audit of family friendly policies)
People’s Experiences

John’s Story

John is a survivor of childhood sexual abuse. Now in his 40s, he has struggled to cope throughout adulthood with the experience and knowledge of being abused and has felt that many areas of his life have been negatively affected.

“I’d lost family, friends and jobs – that one major incident was affecting my whole life. I knew I needed help to stop the slide, so I spoke to my GP.

“I was referred to nine different counsellors. None of them specialised in childhood sexual abuse issues. After listening to me talking about my abuse experience, they would pass me on to another counsellor.”

The whole experience left John extremely depressed and contributed to a major breakdown.

John finally contacted Thrive, a counselling service for adult male survivors of childhood sexual abuse which is part of the Sandyford Initiative – NHSGGC’s sexual, reproductive and emotional health service.

“The initial telephone contact was really helpful – the person I spoke to was very supportive and put me at my ease. At my appointment, they explained how the counselling service would be run. They told me that counselling could take a long time and I appreciated that, I didn’t want to be kidded on.

“Hearing those words (‘we can help you’) made such a difference.   When I left I cried all the way to the Underground, I was just so full of relief and happiness.”

Dr Rosie Ilett, Head of Planning and Partnerships at Sandyford, developed the original funding application for Thrive and appreciates the importance of gender sensitivity in services. “Thrive has been developed because we know that many men have real difficulties seeking professional help about sensitive issues – it’s just not considered ‘manly’.   Experience of abuse can test men to breaking point.   Understanding what makes men tick and the barriers that living up to a stereotype of masculinity can impose on them helps our counsellors work effectively with the most challenging cases and start the healing process”.

Thrive is based at the Sandyford Initiative in Glasgow. Men can access the service by calling the direct line on 0141 211 8133 or visit the Sandyford Initiative website at: www.sandyford.scot

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What is Race & Ethnicity?

Ethnicity refers to a common group identity based on language, culture, religion or other social characteristics. This means that people define their own ethnicity, that everyone (and not just those in minorities) has ethnicity and that a person’s ethnic identity may change over time. For example some people might describe themselves as Scottish Chinese.

Race is the group you belong to, or are perceived to belong to, in the light of a limited range of physical factors. The term ‘race’ should be used in relation to legislation only and not to describe people who belong to an ethnic group.

The term BME is often used within the public sector. It’s an abbreviated term for Black and Minority Ethnic and is often used to describe people from minority ethnic groups, particular those who have suffered racism or are in the minority because of their skin colour and/or ethnicity.

Race and Ethnicity and Discrimination

Racism refers to the combined use of power with racial prejudice (the belief that some races are inferior to others) which leads to the oppression or discrimination of specific racial or ethnic groups.

Racism can be detected through attitudes, processes, behaviours and actions which impact on any ethnic group/s and can lead to differences in education and employment opportunities, living conditions and health. We all have an ethnicity.

The Equality Act is designed to ensure that large public organisations like NHSGGC promote race equality and challenge discrimination on the grounds of race, colour, nationality (including citizenship), ethnic or national origins. We are required to;

  1. eliminate unlawful racial discrimination;
  2. promote equality of opportunity; and
  3. promote good relations between people of different racial groups.

Following is a short film by the Equality & Human Rights Commission titled ‘What is race discrimination?’.

Race and Ethnicity and Other Protected Characteristics

Racism can be intensified by other forms of discrimination, for example on the basis of sex, disability, age and social class.

  1. Maternal mortality for Black women is currently almost four times higher than for white women. Significant disparities also exist for women of Asian and mixed ethnicity.
  2. Women from the South Asian community are less likely to attend breast cancer screening.
  3. Reports have shown that a disproportionate number of people from minority ethnic groups in Scotland experience poverty after housing costs, with figures often exceeding one-third, compared to the ‘White – British’ group
Why Race and Ethnicity matters to Health

Race and ethnicity affect people’s health in a number of ways. Our ethnic background can affect our susceptibility to certain diseases and conditions. There is also a clear link between discrimination and health and implications for the way in which health services should be provided.

For example:

  1. Black and Minority Ethnic Scots are significantly more likely to live in poverty compared to white British people in Scotland, with rates differing substantially. Research consistently shows higher rates of poverty for BME groups, with figures around 34-39% for Asian and Mixed/Black/Black British individuals compared to 18% for White British people. This is linked to socio-economic disadvantage and creates barriers to health and social care
  2. One third of black and minority ethnic people in Scotland report experiencing racial discrimination. Racially motivated hate crimes are the most reported type of hate crime.
  3. Gypsy/Travellers are more likely to report long-term health conditions than the general population. They are also twice as likely to report three or more categories of health conditions. 

How we are addressing Race and Ethnicity issues

How we are addressing race issues

NHS Greater Glasgow and Clyde is committed to becoming a leading anti-racism organisation.

The delivery of an Anti-Racism Plan is a key outcome in the ‘Fairer NHSGGC 2025-29’ report – which explains how the organisation is meeting the requirements of equality legislation. It brings together our existing anti-racism work and our planned new activities in a single document.

