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Objective: The aim of the project was to reduce the risk of patients using the estrogen only part of their hormone replacement therapy (HRT) inadvertently in Banstead PCN. Although understanding about the risk of unopposed estrogen is well understood by prescribers, there are numerous flash points where this exposure can occur which was highlighted by several cases encountered during a study period of 3 months. Study design: Cases encountered revealed numerous reasons for this exposure which were split into three areas: Prescribing factors, dispensing checks and patient understanding. Main outcome measures: Quality improvement suggestions were tailored to the factors involved. IT system changes to EMIS, our main computer software provider, were proposed to enable safer prescribing. Following discussion with key stakeholders, increased education for pharmacists was proposed alongside an alert sticker system at the dispensing end point. Patient understanding and education for all parties was delivered through various routes. Results: The IT system alterations required are complex and still awaited. Funding was obtained and stickers distributed. The results from a re-audit from this intervention are awaited. Interim education measures at an individual level were meantime explored and the impact of them assessed. Patient education and the role of social media were explored. I produced a short video which was circulated to doctors with the plan to distribute via other clinician social media accounts. Conclusions: A key discovery through this study is that many of the flash points identified can be difficult to detect and many are not measurable. The increasing number of HRT prescriptions, time pressures in primary care and the known risk from using unopposed estrogen of endometrial cancer means these changes are of potential great value. [ABSTRACT FROM AUTHOR]

Purpose : We performed a retrospective audit of General Practitioners' (GPs) referrals to the specialist Menopause Clinic at Guys and St Thomas's (GSTT) between 2021 and 2022. We aim to establish the indication for the referrals and whether they were compliant with the National Institute for Health and Care Excellence Guidance NICE. Background : GSTT is a teaching hospital in central London that educates gynaecologists in training as well as (GP) for specialist certification in Menopause. The menopause clinic receives approximately 580 GP referrals per month from South East London practices. The current waiting time for an initial appointment is up to 1 year. This delay reflects an increase in demand for menopause care and a deficit in service provision in many areas of the UK. NICE has recommended that GPs refer complicated cases to menopause specialists, with 11 specific criteria. Study Sample and Data Collection : We randomly selected 50 patients referred to the GSTT clinic by a GP between 2021 and 2022. Patient data were collected, including patient demographics, date of referral, indication for referral, date of consultation, waiting time, past medical history, investigations, and treatment instigated during the appointment. Results : The majority of referrals to the GSTT menopause Specialist clinic met the NICE guidelines (76%). One-sixth of the referrals could have been prevented or managed through alternative routes. Finally, although this is a small study, some patient unmet needs (PUNS) and GPs' educational needs have been identified. [ABSTRACT FROM AUTHOR]

This pilot study evaluated the student user experience of a performance indicator tool (PIT) for formative assessment of a cohort of fourth year medical undergraduates undertaking a 12 week rotation. Scoping and elaboration for the standalone web-based tool was based on the existing paper-based formative assessment system for which training and secure access was made available through the Virtual Campus at King's College London. Thirty-eight participants were randomly assigned to four groups. A baseline survey on formative assessment was carried out in Term 1 by all groups. In Term 2, two groups received the PIT and two the paper-based system. The PIT and paper-based groups were further split into those who gained formative assessment at the end, and those at the middle and end of rotation. Evaluation was by online student satisfaction questionnaires and focus groups. Term 1 baseline survey (n = 13) revealed a lack of one-to-one formal feedback. In evaluation by satisfaction questionnaire (n = 8) and focus groups (n = 30), students valued personalised feedback, and mid-rotation feedback allowed students to reflect prior to the end of rotation. However, some students felt that their tutor did not know them as well as others, thus adversely affecting their feedback. A functional web-based PIT was developed including tutor-student discussion spaces. Students found feedback very valuable. Those involved found the PIT easy to access and use, preferring formative assessment two thirds into the rotation. The PIT has wider applicability within the College for all healthcare faculties and may help improve student satisfaction.

The article discusses the management of menopause in general practice. It emphasizes the importance of primary care clinicians having a robust evidence base and easy access to clinical guidelines to ensure patient safety. The article cautions against assuming benefits with hormonal treatments for all women and highlights the need for a holistic approach to menopause management. It also discusses the importance of providing accurate information to women about menopause and treatment options. The article concludes by mentioning the availability of an online education package for clinicians to ensure they have up-to-date information and can provide individualized care. [Extracted from the article]

The 2024 British Menopause Society annual scientific conference took place at Chesford Grange in Kenilworth, Warwickshire. The conference had 440 delegates, with two-thirds from primary care and one-third from secondary care. There were 75 abstract submissions, with 5 accepted for oral presentations and 59 for poster presentations. The conference received positive feedback and was described as engaging, varied, interesting, and friendly. Janice Rymer took over as Chair of the British Menopause Society during the conference. [Extracted from the article]

The NICE Guideline (NG23) 2015 Menopause: Diagnosis and Management states that 'women who are likely to go through the menopause as a result of medical or surgical treatment should be offered support and information about the menopause and fertility before they have their treatment, and a referral to a Health Care Professional with expertise in the menopause'. To investigate whether discussion about the surgery causing the menopause, and advice on possible treatments had been documented, I conducted a retrospective study of women undergoing bilateral oophorectomy at a central London teaching hospital from 1st April 2018 to 30th September 2018. Only 30% of women (8 out of 27) in this study had documentary evidence of having received menopause advice around the time of bilateral oophorectomy. [ABSTRACT FROM AUTHOR]