Hormone replacement pre-payment certificate exemption

This functionality will be available in ProScript Connect v1.29.0

From 1 April 2023, patients in England who usually pay for their Hormone Replacement Therapy (HRT) prescriptions will be able to purchase an annual HRT Pre Payment Certificate (HRT PPC).

The HRT PPC, valid for 12 months, can be used against an unlimited number of listed HRT items, such as patches, tablets and topical preparations. There will be no limit to how many times the certificate can be used while it is valid.

A patient with only the HRT PPC will continue to pay the prescription charge for any other (non-HRT) medicines (unless another exemption reason applies).

The eligible HRT items will be flagged within the ProScript Connect drug database. Details will be added to the Drug Information tab of the PMR, which can be viewed whilst dispensing an HRT item.

Updating a patient exemption to a HRT PPC

  1. From the ProScript Connect Main Screen, search for and select a patient.
  2. From the Patient Medication Record, click [F1-Patient Details]. 
  3. The Edit Patient Details form displays in a pop-up window.
  4. Edit the Exemption Details and select W-HRT only Prescription repayment certificate.

  5. Add the Certificate number, Expiry and Checked dates if required.

    By adding the expiry date, from the PMR category Edit Application setting, you can use the Exemption Expiry Warning Days to configure the number of days to be warned before a patient’s exemption expires when loading the PMR.

  6. When you are done, click [F10-Save]. 
  7. The patient’s exemption is updated to ‘W’.
    The HRT PPC exemption ‘W’ will now be automatically applied to any prescriptions for eligible HRT items.

For patients with the exemption ‘W’ applied, prescriptions for non-HRT items will automatically default to being marked as ‘paying’. There is no need to manually amend the exemption for non-HRT item prescriptions.

Dispensing a HRT prescription for patients without a HRT PPC

    1. From the ProScript Connect Main Screen, search for and select a patient marked as ‘Paying’.
    2. The Patient Medication Record displays.
    3. Highlight the ENTER – Add New Item text in the first quadrant of the PMR and select [ENTER] on your keyboard.
    4. The Dispense New Prescription window displays. Notice the Select Prescribed Item tab is selected.
    5. Search for and select the required eligible HRT item(s).
    6. Enter the required quantity and dosage information.
    7. When you are done, select [F8-Last Item]. 
    8. The HRT Exemption Alert window will open.
    9. Select Yes to open the Patient Details window to update the patient exemption to ‘W’ and add the HRT PPC details if applicable.
    10. Select No to continue with the patient exemption Not Exempt. 
    11. The Prescription Type Preview window appears with the exemption saved as Paying Patient.
    12. Select [F10-Save]. 
      The system will generate the endorsement, drug label(s), bag label and tracking label (if configured). The ProScript Connect main screen displays.

Managing Prescriptions with mixed eligibility items

While GPs will be required to write HRT items on separate prescriptions, on occasion both a HRT item and another medicine will be prescribed on the same prescription as a mixed prescription. This presents a problem for a patient who has a HRT PPC because a prescription cannot be processed as both ‘exempt’ and ‘paid’ within the NHS prescription processing and pricing systems.

PSNC guidance

PSNC advises that the new regulations give three options to pharmacists facing mixed prescriptions presented by patients with an HRT PPC.

  1. Explain to the patent that you are unable to dispense a mixed prescription and ask the patient to return to the GP for two separate prescriptions.
  2. If the patient has an urgent clinical need for the HRT or other medicine, either:
    • Dispense only the listed HRT item (the patient or the patient’s representative signing to claim the HRT prescription exemption) and endorse the non-HRT item as ND, or;
    • Dispense the other non-HRT medicine(s) with the prescription charge(s) paid and endorse the HRT item as ND.

      The patient will need to obtain another prescription for any items not dispensed.

  1. Dispense both the listed HRT item and the other medicine, then complete an FP57 refund form for the HRT item and charge for the other medicine.