Building occupational and workplace support for nurses and midwives working in health and social care during menopause (BOOST)

The BOOST programme aims to co-design and co-produce holistic workplace support for women experiencing menopause. This preparatory 10-month study will generate the evidence and infrastructure required for a large-scale NIHR Work and Health Research funding application. Background A fifth of employees in the NHS are age 45-54 and 75% are female. Menopause typically occurs between ages 45- 55 meaning many NHS staff are experiencing it. Despite growing awareness many women report a lack of support with six in ten women saying menopause negatively impacts their work. Menopausal symptoms range from physical (fatigue, hot flushes, sleep disturbance), to psychological and cognitive symptoms (anxiety, depression, poor concentration, brain fog, low self-confidence) which fluctuate over time and affects the person in different ways. In the UK, 80-90% of women experience symptoms with 25% reporting these as severe and many struggle in silence. The menopause transition begins with perimenopause, during which individuals may sail through while others may experience diverse changes. In the workplace, these symptoms may pose significant challenges, and several studies have identified strong links between symptom severity, increased absenteeism, presenteeism, intentions to leave work, together with heightened psychological distress. The nurse s role requires balancing physical, emotional, cognitive, and organisational skills along with direct patient care, managing high workloads, navigating healthcare system demands and making critical decisions under pressure. Healthcare environments can be complex and inherently stressful places, and evidence shows healthcare workers are predisposed to severe menopause symptoms. The menopause journey can last for some time and many years; menopause symptoms together with often difficult and challenging work environments can affect quality of work life. The workplace can contribute to amplifying menopause symptoms, creating a cyclical pattern which needs deeper investigation across different the range of nursing and midwifery roles in healthcare organisations. Objectives: Establish an Expert Advisory Group. Build network of collaborators and stakeholders. Conduct a rapid review of workplace menopause policies. Map current organisational support. Conduct focus groups to explore nurses lived experiences. Develop recommendations tailored to clinical roles and settings. Develop full scale project protocol and funding application. Design and Methods A mixed-methods approach will be used across four interlinked work packages (WPs): WP1: Establish the collaborative network and expert advisory group. WP2a: Rapid review of evidence. WP2b: Organisational survey to map how policies are implemented. WP3a: Focus groups to explore lived experiences, practical challenges, and support needs across roles and settings. WP3b: Mixed method analysis. WP4: Develop recommendations and finalisation of a full research protocol. Monthly online workshops and writing retreats will take place ensuring real-time integration of emerging insights. We will use a participative and inclusive approach to ensure underrepresented groups are included. Impact We will gain a nuanced understanding of the menopause transition and how menopausal symptoms affect the working lives of nurses and midwives and the influence of role, ethnicity, cultural context, and clinical setting. An inclusive and sustainable approach to occupational and menopause support will underpin our evidence informed recommendations and future work.