HRT prepayment certificate could add to community pharmacy workload, says PSNC

The Pharmaceutical Services Negotiating Committee (PSNC) has said that it is ‘concerned’ that the implementation of the proposed HRT prepayment certificates ‘may cause additional workload and risks for community pharmacy teams.’

Currently, a prescription for HRT costs £9.35 or £18.70 if a woman needs two types of hormones. This is often only provided by GPs on a short-term basis, which means that the cost has to be paid regularly - once a month or every three months.

However, in November last year, the government announced that it would work with NHS England to look at implementing longer prescribing cycles, in line with NICE guidelines.

This would reduce the need to pay frequent prescription charges, meaning that women could save up to £205 a year by only paying one charge every 12 months.

The plan was delayed by a year, but last month in a Westminster Hall debate on the menopause, health minister Will Quince said that the prepayment certificate for HRT would be introduced by April 2023 ‘subject to consultation with relevant professional bodies’, which the DHSC confirmed would be the PSNC and the British Medical Association.

Gordon Hockey, PSNC’s legal director said: ‘PSNC is concerned that the implementation of a new type of prepayment certificate may cause additional workload and risks for community pharmacy teams. We are in discussion with DHSC on these issues and how best to mitigate them.’

In November last year, pharmacy teams told The Pharmacist that the proposal could be a ‘nightmare’ for pharmacy teams if not implemented correctly.

Ben Merriman, a practice and hospital pharmacist in Cumbria, said at the time that he was concerned about how the new Government policy would be implemented and how it could impact pharmacy financially and in terms of workload.

‘I cannot see an easy way of implementing the method proposed whereby women will only pay once per year — one charge for an oestrogen-only or continuous combined product and two charges for a cyclical combined product),’ he said.

‘GPs could prescribe a year of the HRT at a time, but this may not be appropriate for certain individuals. It would also impact pharmacies as there would be a reduction in dispensing fees and it could destabilise supply of these medicines, medicines which have had a very temperamental supply in the not-too-distant past,’ he added.