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Menopause should be included in QOF to improve treatment, say MPs

by Beth Gault
17 October 2022

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Menopause should be added to the QOF framework in order to improve diagnosis and treatment, a group of MPs has recommended.

In a report published last week, the All Party Parliamentary Group on Menopause (APPG) said adding a menopause indicator to QOF ‘could significantly help resource and reward good practice’.

It also called for all women to be given a health check to screen for menopause symptoms at 45, and for GPs to be given more training on it.

This health check would be offered in a similar way to cervical cancer smear tests where women are invited to make an appointment, and could be ‘crucial’ to ensure women were engaged with the health system ahead of, or in the early stages of, perimenopause.

The APPG report added that the NHS could do more to prepare women ahead of menopause and provide information throughout their lives at cervical smears, mammograms and postnatal checks.

It comes after a year-long enquiry by the APPG, which heard witness statements from charities, campaigners, doctors and businesses.

The report said: ‘Despite the fact that 51% of the population will experience the menopause, the entrenched taboo around women’s health issues has meant that the support for the 13 million women currently going through peri-menopause or menopause is completely inadequate.

‘The APPG is particularly concerned about the socio-economic divide emerging between women who are able to access the right treatment, and those who lose out in the postcode lottery and do not have the financial means to seek treatment elsewhere.’

The report made 13 recommendations in total, which also included scrapping prescription costs for HRT in England and researching the link between menopause and serious health conditions.

Carolyn Harris, chair of the APPG on Menopause, said: ‘The consequences for those suffering with menopause symptoms who can’t get the right treatment can be severe – leading to the break down of personal relationships and jeopardising careers, with women being forced to take additional days off or leave work all together, putting their financial situations at risk.

‘Change is vital and we urge the new Minister and Government to give the menopause the attention it is due and take forward the recommendations in our report for the sake of women across the country.’

Earlier this year, the Government unveiled its Women’s Health strategy which said all doctors would be required to complete mandatory women’s health training from 2024.

The APPG recommended the Government:

  1. Must fund and commission more research into:
    1. The benefits of HRT in different use cases and its long-term health benefits
    2. The link between menopause and other health conditions
    3. The impact of menopause on women’s economic participation.
  2. All research must ensure accurate representation of all minority groups.
  3. Menopause considerations must be weaved into all health and workplace policymaking pertaining to women.
  4. Must co-ordinate and support an employer-led campaign to raise awareness of menopause in the workplace.
  5. Update and promote guidance for employers on best practice menopause at work policies and supporting interventions.
  6. Must urgently grant an exemption from the prescription cost for access to HRT for all in England, as is the case in Wales, Scotland and Northern Ireland.
  7. Create a National Formulary for all types of HRT to ensure that medical professionals can access the most accurate guidance on prescribing the treatment.
  8. Work with the MHRA to evaluate the evidence of testosterone in managing menopause symptoms.
  9. Work with the MHRA to amend and update their information for patients and healthcare professionals on HRT.
  10. Health Education England and the RCGP must consider how to equip existing healthcare professions to deliver the best menopause treatment possible through primary care, such as through Continued Professional Development courses for existing GPs who did not have the option to receive adequate training in the past.
  11. Include menopause as an indicator within the QOF to incentivise GPs to improve their menopause diagnosis, treatment and care within their practice.
  12. Must urgently review the need and demand for specialist menopause care, map existing provision, and evaluate where new specialist NHS services need to be commissioned to ensure this can be accessed by all that need more complex care.
  13. Must implement a health check for all women at the age of 45.

Source: APPG