Pharmacies should take ‘active steps’ to assess whether prescribers, including those in private clinics based outside the UK, comply with latest policy on puberty supressing hormones, the General Pharmaceutical Council (GPhC) has said.

The NHS England policy, published earlier this month, sets out that puberty suppressing hormones are not available as a routine commissioning treatment option for treatment of children and young people who have gender incongruence or gender dysphoria.

And the GPhC has said that pharmacists in England should take account of this when making decisions regarding puberty suppressing hormones, including when presented with prescriptions from private clinics or those based outside England.

In a statement released on 21 March, Duncan Rudkin, chief executive of the GPhC, said: ‘We expect health and care professionals to take account of relevant national and local policies and guidance, alongside our standards and guidance.

‘For pharmacy professionals in England, this includes familiarising themselves with this clinical policy from NHS England and ensuring they take account of it when making decisions in relation to puberty suppressing hormones.’

Mr Rudkin said he understood that some community pharmacies ‘are being presented with prescriptions for puberty suppressing hormones, and other medications relating to treatment for gender incongruence, that have come from prescribers working for private clinics based in Great Britain or overseas’.

And he added that the regulator expected pharmacies to take ‘active steps’ to ‘assure themselves that all prescribers, including those working for private clinics based outside the UK, comply with relevant UK and national regulatory and professional guidance’.

He said that pharmacy teams should ‘provide person-centred care, within the current relevant legal and regulatory context’.

And they should ‘advise on, prescribe, supply, dispense or administer medicines within the limits of their training, competence and scope of practice’.

Mr Rudkin highlighted a GPhC article advising on ‘inclusive and compassionate care’ within services relating to gender incongruence in children and young people, ‘including supporting vulnerable and at-risk patients, and making decisions about the clinical appropriateness of medicines’.

He also said that pharmacies needed to be able to identify vulnerable or at risk patients who may be experiencing a ‘significant negative impact’ on their mental health due to long waiting lists for gender incongruence or dysphoria assessment and treatment.

And he asked ‘all organisations involved in providing these types of services’ to ensure that there were ‘clear routes for pharmacy professionals in their country or area to refer children and young people for the support and care they may need’, as well as working to reduce waiting times ‘as far as possible’.

‘Otherwise we’re mindful that people may try to seek alternative options such as sourcing unregulated products online or through private clinics outside of the UK which exposes them to additional risks,’ Mr Rudkin warned.

A spokesperson for the Royal Pharmaceutical Society (RPS) told The Pharmacist that situations around puberty suppressing hormones were ‘complex’.

‘Pharmacists must assess each case individually and consider available referral pathways to NHS care when in receipt of prescriptions for puberty suppressing hormones,’ they said.

And they added that their Professional Support Service was available to RPS members ‘for one-to-one advice on navigating these challenges’.

Commenting on the introduction of the policy, an NHSE spokesperson told The Pharmacist: ‘This update of the national clinical policy for gender affirming hormones (cross sex hormones) as an option for young people around 16 with continuing gender incongruence or gender dysphoria continues to be subject to strict eligibility and readiness, and now includes assessment by a national specialist multi-disciplinary team to ensure clinical consensus is reached before life changing medical treatment is initiated.’