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Government looking to include menopause in QOF and NHS health checks

Government looking to include menopause in QOF and NHS health checks

GPs could be mandated to screen women for menopause within the NHS health check as well as via QOF, a Government minister has revealed.

In a parliamentary debate last week, health minister Maria Caulfield said it is ‘crucial’ that menopause is incorporated into the health check. 

The Department of Health and Social Care has asked the NHS health check advisory group to ‘review the case’ for including the menopause, she said.

And she added that the upcoming QOF consultation will engage GPs on whether the menopause should be included within the quality framework.

Last month, the All Party Parliamentary Group (APPG) on Menopause urged the Government to make both of these changes as part of their ‘manifesto’.

In the debate last week, members of the APPG reiterated their points, with Labour MP Peter Dowd saying the fact menopause is not part of the health check is ‘at best a surprise and at worst shocking’.

He also said the QOF update would ‘help to balance the deficit in knowledge and understanding among GPs by incentivising improvement in diagnosis levels and treatment provision within primary care’.

In response, Ms Caulfield said: ‘First, on health checks, I have asked the NHS health check advisory group to review the case for including the menopause in the NHS health check alongside its broader future considerations on the health check, following the delivery of the digital check next spring. 

‘I will keep the House updated on that work, particularly the hon. Member for Swansea East, as co-chair of the menopause taskforce, because it is crucial that it is included.’ 

Adults aged between 40 to 74 are invited to an NHS Health Check at their GP practice every five years. GPs currently look out for early signs of stroke, kidney disease, heart disease, type 2 diabetes or dementia.

When pressed on the Government’s plans to ‘boost training and development’ for GPs, Ms Caulfield said they are ‘looking this year to consult on the future of the quality and outcomes framework, which is one of the measures used to look at health conditions, to see whether the menopause should be included’.

‘We fully recognise the importance of ensuring that GPs ask the right questions so that women get the right support. We intend to have those conversations with GPs about the QOF framework,’ she added. 

While no commitments were made on mandatory training specifically for practising GPs, the minister did confirm that from next year all medical students will have to complete a module that includes menopause.

The aim is to ensure that future GPs ‘have better awareness of the signs and symptoms and management of the menopause, so that when women approach for help, they will be better supported’.

Professor Azeem Majeed, professor of primary care and public health at Imperial College London, told Pulse that politicians are ‘often in favour of interventions for single conditions’, but that he does not agree with the minister’s proposals.

He said: ‘The Health Check should stay focused on its core objectives, which are the prevention and early detection of cardiovascular disease and type 2 diabetes. Likewise, QOF should stay focused on its core areas such as secondary prevention.’

Professor Majeed also said that instead of focussing on single conditions like the menopause, NHS primary care should be viewed ‘holistically’ and should be ‘adequately staffed and resourced to manage all the important medical problems that patients present with’.

At the start of this year, the Government rejected a recommendation to introduce mandatory menopause training for GPs, saying ‘it is not necessary’.

Last month, Pulse reported that the QOF public consultation, confirmed by NHS England primary care director Dr Amanda Doyle in August, is expected to launch by mid-November.


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Please note, only GPs are permitted to add comments to articles

Truth Finder 1 November, 2023 1:23 pm

What about Testosterone blood test or PSA al in the name of equality and dropping some QoF targets too.

Dr No 1 November, 2023 3:46 pm

“would ‘help to balance the deficit in knowledge and understanding among GPs”…I do this very well already thankyou and it’s a complex and detailed consultation which I’m very happy to have. But if this is to be raised as a question for all post-menopausal patients then it begs the question “what do you want us to stop doing to make time for this?”, as for ALL new primary care requirements. The tabletop is full. Put another item on it and something else will be pushed off the other side. Let’s hope it’s not a cancer diagnosis who can’t get an appointment.

Drachula H 1 November, 2023 4:23 pm

The government should stay out of medical practice. It is not right to encourage medication, but people should be aware that they can come to see us if needed, and we need the resources to do so.

Dave Haddock 1 November, 2023 5:05 pm

Policy dictated by baying mob.
What could possibly go wrong?

