Rochdale News | News Headlines | Local CCG spent 40% less on menopause Hormone Replacement Therapy per woman than CCG which spent most

Release date: October 18, 2022

A new analysis of NHS prescribing data has revealed some local health sectors are spending three times as much per woman on hormone replacement therapy (HRT).

Data from the BBC’s Shared Data Unit has revealed that between April 2021 and June 2022, the West Suffolk Care Commissioning Group (CCG) spent an average of £14.09 per woman aged 45-60 on hormone replacement therapy (HRT) – the highest spending across the country .

Meanwhile, 79 of the 106 CCGs in the country were spending at least 20 per cent less than the West Suffolk figure – with CCGs in Heywood, Middleton and Rochdale spending 40 per cent less on patients’ HRT at £10.03.

Conversely, Leicester City spent the least on HRT for its patients, averaging just £5.56 per patient.

Clinical Commissioning Groups have now been replaced by Integrated Care Partnerships.

HRT replaces hormones that are at lower levels as you approach menopause. Not every patient needs or wants HRT, and clinicians advise against it in certain circumstances, including in patients with a history of certain types of cancer or blood clots.

Drugs studied in the data compiled by Oxford University included estradiol and estriol with progestin, progestin-conjugated estrogens, estrogel, norethisterone, dydrogesterone and medroxyprogesterone acetate.

Experts said the treatment options offered by some local health authorities are “very limited”, adding that local health authorities’ decision-making has contributed to a “zip code lottery” and that some women are not being offered the full range of options because Her local health authority did not fund her.

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Diane Danzebrink of the charity Menopause Support said GPs were “hands tied”.

“Often we hear from women who are prescribed oral tablets as their first line of treatment and aren’t offered any options,” Ms Danzebrink said.

“Sometimes that’s because those options are just not available in their local CCG form. So that ties the hands of their physicians in being able to offer them choices. But we’re definitely seeing it appear to be more in some parts of the country than others.”

Cultural differences are cited as a further reason for the differences. dr Anne Connolly, a menopause expert and general practitioner specializing in women’s health, said different ethnic groups “may experience or manage symptoms differently,” while Ms Danzebrink added that cultural barriers such as language could cause problems for some groups of women.

She said: “In some communities it is not acceptable to talk about women’s health. Women are not encouraged to talk about their health, they are not encouraged to seek help and support.

“One could also not only talk about the cultural barriers, but maybe also about the language barrier. Not everyone has English as their first language. And I think that’s kind of part of the broader problem that we have in sharing factual, evidence-based information and letting people know that there are ways to help.

“What we need to see is a government-led public health campaign. We need to see something that education shares with all sections of society. And that could mean being in different languages, it could mean being in Braille.”

The NHS says it has stepped up training for clinicians.

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An NHS spokesman said: “The NHS has a Menopause Pathway Improvement Program which includes increased learning for clinicians on how best to support women going through menopause and working with clinical colleges and menopause organizations to raise awareness and improve understanding.

“A new Menopause Optimal Pathway will also guide physicians and help women in the workplace during perimenopause, menopause and postmenopause.”

Patients seeking treatment for menopausal symptoms may be referred to specialist NHS clinics for further treatment.

But the BBC analysis of British Menopause Society data shows that 59% of Clinical Commissioning Group (CCGs) areas in England have no NHS clinics, including all of Devon and Cornwall and large areas of the North – including Rochdale Borough.

The Department for Health and Social Care said it would consider a new target from the Women and Equality Committee to provide at least one NHS menopausal clinic or specialist in every CCG by 2024.

Of the 199 clinics in England, 75 are run by the NHS and 124 are private.

Concerns about HRT supply had grown after reports of shortages of transdermal treatments, including popular gels, following increased demand for the work of charities and celebrities to raise awareness.

In July this year, Parliament’s Secretary of State for Health and Social Care, Maria Caufield, said at a debate in Westminster Hall that demand for HRT products had risen by 30%, but said few products were now experiencing shortages.

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From April 2023 a flat rate of £18.70 will be charged on all HRT prescriptions across England. Currently, HRT is treated like any other prescription and costs £9.35, or £18.70 for two types.

“We met with commercial suppliers, manufacturers and pharmacists to discuss the challenges they face and try to overcome them,” Ms Caufield said.

“Of the more than 70 products available, we now only have three or four under pressure and even on those we are seeing significant progress.”

The Department for Health and Social Care said it would consider a new target from the Women and Equality Committee to provide at least one NHS menopausal clinic or specialist in every CCG by 2024.

A Department for Health and Social Care spokesman said: “We have put women’s health high on the agenda by publishing a Women’s Health Strategy for England, appointing the first-ever Women’s Health Ambassador and taking action to increase supply and the Reduce costs of hormone replacement therapy.

“We have accepted the HRT Taskforce’s recommendations, including the continued use of Serious Shortage Protocols where appropriate to deal with shortages, and NHS England continues to work to collect data to maintain and update local forms in England.

“The UK Menopause Task Force is trying to break taboos surrounding menopause and recognizing the role workplace policies can play in supporting women going through menopause, and the Government’s Health and Wellbeing Fund is helping to scale up and develop projects that help women going through menopause stay in the workplace.”

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