DHSC to address ‘any loopholes’ in prescribing practices following Cass Review

The Department of Health and Social Care (DHSC) is looking to address ‘any loopholes’ in prescribing practices following a major review into gender identity services for children and young people, the pharmacy minister has said.

This includes working with the General Pharmaceutical Council (GPhC) to ‘define the dispensing responsibilities’ of pharmacists providing private prescriptions, Dame Andrea Leadsom added.

Her comments came as part of a written response to a question about how she planned to ensure that online pharmacies adhere to NHS clinical guidance when supplying puberty suppressing hormones to individuals in the UK with gender incongruence or dysphoria.

Dame Andrea responded that ‘all community pharmacists, whether working on a high street or online, have a duty of care to their patients’.

She added: ‘We would expect pharmacists to take reasonable steps to ensure that all the medicines they dispense are against legally valid prescriptions, and appropriate for the patient under the authority of the prescriber.’

But she said: ‘While pharmacists are responsible for a final clinical check, ultimately the responsibility for the product prescribed rests with the prescriber.’

‘We are looking closely at what can be done to address any loopholes in prescribing practices, including work with the GPhC to define the dispensing responsibilities of pharmacists providing private prescriptions, as recommended by the Cass Report,’ Dame Andrea added.

A new NHS England (NHSE) policy, published last month, sets out that puberty supressing hormones are not available as a routine commissioning treatment option for treatment of children and young people in England who have gender incongruence/gender dysphoria.

At the time, the GPhC issued a response statement instructing pharmacists to ‘take account’ of the guidance and take ‘active steps’ to assess whether prescribers, including those in private clinics based outside the UK, comply with latest policy.

And the recently published final report of the Cass Review recommended that the GPhC and DHSC work together to ‘define the dispensing responsibilities of pharmacists of private prescriptions and consider other statutory solutions that would prevent inappropriate overseas prescribing'.

While the Cass report’s recommendations and the NHSE guidance apply to England, GPhC chief executive Duncan Rudkin recently said it would be important to also take into account the context and evidence gathered in Scotland and Wales.

And he confirmed in a council meeting last week that he had reached out to the DHSC to begin the process of engagement to take this recommendation forwards.

One council member raised concerns that the GPhC was not yet in a position of providing clarity to dispensers who might be presented with a private prescription for puberty supressing hormones.

And Mr Duncan stressed that clarifying the role of pharmacists in dispensing private prescriptions would be a ‘key theme’ as part of this work.

In a comment to The Pharmacist today, the GPhC said it was ‘carefully considering the final report from the Cass Review in full’ as well as ‘any communications or other actions’ that it may need to take in response.