Frome Medical Practice - Menopause Policy

July 2020 (review due June 2022) 

 

1.         Introduction

1.1.      The Practice is committed to providing an inclusive and supportive working environment for everyone who works here.

1.2.      Menopause is a natural part of every woman’s life, and it isn’t always an easy transition. With the right support, it can be much better. Whilst every woman does not suffer with symptoms, supporting those who do will improve their experience at work.

1.3.      Menopause should not be taboo or ‘hidden’. We want everyone to understand what menopause is, and to be able to talk about it openly, without embarrassment. This is not just an issue for women, men should be aware too.

1.4.      The changing age of the UK’s workforce means that between 75% and 80% of menopausal women are in work. Research shows that the majority of women are unwilling to discuss menopause-related health problems with their line manager, nor ask for the support or adjustments that they may need.

1.5.      This policy sets out the guidelines for members of staff and managers on providing the right support to manage menopausal symptoms at work. It is not contractual, and does not form part of the terms and conditions of employment – however, if the Practice wishes to amend the Menopause Policy, staff will be consulted on proposed changes.

2.         Aims

2.1.      The aims of this policy are to:

2.1.1.   Foster an environment in which colleagues can openly and comfortably instigate conversations, or engage in discussions about menopause.

2.1.2.   Ensure everyone understands what menopause is, can confidently have good conversations, and are clear on the Practice’s policy and practices, supported by Human Resources and where necessary Occupational Health.

2.1.3.   Educate and inform managers about the potential symptoms of menopause, and how they can support women at work.

2.1.4.   Ensure that women suffering with menopause symptoms feel confident to discuss it, and ask for support and any reasonable adjustments so they can continue to be successful in their roles or studies.

2.1.5.   Reduce absenteeism due to menopausal symptoms.

2.1.6.   Assure women that we are a responsible employer, committed to supporting their needs during menopause.

3.         Scope

3.1.      This policy applies to all Practice staff.

4.         Definitions

4.1.      Menopause is defined as a biological stage in a woman's life that occurs when she stops menstruating, and reaches the end of her natural reproductive life. Usually, it is defined as having occurred when a woman has not had a period for twelve consecutive months (for women reaching menopause naturally). The average age for a woman to reach menopause is 51, however, it can be earlier or later than this due to surgery, illness or other reasons.

4.2.      Perimenopause is the time leading up to menopause when a woman may experience changes, such as irregular periods or other menopausal symptoms. This can be years before menopause.

4.3.      Postmenopause is the time after menopause has occurred, starting when a woman has not had a period for twelve consecutive months.

5.         Symptoms of Menopause

5.1.      It is important to note that not every woman will notice every symptom, or even need help or support. However, 75% of women do experience some symptoms, and 25% could be classed as severe.

5.2.      Symptoms can manifest both physically and psychologically including, but not exclusively, hot flushes, poor concentration, headaches, panic attacks, heavy/light periods, anxiety, and loss of confidence. Some women also experience difficulty sleeping.

6.         Drivers

6.1.      The Practice has used guidance from ACAS and National Institute for Health and Care Excellence (NICE) guidelines, to inform this policy. The NICE guidelines set out the recommendations for medical professionals when treating menopausal women, and for patients as to the treatment and guidance they should be offered.

6.2.      Self-management, with support from Practice managers and colleagues, will help to manage symptoms. Appendix 1 details some recommendations to support symptomatic women and men, who may need advice and support. Appendix 1a is a template to assist you in recording conversations, and agreed actions and adjustments, with members of staff.

6.3.      In accordance with ACAS and NICE guidelines, women should be advised to seek medical advice from a health professional in the first instance. Appendix 2 offers a helpful guide for women on how to have constructive conversations about menopause with a health professional.

7.         Roles and Responsibilities

7.1.      Members of staff:

7.1.1.   All staff are responsible for:

  • Taking a personal responsibility to look after their health;
  • Being open and honest in conversations with managers/HR and Occupational Health;
  • If a member of staff is unable to speak to their line manager, or if their line manager is not supporting them, they can speak to HR
  • Contributing to a respectful and productive working environment;
  • Being willing to help and support their colleagues;
  • Understanding any necessary adjustments their colleagues are receiving as a result of their menopausal symptoms.

7.2.      Line Managers/Team Leaders (see Appendix 1 for Managers’ Guidance)

7.2.1.   All line managers/team leaders should:

  • Familiarise themselves with the Menopause Policy and Guidance;
  • Be ready and willing to have open discussions about menopause, appreciating the personal nature of the conversation, and treating the discussion sensitively and professionally;
  • Use the guidance in Appendices 1 and 2, signposting and reviewing together, before agreeing with the individual how best they can be supported, and any adjustments required;
  • Record adjustments agreed, and actions to be implemented;
  • Ensure ongoing dialogue and review dates;
  • Ensure that all agreed adjustments are adhered to.

