Quantified and characterised menopause health needs so it could be weighed against other priorities
Client and setting
A London NHS ICB: 138,000 women aged 45 to 55 across multiple localities.
The challenge
There was no agreed measure of need for menopause care. Coded general practice activity was sparse, and a narrow SNOMED search returned too little to analyse. Prescribing data said more about who comes forward in better-off areas than about need. The board had to decide how much of a limited budget to put into menopause against three other conditions, with nothing comparable to judge it by.
What we did
Built the analytical logic and coding from published evidence: menopause at an average age of 51, a four-year perimenopausal period, and the NICE-supported estimate that 80% of women have symptoms.
Broke the female population down by single year of age across the six boroughs using GLA and ONS estimates, and produced both the number affected at any one time and the number entering perimenopause each year.
Checked the model against service data: coded general practice activity, and five years of HRT prescribing rising from about 95,000 items to about 172,000, compared with other London systems and England.
Tested, examined and interpreted estimate through an inequalities lens, flagging lower uptake in more deprived communities and the risk of creating demand through supply, set against the benefit to women.
The outcome
48,500 women are in the perimenopausal period at any one time, about 39,000 of them with symptoms, and 12,500 enter it each year. HRT reaches only about 5% of women aged 45 to 74, well below the England rate. Decision-makers could weigh menopause against competing services using comparable numbers.
Timescale and team
Eight weeks from start to final report. Two partners and an engagement manager, with ICB business insights team support.
