MPs told NHS should give meno check at 45

[PalatineHill]

www.bbc.co.uk/news/health-63212957

Sounds like a great idea. (Though I’ve never heard of anyone being offered a health check at 40). Would you welcome this? If so.. write to your MP!
The Women’s Health Strategy was the UK government’s first ever attempt to help women across so many key health issues but seems to have been completely ignored since the arrival of Truss and Coffey. Worth mentioning that to your MP too to put pressure on the government to carry out its aims. Truss and Coffey weren’t voted in so they have no mandate for dropping it.
I think we all know by now that if we don’t ask, we don’t get. And too often, when we do ask, we still don’t get. It doesn’t have to be like this.

I would like some consistency on how long for as two different HCP - one take it forever basically the other definitely not and stop after a few years

Not sure if that information is even known

It would be a great idea if they did it properly. I think I was peri at about 45, but didn't have a clue about it. My GP. of course, put me on anti-depressants.

The consistency is in the formal guidance of the British Menopause Society which was produced years ago and it says there is no time limit- it can be for life. This is on a consensus statement on their website for women to read and of course medical professionals.

@Prestissimo It's fine with me yes, but maybe your posts would be more credible if you said you were working p/t (or are you taking holiday today?)And is it my business if you post about how you don't have a minute, but then spend a while on a forum.

I come back to the same point that GPs are well paid and have better contracts brought in by Blair.

If you think that all other professionals only work the hours they are paid for, you are very out of touch.

Your posts are very much about what works for the 'poor GP' yet not very proactive about the poor patients.

If you want women to know about vaginal dryness, organise a talk on it, advertise it, get posters up.

Or is that all too much like hard work?

God, you're obnoxious aren't you?

Why are you jumping on the previous poster as if the whole NHS is a mess because of them?

They, and no-one else for that matter, owes you a damn thing in terms of explaining why they are on here. You do get that that not all jobs, including GP's, are 9-5? Otherwise we'd have no out of hours GP's did one thing. So rather than pouncing on someone accusing them of god knows what because you perceived they could be spending their time better, try winding your neck in and perhaps ask questions nicely - maybe the poster would have been happy to share further insights with you.

No-one is saying that the current GP service is working well for all patients across the country. But it's well publicised that there's a huge shortage in numbers of doctors and nurses available across the NHS. GP practices are stretched so thin, they cannot do everything.

But sure, pile on a GP a bit more, perhaps you can piss them off enough they decide to leave medicine away well. That will help the situation.

It doesn't even have to be a GP. Our practice nurse runs the diabetes clinic and asthma clinic, and does the smears. She does the peak flows, checks the blood pressures, sugar levels etc. Doctors are just called in when she needs a clinical opinion or to write a prescription.

Menopause is a lot of listening and explaining. Nurses are more than capable of doing this, with GP back up.

Seems like a waste of money to me. Make appointments available at a time appropriate to the individual (might be younger or older) if they want to talk to a doctor. Not all women need or want medical interventions for this natural process. I'm still in peri admittedly but have no intention of taking medication as it has possible side effects

Who, exactly would be offering this service?

To be honest, I think they need to sort out GP practices first. They aren't fit for purpose at the moment, and most people are finding it impossible to get an appointment at all.

I've never been offered a health check and I'm over 55. I feel robbed 😮

I would fully support a specialised clinic as I think after a certain age a lot of symptoms are menopausal based rather than true/other illness based

@JinglingHellsBells I really don't agree with your assessment of my posts. I thought/hoped they demonstrated that I believe patients deserve better than they are currently getting (in many cases) but that there are reasons that this proposed policy is not the best way to achieve that. I'm also not sure why this has become a personal attack. Thank you @Tillow4ever for your support.

GP services are in crisis. I occasionally poke my head above the parapet on here to try to explain why. The trouble is that when we as a profession do this we are instantly portrayed as work-shy and greedy. That isn't actually very constructive but facilitates the continued decimation of primary care by successive governments.

GPs are well paid, I've never argued otherwise. However, we are also highly-skilled and highly-trained, managing high levels of risk and, increasingly, a rare breed. This is a shame because there has never been a greater need for good GPs given the general state of health and healthcare in this country. Those of us who are left are those who have not resigned, retired or emigrated. We won't last forever. There is a massive recruitment and retention crisis despite, as you would have it, the cushy working conditions and overflowing coffers. In general we are doctors who want to help people, who value our ongoing relationships with our patients and want to do our best for them. For varying reasons that is becoming harder and harder. It can be the best job in the world (imho) but frequently at the moment it is not.