Where adjustments are unsuccessful, or if symptoms are proving more problematic, the Line Manager may:

  • Discuss a referral to Occupational Health for further advice;
  • Ask HR to refer the employee to Occupational Health;
  • Review previously given Occupational Health advice, and implement any recommendations, where reasonably practical;
  • Update the action plan, and continue to review.

7.3.      Occupational Health

7.3.1.   The role of Occupational Health is to:

  • Carry out an holistic assessment of individuals as to whether or not menopause may be contributing to symptoms/wellbeing, providing advice and guidance in line with up-to-date research;
  • Signpost to appropriate sources of help and advice (refer to Appendix 2 for more information);
  • Provide support and advice to HR and Line Managers in determining and agreeing reasonable adjustments, if required;
  • Review the Menopause Advice Sheet (see Appendix 2), and keep this up to date.

7.4.      Human Resources (HR)

7.4.1.   HR will:

  • Offer guidance to managers on the interpretation of this Policy and Guidance;
  • Monitor and evaluate the effectiveness of this policy in respect of related absence levels and performance.

8.         Links to other policies

This policy is linked to:

  • Dignity at Work
  • Flexible working guidance
  • Health and Wellbeing Policy

9.         Appendices

  • Appendix 1 – Managers’ Guidance For Colleague Discussions;
  • Appendix 1a – Confidential Colleague Discussion Template; (not included on this webpage) 
  • Appendix 2 – Menopause Advice Sheet.

10.       External links

National Institute for Health and Care Excellence (NICE) guidelines. These explain how your health professional will determine what types of treatments and interventions they can offer you. You can find out more information by using this link. 

The National Health Service provides an overview of menopause. You can find more here. 

Menopause information. The Royal College of Obstetricians and Gynaecologists offer further information in a dedicated area of their website here. 

Premature Ovarian Insufficiency (POI) information and support on very early menopause. You can find out more here. 

Information on hysterectomy. This provides an insight into surgically induced menopause as a result of having a hysterectomy. Further details can be found here. 

A Government Report, researched by the University of Leicester’s School of Business has been published. Read more here Menopause transition: effects on  women’s economic participation.

Henpicked - this site provides information on managing menopause, and an insight into women's stories

The Menopause Exchange - a monthly newsletter e-mailed for free

Appendix 1

Managers’ Guidance for colleague discussions

We recognise that every woman is different, and it is, therefore, not feasible to set out a structured set of specific guidelines.

All advice is given, and written, in accordance with the ACAS recommendations and best practice.

If an employee wishes to speak about their symptoms, or just to talk about how they are feeling (they may not recognise themselves that they are symptomatic), or if a male employee wishes to speak about a family member, please ensure that you:

  • Allow adequate time to have the conversation;
  • Find an appropriate room to preserve confidentiality;
  • Encourage them to speak openly and honestly;
  • Suggest ways in which they can be supported (see symptoms below) – hand out the Menopause Advice Sheet (Appendix 2);
  • Agree actions, and how to implement them (you should use the template at Appendix 1a to record the meeting, so that all parties agree what has been discussed, and the next steps, before the meeting ends). Ensure that this record is treated as confidential, and is stored securely.
  • Agree if other members of the team should be informed, and by whom;
  • Ensure that designated time is allowed for a follow up meeting. Do not rely on quick queries during chance encounters in the corridor or staff room.

Symptoms Support

Symptoms can manifest both physically and psychologically, including, but not exhaustively or exclusively; support for women should be considered as detailed below:

Hot Flushes
  • Request temperature control for their work area, such as a fan on their desk (where possible a USB connected desk fan to ensure environmentally friendly) or moving near a window, or away from a heat source;
  • Easy access to drinking water;
  • Have access to a rest room for breaks if their work involves long periods of standing or sitting, or a quiet area if they need to manage a severe hot flush.
Heavy/light Periods
  • Have permanent access to washroom facilities;
  • Request an extra uniform if a uniform is provided.
  • Ensure storage space is available for a change of clothing.
Headaches
  • Have ease of access to fresh drinking water;
  • Offer a quiet space to work;
  • Offer noise-reducing headphones to wear in open offices;
  • Have time out to take medication if needed.
Difficulty Sleeping
  • Ask to be considered for a temporary adjustment to work pattern, particularly if suffering from a lack of sleep.
Low Mood
  • Agree time out from others, when required, without needing to ask for permission;
  • Identify a ‘buddy’ for the colleague to talk to – outside of the work area;
  • Identify a ‘time out space’ to be able to go to ‘clear their head’;
Loss of Confidence
  • Ensure there are regular Personal Development Discussions;
  • Have regular protected time with their manager to discuss any issues;
  • Have agreed protected time to catch up with work.
  • Promote the compassionate listeners network.
Poor Concentration
  • Discuss if there are times of the day when concentration is better or worse, and adjust working pattern/practice accordingly;
  • Review task allocation and workload;
  • Provide books for lists, action boards, or other memory-assisting equipment;
  • Offer quiet space to work;
  • Offer noise-reducing headphones to wear in open offices;
  • Reduce interruptions;
  • Have agreements in place in an open office that an individual is having ‘protected time’, so that they are not disturbed;
  • Have agreed protected time to catch up with work.
Anxiety
  • Promote the compassionate listeners network.
  • Identify a ‘buddy’ for the colleague to talk to – outside of work their area;
  • Be able to have time away from their work to undertake relaxation techniques;
  • Undertake mindfulness activities such as breathing exercises, or going for a walk.
Panic Attacks
  • Agree time out from others, when required, without needing to ask for permission;
  • Identify a ‘buddy’ outside of work area;
  • Be able to have time away from their work to undertake relaxation techniques;
  • Undertake mindfulness activities such as breathing exercises, or going for a walk.
  • Discuss whether the member of staff has visited a health professional. Depending on the discussion, this may be the next step suggested, particularly if the areas of difficulty are sleeping, panic attacks or anxiety.
  • If they have visited a health professional, and are being supported by them, it may be helpful at this point to make an Occupational Health referral to give specific advice regarding the workplace.

