Women's health plan: interim progress update 2023

Menopause and menstrual health, including endometriosis

Menopause

• A Menopause Clinical Reference Group has been established to drive forward the more complex menopause actions within the Women’s Health Plan, as well as to share best practice and improvements in menopause care and support.
• Chaired by Dr Heather Currie, this group is focussed on how best to enable women’s access to menopause care through both primary and secondary care, looking at the transferability of best practice and a menu of interventions on ‘what works’. The group first met in June 2023 and will meet quarterly.

Menopause Innovation Challenge

• On 27 June 2023 CivTech, in partnership with The Scottish Health Industry Partnership (SHIP), part of the Scottish Government Chief Scientist Office (CSO), launched the Menopause Innovation Challenge.
• This challenge aims to look at how technology can empower women to better understand menopause and access the right support for their needs, by helping them to understand and identify the best options for individualised support; understand which self-help measures may be useful and to manage symptoms in the workplace; and to access medical support.

Spotlight on: Menopause Service Innovation NHS Dumfries and Galloway

The Specialist Menopause Service in NHS Dumfries and Galloway now run a virtual ‘Menopause Drop-in" session every fortnight to support and provide consistent advice to primary care teams on menopause. These sessions provide a space to answer frequently asked questions on the menopause and share new guidance or best practice examples. The main aim of the sessions is to ensure there is consistency in advice given from primary care and that patients are provided with better menopause care. There are plans to expand these sessions to other aspects of women's health in due course.

To compliment this work, NHS Dumfries and Galloway are looking at ways to improve access to reliable, accurate information for women locally to assist them to make informed choices about their menopause care. This includes hosting local information webinars on the menopause, and looking at ways to introduce discussions on menopause, and signpost to information, during cervical screening appointments with women of menopausal age.

Spotlight on: NHS Greater Glasgow and Clyde Menopause Service Developments

Menopause Referral Guidance

The NHS Greater Glasgow and Clyde Menopause Referral Guidance was developed by a multidisciplinary group of menopause experts and published in June 2023. It sets out clear criteria for both referral and the expected initial management of menopause and is available on the Right Decision platform.

Psychiatry Multi-Disciplinary Team Case Conference.

Dr Sinead McAree, a consultant psychiatrist, recognised that along with educational inputs, a Psychiatry Multi-Disciplinary Team (MDT) would be an excellent platform to improve knowledge and practice of menopause. The first MDT was held in May 2023 and included staff from primary care as well as psychiatry. The MDT outcomes are:

• better understanding of the relationship between menopause and illness.
• differentiating and understanding the relationship between physical and mental causes of symptoms
• improvement in both mental health and physical health symptom control
• increased learning and co-working opportunities for clinicians
• avoidance of an individual sitting on multiple waiting lists for specialist clinics

The Sandyford menopause email advice service

This service was established in 2019 in response to increased referrals and enquiries about menopause. Clinicians email their enquiries about menopause symptoms, treatments and side effects and to check if a referral is appropriate, to a discrete email address. The Sandyford consultant on-call answers the emails as part of the on-call duty and consequently, the majority of emails are responded to within 24 hours.

“”I just wanted to comment on the support I have received as a GP from the menopause advice […] staffed by the CSRH consultants. They provide a genuinely outstanding service - not only in the quality of their responses but also the speed with which they reply. I have rarely waited more than hours for a comprehensive response to my query. At a time where most NHS services are struggling to meet patient/primary care demand it's almost unbelievable a service of this quality exists “”.

From a GP, NHS Greater Glasgow and Clyde

The number of enquiries to the email advice service continues to increase, from under 200 in year 2, to more than 1,000 already in 2023, almost the same as the whole of 2022. This has led better initial menopause management for women and a reduction in inappropriate referrals to the specialist menopause clinic at Sandyford. This has been a valued service development, illustrated by the increased use of the email service, and the frequent replies expressing thanks and appreciation.

