The British Medical Association (BMA) has declared its disappointment that the HRT pre-payment certificate (PPC) was launched before GP computer systems were updated to automate separate prescriptions for HRT and other items.

In a bulletin sent on behalf of its GP Committee in England (GPCE), the BMA said that 'GPCE supports the government’s decision to make HRT medicines more accessible to patients at reduced cost', but considered the introduction of the HRT PPC 'too complex'.

It added: ‘We are disappointed that despite our advice, the DHSC has decided to proceed before the IT for automatic separation of prescriptions is ready.’

The new HRT PPC, which came into force on 1 April, will reduce HRT prescription costs to £19.30 per year, and can be used against a list of eligible HRT items including patches, tablets and topical preparations. It is thought around 400,000 women will be eligible.

But other products that may be prescribed in patients with menopause, including citalopram, clonidine, duloxetine, escitalopram, evening primrose oil, sertraline, testosterone and venlafaxine, are not covered by the HRT PPC.

Patients will run into problems if listed HRT items and other medicines are issued on the same prescription because it cannot be processed as both ‘exempt’ and ‘paid’ at the same time.

Instead, GPs have been asked to write a separate FP10 form for each item covered by the HRT pre-payment certificate.

It is been proposed that prescribing systems should automate the process of listing HRT medicines as single-item prescriptions, but DHSC has not yet confirmed the timescale for this to happen, the Pharmaceutical Services Negotiating Committee (PSNC) said.

PSNC added that they had raised the issue with ministers directly, warning it could cause extra workload and confusion for patients, and that it should have been solved before roll out began.

Pharmacists faced with mixed prescriptions have been advised by DHSC to refuse to dispense.

PSNC chief executive Janet Morrison said that it was 'totally unacceptable' that 'NHS systems have not kept pace with policy', resulting in the certificate being launched without the IT in place to support it.

She added that DHSC 'has recognised the impact this will have on pharmacies', and said that the negotiating body was pressing for appropriate financial compensation for pharmacy owners.

‘We have also sought guidance for GPs, and now published our own guidance to try to make the launch go as smoothly as it can for pharmacy teams.’

Ms Morrison also said that the HRT PPC was a positive development for patients, but added that making HRT medicines free-of-charge items would be easier for pharmacy teams to implement and more cost-effective.

While Thorrun Govind, England chair of the Royal Pharmaceutical Society, has welcomed the introduction of the PPC making HRT more affordable but said ‘it remains inequitable that people with other long term conditions still have to pay the prescription charge which is in effect an unfair tax on health’.

A version of this article first appeared on our sister publication, Pulse.