Hormone Replacement Therapy (HRT)

ID

RM186

Version

1.0.1

Type

Roadmap Item

Frameworks

Title

Hormone Replacement Therapy (HRT)

Description

GP Clinical Systems in England to generate a separate prescription for each Hormone Replacement Therapy (HRT) medication for the treatment of menopause symptoms.

Date Added

May 15, 2023

Standards and Capabilities

Prescribing

Change Route

Managed Capacity - Minor

Change Type

Uplift

Status

Closed

Publication Date

Dec 8, 2023

Effective Date

Jul 1, 2024

Incentives / Funding

Yes

Incentive / Funding Dates

Suppliers will be paid the lesser of:

(a) the Supplier’s costs in meeting the requirement; or

 (b) £50,000

 the “Incentive Payment

The Supplier shall provide to the Authority a detailed breakdown of its costs in meeting the requirement and the Authority shall confirm its acceptance of these costs prior to it commencing with the requirement.

The Incentive Payment will be payable only if the Supplier shall complete the requirement to such an extent that it is ready for and has been submitted to the Authority for assurance by the 31st of March 2024

Payment Rules

As above

Background

The Government has committed to reduce the costs of Hormone Replacement Therapy (HRT) through a new bespoke HRT pre-payment certificate which was introduced on 1st April 2023. The Department of Health and Social Care (DHSC) consulted with the representative bodies for general practitioners and pharmacists (the General Practitioners Committee England and Pharmaceutical Services Negotiating Committee) regarding the introduction of a new HRT pre-payment certificate for the treatment of menopause, and its potential impact on existing processes.

In order to effectively introduce the HRT pre-payment certificate, it is necessary to prescribe each licensed HRT medication individually, as defined in regulation 56 of the GMS Regulations. This ensures separation from any other medications prescribed simultaneously (HRT PPC guidance | NHSBSA).

To support General Practices in creating separate prescriptions for each item listed in the Part XVI – Notes on Charges of the Drug Tariff, changes need to be made to GP Clinical Systems so that separate prescriptions are automatically generated.

Outline Plan

All Foundation Suppliers must be compliant against this specification by the Effective Date. Prior to going live Suppliers must have completed the Solution Assurance by NHSE.

Summary of Change

Prescribing: MUST Epic added

E00623 - separate prescription for licenced Hormone Replacement Therapy (HRT) medication for the treatment of menopause symptoms

As a Health or Care Professional

I want to create a separate prescription for each prescribed licenced HRT medication for the treatment of menopause symptoms

So that each licenced HRT medication for the treatment of menopause is created on a separate prescription

Acceptance criterion 1: separate prescription for each licenced Hormone Replacement Therapy (HRT) medication for the treatment of menopause symptoms

Given the Health or Care Professional is permitted to create prescriptions 

When the Health or Care Professional selects to create a prescription for multiple prescribed medications

And any of the prescribed medications are licenced HRT medication for the treatment of menopause symptoms

Then a separate prescription is created for each licenced HRT medication for the treatment of menopause symptoms

And another prescription is created for all other medications

E00623 - Additional Implementation Details

Solutions MUST comply with the following when implementing this Epic:

  • Licenced HRT medications for the treatment of menopause symptoms will include all medications listed here

  • Mapping between medication in the list and the Solution to be done using SNOMED codes

E00623 - Supporting Information

  • See HRT PPC guidance and the amendment of regulation 56 of the GMS Regulations for further background

  • See NHS Electronic Drug Tariff Part XVI for the notes on charges across the UK

  • Example scenarios for creating a separate HRT prescription MAY include, but are not limited to:

    • Patient is prescribed a single licenced HRT medication for the treatment of menopause symptoms, then a single prescription is created for that medication

    • Patient is prescribed multiple licenced HRT medications for the treatment of menopause symptoms, then a separate prescription is created for each medication

    • Patient is prescribed a combination of licenced HRT medication for the treatment of menopause symptoms and other medications, then a separate prescription is created for each licenced HRT medication, and another prescription is created for the other medications

Full Specification

Prescribing v2.0.0

Assurance Approach

  • Suppliers will be asked to submit video evidence of test scenarios

  • Suppliers will be asked to provide evidence to the NHSE EPS Clinical Team on the process of UUID’s and tokens

  • Suppliers will be asked to provide a statement on how the system will handle certain scenarios. (e.g. bulk signing)

  • Suppliers will be asked to provide a change request once the test scenarios are reviewed to effect changes in the Live environment

  • No assurance will be required from CSG or clinical drop in

  • Assurance test plans will be provided by the EPS Clinical Team