NHS Scotland Menopause and Menstrual Health Workplace Policy

• The upcoming NHS Scotland Menopause and Menstrual Health Workplace Policy is in the final stages of policy development and is expected to launch later this year. Throughout this process the policy has been informed by the Menopause and Menstrual Health Working Group, NHSScotland governance forums, and the University of Glasgow’s research into NHSScotland staff experiences of menopause and menstrual health in the workplace.
• Alongside the policy, supporting documentation is being developed that can be used by staff and managers to further develop their knowledge and increase the support for those experiencing menopause and menstrual health in the workplace.

Spotlight on: NHS Ayrshire and Arran Workplace guidance

NHS Ayrshire and Arran recognised that over 75% of their workforce are female and of those, 45% are females over the age of 45, therefore identifying an opportunity to better support their staff as they navigate the menopausal transition.

In October 2022, NHS Ayrshire and Arran launched their menopause workplace guidance, to provide line managers with clear guidance on how to support employees through peri-menopause and beyond. It is designed to be inclusive of all gender identities and draws together guidance from the Faculty of Occupational Medicine, the British Menopause Society and the National Institute for Care and Excellence (NICE).

In addition, NHS Ayrshire and Arran host regular menopause awareness sessions for all staff seeking advice on managing the menopause transition in the workplace.

A learn-pro module is also available for line managers enabling them to understand more about the menopause and better support their staff.

A strategic group, the Menopause At Work Group met first in late December 2022 and will continue to drive forward improvements in their approach to the menopause in the workplace.

The aim of this work is to build a culture of awareness and support in all levels of the organisation, ensuring that every staff member has access to the right support and information.

Spotlight on: NHS Grampian workplace support

NHS Grampian have hosted a number of menopause awareness in the workplace sessions for their staff, and through a local survey have created a summary of the evaluation from these sessions which have been well-received.

Menstrual health

• Building on the success of the Menopause Specialist Network we have now established an equivalent network for health care professionals focussing on menstrual health.
• The Scottish National Menstrual Health Specialist Network, chaired by Dr Jackie Maybin, will meet quarterly. It will provide a forum for peer support and sharing expert clinical advice, best practice and innovation across NHS Boards to support healthcare services to be responsive and adaptive to the individual needs of women and girls.
• In addition, there is now a Scottish Menstrual Health Clinical Reference Group, a smaller focussed subset, designed to take forward issues and actions raised by the larger Network as well as acting in an advisory capacity, providing clinical expertise when necessary.

Endometriosis

Work continues to be taken forward to improve access to appropriate support, speedy diagnosis and best treatment for Endometriosis. This includes continued engagement with those with lived experience and our lived experience forum to support the delivery of the Women’s Health Plan.

• In March 2023, we developed an engagement campaign with Young Scot targeted at young people. The campaign delivered content which raised awareness of the condition, provided support to those diagnosed and provided guidance to those supporting someone with endometriosis. The campaign also created learning materials in line with the Curriculum for Excellence for use in schools.
• The ALLIANCE, in partnership with the Scottish Government, delivered a virtual webinar which focussed on raising awareness of endometriosis. The webinar provided information from an expert clinician as well as people with lived experience to provide insight and reflections from their own endometriosis journey.

  

• Endometriosis UK have been granted funding of £24,000 by the Scottish Government to deliver a project which will create new resources to enhance the information available on the support, treatment and management of endometriosis associated pain symptoms.
• In March 2023 we announced the University of Edinburgh as the recipients of the £250,000 research grant from the Scottish Government and Wellbeing of Women. The researchers at the University of Edinburgh will work with the Universities of Aberdeen and Birmingham to run a clinical trial called EPIC2. The research will investigate whether a drug called dichloroacetate is effective in treating endometriosis associated pain symptoms. The research team hopes this could lead to the first ever non-hormonal, non-invasive treatment for endometriosis.
• The Minister for Public Health and Women’s Health and the Women’s Health Champion had the opportunity to visit the research centre in May 2023 to learn more about the research and the impact it could have on the lives of people with endometriosis.