Our current areas of work include:

Access to Services

National evidence shows the BME community experience additional barriers in accessing health and social care services.

We have been working intensively with two services – diabetes and pain management/physiotherapy – to improve access for BME patients. The learning from this has helped develop a Equality Sensitive Patient Pathway for NHSGGC as a whole.

Following consultation with staff and patients current actions include –

Review all patient information for readability and accessibility
Develop information routes for those with lower health literacy around pain
Explore how the opt-in service accommodates the needs of those from BME communities specifically
Develop a route for non-English speakers to ask for advice outwith appointment times via direct patient access to telephone interpreting
Understand how therapeutic group work can work best whilst utilising spoken language interpreters.

Perinatal Care

National evidence indicates marginalised groups, in particular, BME pregnant women; women living in poverty and those experiencing gender based violence, fair worse in accessing and using maternity services.

A local baseline research was conducted with patients, maternity and third sector staff to assess current issues for marginalised groups using NHSGGC maternity services. A review of best practice interventions was also carried out. The focus of the work has been to look at the patient journey through maternity and identify any barriers for BME women.

Actions identified so far to address these issues include –

Develop a leaflet in multiple languages to describe each stage of the maternity pathway, how to access support and highlight emergency routes
Explore how to maximise the value of ante natal classes for non-English speakers
Develop training for Maternity Staff on meeting the needs of BME women throughout our pathway
Develop a route for non-English speakers to ask for advice outwith appointment times through direct patient access to telephone interpreting.

Interpreting service

Interpreting services address a number of risks for both service users and staff. For example, patients who have a limited understanding of English:

  • may not be able to give informed consent
  • may not be able to ask questions or seek assistance
  • may not be aware of what services are available to them
  • may not be able to use medication properly or follow care plans
  • may come from cultures with different understandings of health and illness
  • may not understand how to use NHS services
  • may not understand their rights and responsibilities within the healthcare system

Ensuring that everyone has an equal opportunity to engage in the health care process benefits all concerned.In addition, equalities legislation stipulates that the organisation must be pro-active in ensuring that this is the case.

NHSGGC’s in-house interpreting service provides interpreters to NHS patients on request. The service is available to a wide range of service areas and departments, including hospital wards, outpatient clinics, medical practices, dental surgeries,pharmacies and opticians located throughout the NHSGGC area.

‘Clear to All’ Accessible Information Policy

Effective information and communication are vital for the provision of high-quality services and care. Many of those who access services have difficulty understanding the information provided. An Accessible Information Policy has been produced to ensure that all information can be made available in various languages and formats to meet the needs of our diverse community.

A toolkit for staff has been developed which helps to provide information and support in the development of accessible information for NHS patients, their carers and the public. The toolkit aims to ensure that the material we develop is clear, consistent with NHSGGC guidance, accurate and in everyday language.

Details are available on the ‘Clear to All’ Accessible Information Policy web page.

Stand Against Racism Campaign

Our workplace should be a place where discrimination is unacceptable and where everyone has the chance to thrive, regardless of their background or identity.

Our anti-racism campaign is based on the words of our own staff from their experiences at work. NHSGGC is an inclusive employer and there is no place for racism in our services.

People’s Experiences

Briony’s Story

Briony is part of the travelling people’s community and has lived in Scotland all her life.

Briony and her family have lived on the caravan site for 8 of the last 10 years. They were there for three years, moved into a flat for two years, and then have been back at the site for the last five years. When they moved into the flat it was mostly due to her health problems, but they also felt like maybe they would want a change and settle in for a little while. But after a couple of years, they wanted to move back to the caravan site because that is who they are and it was where they wanted to be.

She tells about how it was for her and her family to register with the local surgery when they first moved to the caravan site. There was not just one doctor’s surgery for everyone on the site, so all of the people living there were allocated to different surgeries. Briony herself went around to all of the local surgeries to see if she could register with one, but none would take them on. “They kept telling me ‘you aren’t from this area, so we can’t take you. She had to wait to get a letter from NHS telling her which surgery they had been allocated to and where to go before she could register.

When they moved into the flat, they didn’t have any problem registering with a surgery, and everyone was really nice to her. When asked why she thought there were no problems with getting registered and why they were nice, she says, “Oh, I couldn’t speak for them. But it could because I was in a flat at the time and not from the caravan site. This surgery was one of the ones I went around to when we were first at the caravan site and they said they wouldn’t take us on. But when we were in the flat, they would.

“I‘m still with that surgery now, even though we’ve moved back to the site. And they are still nice”.

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The Equality Act says you must not be discriminated against in employment because you are married or in a civil partnership.

In the Equality Act marriage and civil partnership means someone who is legally married or in a civil partnership. Marriage can either be between a man and a woman, or between partners of the same sex. Civil partnership is between partners of the same sex.

Following is a short film by the Equality & Human Rights Commission titled ‘What is marriage & civil partnerships discrimination?’.

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Further Education & Partnerships

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