Letter from the Chief Inspector of General Practice
We rated this service as
Good
overall. We have not previously inspected this service.
The key questions are rated as:
Are services safe? – Good
Are services effective? – Good
Are services caring? – Good
Are services responsive? – Good
Are services well-led? – Outstanding
We carried out an announced comprehensive inspection at Online Menopause Centre on 14 March 2022 and completed a short site visit on 17 March 2022 as part of our inspection programme.
The Online Menopause Centre launched in 2020 and provides online consultations to ladies predominantly between the ages of 40 and 60 years old, experiencing the menopause or perimenopause. Menopause is the stage in a female’s life when periods (menstruation) cease, usually occurring between the ages of 45 and 55 years old. This may happen suddenly, or periods may become less frequent over the preceding months prior to coming to a complete cessation. Perimenopause is described as the period of time in which hormonal changes are occurring. During this stage of transition, symptoms start to be displayed in females. For example: night sweats; mood changes; and weight gain.
Advice on hormonal balancing as an addition to the initial treatment and to maximise effectiveness (known as an “adjunct treatment”) is also provided for the following conditions:
- Thyroid dysfunction
- Osteoporosis
- Pre menstrual syndrome (PMS)
- Polycystic ovary syndrome (PCOS)
- Endometriosis
At this inspection we found:
- The service had good systems to manage risk so that safety incidents were less likely to happen. When they did happen, the service learned from them and improved their processes.
- The service routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
- Staff involved and treated people with compassion, kindness, dignity and respect.
- Patients could access care and treatment from the service within an appropriate timescale for their needs.
- There was a strong focus on continuous learning and improvement at all levels of the organisation.
We saw the following areas of outstanding practice:
- Online Menopause Centre had implemented a function on their video consultations to allow for an interpreter or sign language facility to be utilised when needed. This helped to improve accessibility to those patients who did not speak English as a first language or were hard of hearing.
- The provider was proactive in developing the service in response to needs. For example, at the beginning of 2022, a “live chat” feature was implemented on to the provider’s website. This is managed by an external company, who Online Menopause Centre have provided a comprehensive information pack to, which helped to inform the conversation and allowed for non-clinical advice to be given outside of standard working hours. In addition, the clinical director explained that Online Menopause Centre would receive transcipts of all conversations, and use this to identify trends (i.e. if commonly asked questions were arising, the frequently asked questions section on the website would be updated). Additionally, the clinical director maintained open channels of communication with the clinical records system they used, meaning that potential improvements to their system could be implemented quickly.
- The service contributed nationally to the field of menopause through production of the “Annual Menopause Report”. The report surveyed 455 women to obtain a greater understanding of what was understood about various aspects of menopause. This report was then shared with health journalists, the media, and on Online Menopause Centre’s social media platforms. In particular, the service identified that 47% of women did not feel as though there was enough freely available information on the menopause / perimenopause to access. In response to this, Online Menopause Centre introduced a free “menopause café” which was held virtually every month. The team would proactively source guest speakers who also had menopause expertise to cover other topics, such as exercise, prolapse and sexual dysfunction. In addition, a number of other free resources were made available on the service’s website, such as blog updates, videos and monthly newsletters.
The areas where the provider should make improvements are:
- Ensure a standardised approach is implemented for all patients new to the service, even those who have migrated from a previous service. For example, ensuring that all patients have completed the same registration forms and consent forms which pertain directly to Online Menopause Centre.
Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care