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Add menopause to QOF, says Parliamentary group

by Julie Griffiths
23 October 2023

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MPs have recommended that discussion of menopause should be introduced into the NHS free health checks offered to women over 40.

The All Party Parliamentary Group (APPG) on Menopause has also reiterated last year’s suggestion that menopause be added as an indicator within QOF to incentivise GPs to improve GP diagnosis, treatment and care.

In its manifesto for menopause, the APPG said there is a ‘deficit of knowledge and understanding amongst GPs’ when it comes to recognising and diagnosing menopause symptoms, adding that ‘incentives within primary care would encourage better understanding and help to alleviate the problem ensuring more timely access to treatment’.

But RCGP chair Professor Kamila Hawthorne urged caution about menopause checks saying it was ‘hard to see how GPs and their teams could take on this additional work, given the workload and workforce pressures we are currently buckling under’.

And she said that introducing such a measure for all women ‘could be overriding patient choice and “over-medicalising” a stage of life that some women will opt to manage with lifestyle changes and without the need for medication’.

The APPG also called for a national formulary for all types of HRT to ensure doctors and pharmacists ‘can prescribe any approved medicines’ supported by local prescribing guidance.

This would also help to tackle ongoing shortages of HRT products as well as address inequity and regional variation in the types of HRT patients are able to access, the manifesto said.

And there should be an evaluation of female-specific testosterone treatments for managing menopause symptoms, with the Medicines and Healthcare products Regulatory Agency (MHRA) seeking to license such products.

The manifesto explained that GPs are ‘often reluctant to prescribe off-license’ and so in the absence of a specific product for women, ‘there must be comprehensive guidance around safe dosages and the benefits of prescribing testosterone.’

The latest call from the APPG is for all political parties to commit to their manifesto before the next general election.

The Government’s Women’s Health Strategy, published last year, failed to address the complex and varied challenges that women face when going through menopause, the APPG said.

However, the APPG acknowledged that additional funding and support for GPs was needed, which Prof Hawthorne welcomed.

‘General practice is running on empty, and we desperately need a bold plan of support that will enable GPs to give all their patients the care they need and deserve,’ she said. 

Prof Hawthorne added that the RCGP has had an active role in ‘reforming the treatment and perception of the menopause, having worked with partners including the British Menopause Society and Royal College of Obstetricians and Gynaecologists to develop educational resources for GPs on women’s health’.

These include resources about menopause as part of toolkits on women’s health and menstrual wellbeing, e-learning resources and events, and the RCGP’s  Women’s Health Online Library

‘We will continue to develop these to support GPs and other healthcare professionals in delivering the best possible care for women, based on the latest evidence,’ Prof Hawthorne said.