I've never done a different high-hours-high-pay job so cannot (obviously) do a direct comparison. I assume that the people who do those jobs feel that the job satisfaction and other rewards outweigh the costs in terms of time and impact on the rest of their lives. Increasingly people are not feeling that way about general practice. It's a shame. I don't believe that the character or virtue of wannabe GPs has particularly changed in the last two decades. I can tell you that the job has changed massively.

'It’s a waste of public funds. This will give the “worried well” another excuse to fill up waiting rooms and appointments'

Absolutely this. You can't see a hcp when you're ill would seem mad just because you have reached a certain age.

Women need to take some responsibility, we see it on this board all the time 'I'm 51 my periods erratic is this peri?' Probably! Newsflash, after 45 periods fluctuate, women may experience sleep problems, hot flushes, anxiety, vaginal atrophy. The list goes on. There are 2 choices, manage it with lifestyle changes like cutting out booze, vaginal lubricants etc or see your GP and ask for HRT after reading up about it on the many sites available.

To go for a health check would seem a ridiculous waste of everyone's time.

As a very post menopausal woman I'm on the fence about this. The Menopause is a pain in the bum but it doesn't kill people. Many of its symptoms overlap into other areas including well-being as it often hits at the same timenas children leave home, aged parents die, looks begin to fade etc.

I had a peri test at 43. It was negative although I was having large gaps. Hot flushes started at about 45. I went on HRT aged 47. Last period at 48/49 but stayed on HRT for a while. GP initially prescribed something pedestrian. I had an apt with a gynaecologist for something else and he prescribed something more tailored to me.

Meanwhile I was diagnosed with severe osteoporosis (I suspect due, as well as a family history, to struggling with undiagnosed graves for about two years in my late 20s - symptoms dismissed by GP). Since then my GP refused initially to refer me to a specialist after fracturing a vertebrae subsequent to diagnosis (it was the private consultant who hooked me up with possibly the best rheumatologist in the country - NHS). On fracturing the second the GP refused to believe it was fractured and diagnosis was achieved privately. When rheumatologist ventured the best treatment, subsequent to a course of zolendronate, was teriparatide, it became clear that this was not findable under the NHS because I am under 65. I am therefore funding it myself. I note I still work full-time and contribute to the NHS via tax and NI. I note further that I find it extraordinary that Dr's claim Nice is a guideline and doesn't have to be followed. Regarding reducing a distal radius fracture NICE says G&A is insufficient but many hospitals do it with just G&A. Regarding teriparatide at under 65 providers follow the guideline to the letter. It's incredulous to think the guidelines can be ignored when it saves money but not when money needs to be spent.

I have not found GP services to be particularly helpful over the last 40 years and I do not find as a patient I am treated as an equal stakeholder.

I am afraid I believe there are far more serious diseases that kill that need to take priority over the menopause.

It seems to me it is time to be realistic about what the NHS can and cannot do and very transparent about what it offers. If people want more than the minimum SLA provides then I think we have reached a point where that needs to be provided for through alternative means. I would fully support a system of social insurance as they have in Continental Europe.

Overall I'd like to see a little more integrity in the NHS and a little more respect for patients. If I were to continually complain to my key stakeholders that I was overworked and exhausted despite earning six figures and it was the fault of my Employer, my clients would rightly complain and I would lose my job. If I used my clients first names whilst expecting them to address me with a title I'd be dismissed for insubordination.

Something has gone deeply and badly wrong and I don't think it's the fault of governments or the public rather that the NHS has been allowed to become an over bureaucratic behemoth that wishes to dictate without being accountable and has lost its sense of service to the public who receive it free only at the point of delivery. The NHS exists for the public who need both to stop being grateful for suboptimal standards whilst also being realistic.

Apologies for length of post and typos.

@RosesAndHellebores I hope you see this. I know women under 65 on teriparatide. It's on the NHS and they are younger than you. It's prescribed (they were told) as they have two fractured vertebrae. My understanding is that NICE has also just recently licensed Evenity which is as good, if not better. Is this something you need to ask about?

@JinglingHellsBells will do. Am already taking it and paying for it though. I challenged it with my GP and was advised the CCG had refused to meet the cost. I have been taking it since July. The cost is not an issue.

Feels patronising to me. I suppose fine as long as it's an offer I can easily ignore. I don't feel it's outside NHS remit, but I hate being typecast as "Oh you poor thing you must be suffering." Feck that shit. I'm fine & please don't ask again. I'm a big girl who can find help if I need it.

JinglingHellsBells no need to pull me up- I didn’t say that only rural areas lacked Well Woman services at GPs. Nor did I say that the problem that hospitals in whole geographical regional areas are lacking any specialist meno clinics at all, (for meno care of complex cases and for professional training), is a solely rural problem.