 

Appendix 1a

Confidential Colleague Discussion – Template

Member of staff’s details:

Name

 

Job Title

 

Department

 

Location (room number)

 

Summary of Discussion:

 

Agreed Actions/Adjustments:

 

Date of next review meeting: ____________________________________________

Signed (Member of staff):       ____________________________________________

Signed (Team Leader/Manager):           _________________________________________

 

Appendix 2

Menopause Advice Sheet – How to talk to your health professional about menopause

If you are suffering from menopausal symptoms to the point they’re getting in the way of you enjoying life, it’s time to talk to your health professional. But, sometimes, that’s easier said than done.

We all know how difficult it can often be just to get an appointment, and then it’s often only ten minutes. And talking about symptoms can be hard, let alone if you feel rushed or unprepared. So, what can you do? We’ve put together some helpful, straightforward tips to help you get the best from your appointment.

Don’t wait. It is all too common for women to feel they must simply ‘put up’ with menopausal symptoms as a part of life, but if they are affecting you, there are things you can do, and support available. There is no need to wait until symptoms feel unbearable.

Read the NICE guidelines. This stands for National Institute for Health and Care Excellence and these guidelines are what your health professional will use to determine the type of conversations to have with you and treatments to offer. There are guidelines for patients, which are really useful to read before you see a health professional, so you know what to expect.

Prepare for your appointment. It’s easier for your health professional to understand what’s going on if you provide them with all the information. That may sound obvious, but blood tests to say where you are on the menopause transition aren’t always available or accurate – your hormones can fluctuate daily during this time. So, your health professional will be thinking about what to recommend for you, based on your symptoms.

Keep a list of your symptoms, your menstrual cycle, hot flushes, how you’re feeling, and any changes you’ve noticed. Write them down, and take them to your appointment. Your health professional will thank you for it, and it’s more likely that together, you’ll find the right solution faster. And, if you have any preferences about how you manage your symptoms, tell them that too – for example, if you’d like to try hormone replacement therapy (HRT), or not.

Ask the receptionist which health professional is best to talk to about menopause. They are often the font of all knowledge at a surgery, and can help you find the best person to speak to – it might not be your usual contact, it could be someone who has had special training in the subject.

Ask for a longer appointment. If you don’t think your standard appointment will be long enough, try to book a double appointment, as some surgeries do offer this.

Don’t be afraid to ask for a second opinion. If you don’t feel you’ve received the help you need, ask to speak to someone else. Don’t be put off, you know how you’re feeling, and how it’s affecting you.

Ask if there is a menopause clinic in your area. Occasionally, there are regional clinics, specifically devoted to menopause. If there is one in your area, and you think this would be helpful, ask for a referral.

Take your partner or a friend with you. The chances are, you spend your life supporting others and, during menopause, it’s your turn to ask them for support. Your partner, or a friend, will know how the symptoms are affecting you. They could support you at the appointment, and also find out how they can continue supporting you.

What to expect from your health professional

There are certain things a health professional should – and should not – do during your appointment.

They should:

They should not:

  • Tell you that it’s just that time of your life. Yes, menopause is a natural stage, but please don’t feel that means you should have to put up with every symptom without help;
  • Tell you they don’t prescribe HRT. It’s up to you what you want to try, and for them to say whether it could be right for you, depending on your medical history;
  • Impose unnecessary time restrictions, such as they will only prescribe this once, or for a year or two. This is an ongoing conversation, and if your symptoms persist, you will still need help to manage them.

Remember, your health professional is there to help and support you, and you should feel comfortable and confident in talking to them about your symptoms, and any help you need. Don’t think you have to struggle through menopause when there is help and support available.