The Government has rejected a recommendation to introduce mandatory menopause training for GPs, saying ‘it is not necessary.’
Last year, the House of Commons Women and Equalities Committee recommended that the menopause is be given ‘more priority’ in initial training for GPs and a ‘mandatory aspect’ of continuing GP professional development.
In a report on menopause and the workplace published in July, the committee of MPs said: ‘We recommend that the Royal College of General Practitioners makes training on menopause a mandatory aspect of continuing professional development requirements for GPs.’
The committee also demanded that all GP surgeries should ensure that at least one member of their clinical staff ‘has received specific training around menopause.’
Today the Government has responded to the report, saying it is not within its remit to require every GP surgery has training on menopause.
The response added: ‘GPs are responsible for ensuring their own clinical knowledge remains up-to-date and for identifying learning needs as part of their continuing professional development. Menopause care is a core competency of all qualified GPs.
‘The Royal College of General Practitioners regularly review training provision and requirements for GPs.
‘The Government cannot respond on behalf of the RCGP; however, the RCGP position is that mandating menopause training is not necessary.’
Dr Kamila Hawthorne, chair of the RCGP, told Pulse that GPs take menopause and perimenopause ‘very seriously,’ and want to do the best for women, taking into account each individual’s needs.
She said: ‘Menopause is included in the RCGP curriculum which all GP trainees need to demonstrate competency of in order to practise independently as a GP in the UK.
‘GPs have the broadest curriculum, which aims to expose trainees to the full extent of conditions they are likely to see in general practice. Introducing additional mandatory training courses for some areas of medicine and not others would be unworkable.
‘We also undertake lifelong continuing professional development and have to demonstrate ongoing learning across the curriculum to continue to practise.
‘To this end, the College has 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.
‘We will continue to develop these and more to support GPs and other healthcare professionals deliver the best possible care for women, based on the latest evidence.’
The Government also rejected the committee’s recommendation there should be a menopause specialist or specialist service in every CCG area, saying: ‘It is not within the remit of central government to commission specialist health services.
‘Integrated Care Boards are responsible for commissioning services that meet the health needs of their local population and have discretion to determine what priority needs are required in their area and can commission and implement specialist services where appropriate, including services for menopause.’
The committee had also asked the Government to act ‘urgently’ to ensure that lower cost HRT prescriptions were being issued and dispensed.
It said: ‘Over the next three months the Government should communicate widely to ensure GPs and patients know about both the current NICE guidelines permitting a 12-month prescription, and the forthcoming single-cost prepayment certificate.’
But the Government responded saying it has ‘no plans at this time’ to encourage GPs to issue 12-month prescriptions, given the planned introduction of the HRT PPC which will reduce costs of HRT prescriptions and because this could have a detrimental impact on the current supply situation for HRT medicines.
It said: ‘The Government is committed to reducing the cost of HRT prescriptions and work is underway with the NHS Business Services Authority to develop a bespoke prepayment certificate (PPC) for HRT medicines licensed to treat the menopause.
‘This will be introduced from April 2023, subject to consultation with all relevant representative bodies which is still ongoing.’
Dr Hawthorne said: ‘We are highly trained to prescribe HRT within clinical guidelines and in conversation with women. While we fully support the aims of reducing the prescription costs to women themselves, it is essential this is undertaken in a way that is safe for the patient and does not have a negative impact on the supply chain.
‘We are supportive of innovative solutions to reducing prescription costs such as prepayment certificates, rather than the provision of a 12-month prescription.’
Though the Government said it has accepted, partly accepted, or accepted in principle six of the recommendations in the report, it came under criticism from the committee for ‘not actually committing to any new work in response.’
The response rejected five of the committee’s recommendations outright, including the recommendation to consult on making menopause a protected characteristic under the Equality Act 2010 and pilot a specific menopause leave policy.
Caroline Nokes MP, chair of the Women and Equalities Committee, said: ‘It is clear from evidence to our inquiry that women experience an inconsistent service when going to the GP with symptoms of menopause.
‘The Minister herself said it is a “postcode lottery”. It is disappointing then the Government hasn’t committed to any further action to rectify this. We know continuing with the current approach is unlikely to be enough.
‘We don’t agree with the Government that 12-month prescriptions can wait until HRT pre-payment certificates are introduced. It is high time the Government gets a handle on the HRT supply problem. Women who require treatment should not be expected to bear the burden of the problem financially.’
The DHSC suggested in December that GPs should have ‘compulsory training’ in women’s health, including the menopause.
However, GPs pointed out that ‘all GPs are trained in women’s health’ as part of their training.
And the Medicines and Healthcare products Regulatory Agency (MHRA) has given the green light for certain vaginal HRT tablets to be available over the counter without a GP prescription.