The Government scheme to reduce prescription costs for hormone replacement therapy (HRT) has gone ahead without the IT in place to support it, pharmacy negotiators have warned.
They have also sought guidance for GPs on how to manage the issue until IT systems are changed.
Patients using a HRT pre-payment certificate which came into force on the 1 April will hit problems if 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.
The Pharmaceutical Services Negotiating Committee (PSNC) said 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.
The certificate will reduce prescription costs to £19.30 per year, against a list of eligible HRT items including patches, tablets and topical preparations and it is thought around 400,000 women will be eligible.
As part of updated regulations, GPs are now required 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 listing HRT medicines as single-item prescriptions, but DHSC has not yet confirmed the timescale for this to happen, the PSNC said.
Some products not covered but may be prescribed in patients with menopause include citalopram, clonidine, duloxetine, escitalopram, evening primrose oil, sertraline, testosterone and venlafaxine, PSNC guidance said.
Pharmacists faced with mixed prescriptions have been advised by the Department of Health and Social Care (DHSC) to refuse to dispense.
The BMA had also raised the issue with LMCs, stating in its GPC England bulletin that: ‘GPCE supports the Government’s decision to make HRT medicines more accessible to patients at reduced cost, but we consider the introduction of this new prepayment certificate, specifically for HRT medicines, too complex.
‘We are disappointed that despite our advice, the DHSC has decided to proceed before the IT for automatic separation of prescriptions is ready.’
The BMA would not elaborate on what GPs should do.
PSNC chief executive Janet Morrison said HRT pre-payment certificate was a positive development for patients.
‘Indeed, we argued that these medicines should have been made available for free – but NHS systems have not kept pace with policy, meaning the certificate is launching without the IT in place to support it. This is totally unacceptable.’
‘DHSC has recognised the impact this will have on pharmacies we are 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.’