Women's Health Concern/British Menopause Society can't be arsed

[Crystaltree]

Like many women, I've been having problems getting my HRT for months due to shortages. The usual rigmarole is that the GP doesn't know the up to date shortage situation, so guesses.. The pharmacist then says it's out of stock and refers it back to the GP for a new prescription. No communication between the two.

The British Menopause Society (for clinicians) and it's associated women's health info charity Women's Health Concern, allegedly bridge this gap by producing an info sheet giving the current situation. But this week I spoke to my GP and she said "I'm looking at information from January. This is really difficult". She was referring to the latest info sheet from BMS ie January.

I contacted the organisation by email asking why this sheet was not updated, and got a whiny bunch of excuses about the doctors all being "on the frontline". I said I didn't know what that has to do with an admin matter. I said that the out of date info was causing time wasted by doctors and pharmacists. She got back to me that basically "as far as they know" the sheet is up to date, based on waiting for drug companies TO CONTACT THEM. Ie they don't do anything proactive whatsoever to update the list. [This coming from an admin officer whose email signature mentioned a conference in Dec 2019].

She basically gave me the brush off and refused to do anything proactive, despite that they claim on their website that it's business as usual. Not only does the lack of action impact professionals, it could also put people at risk by making fruitless trips to pharmacies.

I have written to the chair, but I could only find an email on his private practice site, so no idea if that gets to him. If anyone else thinks this is disgusting laziness harm please write to the two organisations using their web forms:

thebms.org.uk/contact-bms/
www.womens-health-concern.org/contact-whc/

Also you could write to the chair Mr Haitham Hamoda or the CEO Sara Moger via any address you can find other than BMS general contact form (which is no doubt filtered by the above jobsworth admin person).

I think this is absolutely disgusting. The BMS is a membership organisation so it's not like it's funding has suddenly been cut. It's basic reason to exist is to provide information. Which is is failing at.

Thanks for reading

I've also just written to Kathy Abernethy the deputy chair via her personal website:
www.kathyabernethy.com/

Sorry but dealing with a deadly pandemic is more important than HRT for menopause. How can you fail to understand this? You are acting very entitled by expecting nonurgent nonlife sustaining medical processes to continue without interruption or impact.

What type are you wanting to use?

There are many types with no shortages.

The BMS published this list end of Jan. In terms of drug info that it quite up to date. Also, your pharmacist will get a list each week of what items are still in short supply or unavailable. This is also online often so you could do a search.

thebms.org.uk/2020/01/british-menopause-society-further-update-on-hrt-supply-shortages-27th-january-2020/

There are several options available for anyone whose hrt is out of stock.

If you cannot find the one you need, you can call the manufacturer yourself and ask about supplies. I've seen women on other forums saying they do this.

I contacted the organisation by email asking why this sheet was not updated, and got a whiny bunch of excuses about the doctors all being "on the frontline". I said I didn't know what that has to do with an admin matter.

It's not an admin matter though.
It requires specialist drs to sift through the information and then write a summary of alternatives. The person you spoke to is probably a) working from home and b) not able to access any further updates. It's a very small organisation in terms of admin support.

Given the dire situation at the moment it seems a bit unrealistic to expect busy gynaecologists to sort this when it's actually down to pharmacists to ring their suppliers and the manufacturers.

And..the BMS is being proactive. They have issued a directive written by the chairman, saying that the prescribing of HRT can and must continue during the COVID19 pandemic and that drs can write prescriptions without seeing women, and go beyond the need for f2f reviews, as long as the women are low risk and have no medical issues.

see here

www.menopausedoctor.co.uk/news/hrt-prescribing-during-covid-19

If you used patches or pills, you can choose gel and micronised progesterone if the supply remains ok which it did in January.
There are also other options, as on the Jan list.

@Crystaltree Not sure if you have come back to your thread but if you have, this is something on the web about the shortages, in the journal for pharmacists.

www.pharmaceutical-journal.com/news-and-analysis/features/the-true-impact-of-the-uks-hormone-replacement-therapy-shortages/20207775.article

It's a multi-factorial issues. GPs, pharmacists, consultants and women are all frustrated by it.

There is probably some HRT you can get hold of but might not be exactly what you prefer.

It's not the fault of the BMS and really, the buck stops with your GP who ought to be able to find out what is available and what is right for you as an option. They can make that medical choice, and also contact their local pharmacies for information.

The availability list I am talking about is this:
www.womens-health-concern.org/2020/01/british-menopause-society-further-update-on-hrt-supply-shortages-27th-january-2020/
It does not require any expertise to compile or update, it's basically cutting and pasting from emails.

It is not the alternatives list (which is a pdf download from the same page dated 4.11.19), which I agree requires expertise to update.

"and also contact their local pharmacies for information".. GPs don't have time to be phoning round pharmacies, not usually, and certainly not now.

"you can call the manufacturer yourself and ask about supplies. I've seen women on other forums saying they do this". What exactly is the point of the BMS existing then? This is the most basic level of information. Their admin is at work. They claim they are business as usual.

"You are acting very entitled by expecting nonurgent nonlife sustaining medical processes to continue without interruption or impact" I'm expecting one administrator to pull their finger out, show a jot of initiative and do their job, to save the valuable time of clinicians, that's all. I've had to have an unnecessary appointment with my GP.

I agree it's poor practice to expect women to make multiple contacts with GP practices and visits to pharmacies, at this time especially.

That list is irritating for patients, pharmacists and GPs.