(GP services are important but they also need to be offered with regional hubs of meno specialist clinic back up, so as to offer a comprehensive service to all patients, some of whom will have complexity in their meno care, due to pre existing health conditions for example. And GPs will always need up to date training and professional support. This same GP practice offered me antidepressants for the physical health symptoms of menopause ie they do not follow NICE guidance. So they could really do with more training and professional support around menopause care.)

I was responding to a PP who said that ‘GPs have Well Woman services’. Which unfortunately isn’t true universally in the UK, including my area. I’m sorry to hear that it’s also the same for you where you live in SE England.

I got offered a health check at 40, which I didn't take, but I did take the one I was offered at 45, which I think was when they decided I needed to be on blood pressure tablets.

I'm not sure about being offered a meno check. I didn't notice any symptoms till periods started going irregular at 49, and that's mostly the only thing I've noticed. That's not to say a blood test wouldn't shield up hormonal changes, though.

In any case, I saw the GP in November after a smear showed I had a polyp, and she quizzed me then about peri symptoms, and asked other questions to see how well-informed I am about it. So I guess I had it by default.

I think it's as much about a switch in thinking, putting menopause into the minds of GPs as a possible factor in why middle aged women are presenting with other symptoms.

I was twice prescribed anti depressants by (middle aged, female) GPs who hadn't joined the dots that all the symptoms I was having were hormonal. There's just such a lack of awareness. Yes it's changing but not quickly enough.

So where I work currently NHS referral for urgent suspected cancer are 20+ weeks for some specialties.
Outpatient waiting lists are over 5 years for neurology, gastroenterology, orthopaedics, general surgery and respiratory medicine. Urology is near 7 years.
So if you have rheumatoid arthritis, osteoarthritis, neurological symptoms (not a brain tumour - if that is suspected you are referred to A&E) Crohn’s disease, recurrent gallstones - basically any number of conditions, you are left with no specialist input. As a GP I spend hours each week trying to get people seen or “remote” advice for those who need it most. Eg yesterday home visit for lady with severe hip osteoarthritis. Poorly mobile since Nov 2021. No chance of surgery for another 2+ years despite being graded urgent. Has had OT, physio at home (when what she needs is hip replacement). Can’t afford 12k to pay for it. Struggling with the painkiller side effects and getting generally weaker as can’t do much. Similar situations being replayed again and again.

It would be lovely to offer well women a health promotion appointment but this area (and plenty others, although maybe not everywhere) are collapsing.

What services will be cancelled to do these clinics?

Mine never came either so I asked for one a few weeks ago and when I was in with my lovely GP for something else he translated the results for me.

You just have to ask.

'So where I work currently NHS referral for urgent suspected cancer are 20+ weeks for some specialties.Outpatient waiting lists are over 5 years for neurology, gastroenterology, orthopaedics, general surgery and respiratory medicine. Urology is near 7 years'

Don't you have a 2 week rule for suspected cancer where you work? I find it it absolutely unbelievable there are 5 yr waiting lists or even 7yrs for routine OPAs. Must be a postcode lottery, everyone i know has been seen quickly for suspected cancer and within a year or even 6 months for routine stuff.

So where I work currently NHS referral for urgent suspected cancer are 20+ weeks for some specialties. Outpatient waiting lists are over 5 years for neurology, gastroenterology, orthopaedics, general surgery and respiratory medicine. Urology is near 7 years.

That's a complete disgrace @PlasticsFantastic Which health authority is this?

England? Wales, Ireland? Scotland?

@LookingAtYou the 2 week rule referrals here now take up to 20 weeks eg gastroenterology

Breast cancer /melanoma wait eg new suspicious lump was 6 weeks recently.

I’ve heard about 2 GP practices “handing back their contract” today (we are a small region).

@JinglingHellsBells I work in Northern Ireland but I’ve colleagues in England and Wales and although not as bad, there are plenty of places where NHS collapsing/poor functioning due to lack of staff.
Yes it’s a disgrace, I am a broken record complaining on behalf of my patients.

I was offered a health check with a nurse at my practice at 40. Was just the usual weight, blood pressure, lifestyle questions.

I requested a menopause appointment last month and I am indeed 45. Had bloods which were ‘normal’ (and I now know from further research are meaningless) and offered antidepressants.

I’m seeing a different doctor soon to try to get some more sense out of them.

Everyone saying ‘what key services must be withdrawn to do this’.. I’m not a doctor and I don’t know if this specific approach is the best.. but you do know that the current situation of untreated menopausal symptoms have a HUGE impact on the health system, employment and therefore tax recipts etc, yes?
Not to mention impacting hugely on female quality of life or lack of. This change or something like this, doesn’t seem like a false economy at all.