The Department of Health and Social Care (DHSC) has introduced pharmaceutical regulations to accompany the introduction of the HRT PPC.

The  National Health Service (Amendments Relating to Pre-Payment Certificates, Hormone Replacement Therapy Treatments and Medicines Shortages) Regulations 2023  take effect on 1 April 2023.

GPs in England will be required to write HRT items on separate prescriptions, as mixed prescriptions cannot be processed as both ‘exempt’ and ‘paid’ within the NHS prescription processing and pricing systems.

Pharmacy regulator PSNC has issued this advice on the options to dispensers facing mixed prescriptions presented by patients with an HRT PPC:

First, ask the GP to reissue the prescription as two separate prescriptions.

Second, either:

• dispense only the listed HRT item (the patient or the patient’s representative signs to claim the HRT prescription exemption), or
• dispense only the other non-HRT medicine(s) with the prescription charge(s) paid.  The GP will need to issue another prescription for any items not dispensed.

Third, dispense both the listed HRT item and the other medicine – and ask the patient to complete an FP57 refund form for the HRT item and charge for the other medicine.