@Crystaltree. That is exactly the same list as the one I linked too, surely?

thebms.org.uk/2020/01/british-menopause-society-further-update-on-hrt-supply-shortages-27th-january-2020/

If you can see the list, why do you want the BMS to do something more?

Their administrator has done the work. There is a list on the website.

What else do you want?

That is the list. No one in the BMS office can do anything except refer you or your GP and pharmacist to the list.

I'm confused as to what you want.
The list is what is available and expected dates of supplies resuming.

GPs do have the time to read this list and the expertise to choose other types for women who can't get their usual one.

Basically, what is needed is a form of hrt that has
1 the same dose of estrogen
2 the same type of progesterone
3 the same regime- sequential or continuous.

It might mean swapping from patches to pills or gel. tablets, but there are options.

All your GP has to do is get their head round this and yes, they can speak to pharmacists. It takes 10 mins to make a call and gather information which will serve ALL the women in their practice.

My point is that the list dates from January. And my GP specifically said to me that it being not up to date made it difficult for her to rely on it, it being now April, and the supply situation changing constantly (which the pharmacist corroborated).

So the person at BMS said they THINK it's up to date, but they don't ever proactively contact any of the companies to check it. So my point is, why not just fire off a few emails to get updates? So when a GP looks at the list, it's not four months old? It's not exactly too much to ask of a well funded membership organisation whose sole purpose is to provide up to date information to doctors.

But no, apparently that's too much trouble. So patients and doctors have to go round in circles.

I have it in writing from my GP (well, a patient portal text) that it's MY job to contact pharmacies and source HRT and other medications including Levothyroxine, not the GP's. (England.)

The pharmacists from Boots, Asda, Rowlands and now an independent pharmacy have all told me that that list from British Menopause Society is NOT a correct reflection of the availability of HRT.

So I think the OP had a valid point tbh.

The list was published on the 27January.
That is approximately 10 or 11 weeks (not 4 months) ago.

Since then we have had the Covid19 situation. The drs who belong to the BMS are all busy, working doctors who will be trying to work in their gynaecology practices, doing essential surgery or seeing urgent cases in this difficult time. They don't 'work' for the BMS.

They have issued a very helpful statement in that time stating women should be allowed repeat prescriptions for hrt without always having to have their reviews, with a dr, if they have no risk factors.

The BMS is not a large organisation in terms of admin. I think they have one or two part time office staff. They are also not as far as I know 'well funded'. Their main purpose as a professional body is to train GPs and nurses, draw up guidelines and highlight research that is published. They have done a lot regarding pursuing the supply issues, but surely over the last 11 weeks they can be forgiven for not doing more?

I am not sure that what pharmacists are telling you @AutumnCrow is the whole truth. It may be that they can't get hold of supplies because they are not trying hard enough to source them from more than one wholesaler (and giving you an excuse.) AND (I know a pharmacist as a friend) they get briefings through their own professional organisation's newsletters/ manufacturers advising them on what is available.

The list @Crystaltree as it stood on 27 Jan, gave options that were in stock with no problems on supply.

What sort were you using? Has your GP suggested alternatives? What are you struggling to find and what has been offered instead?

This shows all HRT and you can click on the tab for other options ( estrogen, progesterones, post menopause)

www.menopausematters.co.uk/perimeno.php

Kathy Abernethy has replied, her message in full:

Thank you for your message. I am sorry you feel the office staff were unhelpful. They are not clinical and rely on us medical professionals to keep the site updated, so it is our mistake, not theirs. They are currently keeping the society going under very difficult circumstances.

My experience is that HRT supply issues are greatly improved, although some do need to be ordered and at the present time, that is proving difficult to already overwhelmed pharmacies.

I take your point though about the date of the BMS update and will suggest it is reviewed, although the information itself may not be much different for many of the products. There also seems to be regional variation as to what is available at local level.

If you have a query about a specific HRT, I am happy to try and help. There are several HRTs that are readily available.

Also a bit of background:

"It may be that they can't get hold of supplies because they are not trying hard enough to source them from more than one wholesaler"

Only independent pharmacies can use all 5 wholesalers. My GP's receptionist gave me a list of the only three pharmacies in my borough which are still independent. Most pharmacies, even if they appear to be independent, are owned or tied to the major wholesalers, therefore they will not search all the suppliers.

So your reply from Kathy A confirms my point: the BMS staff are not medical. They cannot update medical information without input from doctors and doctors are busy people.

It's not entirely true what you said about pharmacies. Some will not try several suppliers and have to stick to whichever the chain uses.

All this is beside the point really. As Kathy says, the answer to your own situation is for your GP to use the 'available' list, and come up with two options at least for you.

What do you use and what have you been offered an an alternative?
For many women swapping to separate estrogen and progesterone (as two items) means they can get HRT, rather than both in a pack together.

Thanks for all your pertinent comments Jingling, and your offer of help finding alternatives, but I didn't come on here for specific medical advice, but to highlight information issues, as raised to me by my GP.

Your GP ought to be aware that one form of estrogen and progestogen are ,so far , available. Many specialists consider these two types the gold standard for HRT anyway and prescribe as their first choice. Some women have specifically gone for private appts to get them as some GPs refuse to prescribe (mainly as they don't know enough about dosage .)

It sounds really as if your GP hasn't done their homework and isn't up to swapping one type of hrt for another, using the ones available.

Maybe I am wrong, but that is what comes over from your posts.
GPs are professionals and they ought to be able to work their way through this and, if necessary, ask more highly qualified drs for help.

There are women who are reading the BMS list and going to their GP saying 'Ok, I can't find this type, but what about this other one?'

Why isn't this GP clued up?