David Jarvis 1 November, 2023 5:50 pm

So menopause is when your periods stop. So what screening should I do? Check whether the stock of sanitary ware is going down or inspect their Asda shopping receipts. Hmm no tampons is there a problem? Or are they thinking of all over 40’s with changes in their cycle length and bleeding amounts. If so what test as FSH is usually still in normal range really until menopause has actually happened. Many women in their 40’s have a myriad of gynaecological issues not related to menopause as well. Now last I checked it is a natural process from which nobody dies except perhaps a partner being murdered. So what is the test what are we treating what are the benefits of early diagnosis? Doesn’t seem to really be screening they are talking about.

Or can we just text and ask if they are still having periods kerching!

Frances Webster 1 November, 2023 5:51 pm

Enquire about the menopause, ask if any help is needed with menopause symptoms. Yes. Screen for the menopause. No It’s not a hidden condition like hypertension or cervical cancer. Women are not helpless flowers who need someone clever to tell them what is happening. What we do need is timely access to unbiased help and reliable supplies of treatments.

Turn out The Lights 2 November, 2023 10:01 am

1st world problems in whats rapidly becoming a third word health care system.

SUBHASH BHATT 2 November, 2023 11:04 am

How many menopausal women in the country? This is number of the votes they are after. As f we knew nothing about menopause after decades of practicing.

Mulled Whine 2 November, 2023 11:16 am

Maybe the National Screening Committee will remind the Minister about the criteria for a screening programme?

Nicola Williams 2 November, 2023 12:47 pm

Why are we screening for a natural event that is part of life for all women ? We can’t “prevent ” it as in screening for DM etc , it happens no matter what we do . And women know how to make routine appointments with us

fareed bhatti 2 November, 2023 1:48 pm

Oh yes please- don’t forget to mandate that it has to be done outside core hours and don’t bother pay for it either. We just thrive on this. Doesn’t it just brighten my whole day answering ‘is it my hormones?’ after each symptom from achy toenails to twitchy eyes to PR bleeding in patients aged 24 to 80 ( and now even men!).
Lets make it compulsory- I’ll put the checklist for implementing this in the CQC and safeguarding folders and my appraisal evidence.
There remains some confusion about the order in which to sequence this though. Is this meant to come before screening for gambling, addiction, gender identity, FGM, domestic abuse, and radicalisation or after?
Another NICE guideline would greatly help too please.
In fact an RCGP working group is likely to come up with a fabulous dress code for these consults before the next years honours list comes out, and GPC will celebrate the success of negotiating that GP partners undertake this consult while holding their breath.

Rogue 1 2 November, 2023 3:25 pm

OK, even if you confirm the menopause to cant get medication from the pharmacy – its simply whatever they have in stock

Keith Greenish 2 November, 2023 8:53 pm

Menopause is an event in a woman’s lifetime not a disease, and for most women is unproblematic, though it may bring with it issues that require medical attention, just as puberty may bring menstrual problems and acne. Politicians are simply trying to curry favour with the populace, and fixing the NHS that has been wrecked by political interference over the years now seems to have become the preferred vote winner for MPs and candidates. When will they realise that what they are successfully doing is demonstrating their ignorance of medicine, of healthcare, and of the fact that their approach is destroying the profession and the NHS?

David Banner 3 November, 2023 9:08 am

The medication shortages render this not only pointless, but dangerous. There’s a worrying rise of non-hysterectomised women taking unopposed oestrogen once the progestogen supply runs out.

I hope we don’t have to repeat the mistakes of history. In the late 90s we were encouraged to put virtually every menopausal woman of any age on HRT, then when in the early Noughties we all saw the data on breast cancer, strokes etc there was a mass panic and overreaction which denied patients adequate treatment for a couple of decades

Menopausal women will seek help if they need it, at which point we can discuss their individual risk/benefit and help them make an informed decision based on their personal needs and possible contraindications.

But forever stoking up menopausal womens’ expectations (as we are at the moment) will only lead to inappropriate and possibly dangerous indiscriminate prescribing whilst denying treatment to others as HRT supplies continue to dry up.