Revolutionising Menopause Care: Improving Access via a Pharmacist Led Clinical Service

South Sefton Primary Care Network

Project summary

A primary aim of this project was to provide women across South Sefton with equitable, timely access to high-quality menopause care within the NHS.

A landmark study by the Fawcett Society (2022) highlighted significant gaps in menopause care, showing that only 39% of women diagnosed with (peri)menopause were prescribed HRT at the point of diagnosis by a GP or practice nurse. Furthermore, 31% of women reported needing multiple appointments before treatment was initiated in primary care. These findings underscored the need for a more streamlined and accessible service model.

To address this, we developed a “one-stop shop” model providing comprehensive menopause care. This includes diagnosis, clinical assessment, holistic counselling, and where clinically appropriate, a prescription for HRT within a single appointment. The clinics are led by clinical pharmacists with specialist expertise in menopause care and offer extended consultation time to ensure a high-quality, patient-centred experience.

The pharmacists involved were highly motivated, with a shared commitment to reducing inequalities in women’s health. The project also aimed to demonstrate the valuable role pharmacists can play in leading clinical services within primary care.

The service was delivered across the Primary Care Network (PCN) footprint covering 25 practices. Full access to patient medical records was essential to support safe prescribing and continuity of care. This was facilitated through local data-sharing agreements and the use of the shared EMIS system, enabling pharmacists to access complete patient records while ensuring consultations were visible to GP practices within the extended services section.

A pilot was conducted across a small number of practices, during which feedback was gathered from both patients and clinicians. This feedback was instrumental in refining and improving the service.

Following a successful pilot, the service was expanded to locality level and subsequently rolled out across the entire PCN. Implementation included direct communication with practices, clear referral criteria (any patient presenting with menopausal symptoms), and the creation of educational materials such as posters to support practice staff in identifying and referring suitable patients.

Feedback from patients, clinicians, and stakeholders has been overwhelmingly positive and has played a key role in shaping the ongoing development of the service. While it is still too early to fully evaluate long-term outcomes, our findings show a reduction in both initial GP presentations and follow-up appointments for menopause-related symptoms since the service was implemented. At a time when general practice, and the wider NHS, is under significant pressure, this project demonstrates that high-quality menopause care can be effectively delivered in primary care with appropriate time and resource.