UPDATE: Hormone Replacement Therapy on PPC

HRT Prescribing For PPCs – GP IT update


Source: Community Pharmacy England

As announced in the NHS Primary Care bulletin (published 14 March 2024), over half of GP surgeries have
digital solutions available to automate the issuing of listed HRT items as single-item prescriptions at the
point of prescribing (separate prescriptions for each HRT item). This is something that NHS England and
Department of Health and Social Care (DHSC) had committed to enabling when the HRT Pre-Payment
Certificate (HRT PPC) was first introduced in April 2023.

NHS England and DHSC are continuing to work together with IT suppliers to implement changes across
all GP IT systems over the coming months. Click
here to read the source article in full.


  • In the meantime, where automation has not been introduced yet, please bear in mind that prescribers
    must manually issue all HRT items for patients on PPC’s as single-item prescriptions. This is because
    NHSBSA & dispensing systems are not designed to handle mixed charge prescriptions; a patient either
    pays for all items on the prescription or they are exempt from being charged.
  • The HRT PPC cannot be used to provide exemption from charges for any item not included on the HRT
    medicines list, even if the medicine is often used to treat the symptoms of menopause e.g. anti-depressants.
    HRT that is not licenced for use in the UK is also not in the scope of the HRT PPC e.g. testosterone.
  • Only HRT medicines published in the Drug Tariff Part XVI can be prescribed under the HRT PPC scheme,
    here for the Drug Tariff.
  • A digital solution will be introduced as soon as possible to automate the issuing of listed HRT items as
    single-item prescriptions at the point of prescribing.

Mixed Prescriptions

  • If a prescriber issues a mixed prescription in error (i.e. one that includes both listed HRT medicines and
    other medicines), they will need to issue to the patient new single-item prescriptions for any listed HRT
    items, alongside a separate prescription for the other items.
  • If a patient takes a mixed prescription to a dispenser, they will likely need to return to the prescriber to
    issue separate prescriptions for listed HRT items, having been unable to fill their prescription.

The Dispenser

  • should check evidence of a valid HRT PPC.
  • should confirm the items for which the HRT PPC is being used are on the HRT medicines list.
  • Place paper prescriptions in the exempt bundle.

For the DHSC’s full guidance please click here.

Further Resources

Dispex members can download our NEW HRT Prescription Sorting SOP here. As well as a patient’s HRT
poster, for display in the dispensary.