Changes are being made to pharmacy IT systems ready for the HRT prepayment certificate (HRT PPC) to go live on 1 April, PMR suppliers have confirmed.

Cegedim Healthcare Solutions, which supplies the Pharmacy Manager PMR system, told The Pharmacist that for EPS Release 2 prescriptions, pharmacy staff will be required to manually select an exemption at prescription form level, as and when a prescription is received for an HRT medicine, and the patient has an HRT PPC, while paper scripts should be marked as ‘No Patient Charge’.

This will rely on patients presenting pharmacy teams with their HRT PPC, and pharmacy staff manually identifying the HRT medication on the prescription.

Cegedim said that this functionality will be automatically enabled on 1 April for all customers on a supported version of Pharmacy Manager PMR, as it has now received confirmation from the NHS Business Services Authority (NHSBSA) that the service will definitely begin on 1st April.

Cegedim said that initial guidance around the HRT PPC was very limited but that possible enhancements would be considered at a later date if more concrete and defined guidance was issued to suppliers – for instance, the publication of an HRT medicines list.

It also said that it was awaiting confirmation of what pharmacy teams should do around payments a patient may need to make for non–HRT items on a mixed item prescription, as well as what would need to be selected on the older style prescription forms, if still in circulation by April.

Cegedim has tested the approach internally and validated with pharmacy end users, and has received support on the implementation from NHS Business Services Authority (NHSBSA) and the Pharmaceutical Services Negotiating Committee (PSNC).

It said that it plans to roll out the changes to all sites by 1st April and will keep in contact with NHSBSA on its progress. It added that as yet, no workaround has been communicated by DHSC or NHSBSA regarding any pharmacy not on a version of software that supports HRT PPC on 1 April 2023.

A spokesperson for Positive Solutions said that it had also implemented the necessary changes. The Pharmacist has approached other community pharmacy PMR suppliers for comment.

A spokesperson for PSNC said in January that it remains concerned that community pharmacies will not be ready to start delivering the HRT PPC from April 2023.

PSNC was still awaiting further details of the proposals from DHSC which are yet to be finalised and agreed, the spokesperson added.

Given the very short deadlines for implementation, PSNC said that it was also concerned about the ability of IT system suppliers to fully develop, test and deploy the new functionality into PMR systems by 1 April.

The process for patients

The process for patients to apply for the certificate is currently in development with NHSBSA, who will be responsible for implementing the patient-facing system.

A pilot, running from February to March 2023, will engage with potential users of the certificate, with around 1,000 members of the public planned to take part. It does not include testing with community pharmacies.

A spokesperson for NHSBSA told The Pharmacist: ‘The pilot phase enables the NHSBSA to test the online service to ensure that it is fit for purpose prior to the service going live. This is a usual stage of the development of an online service.’

Gordon Hockey, PSNC’s legal director, told The Pharmacist in January that PSNC was fully supportive of the idea to make HRT medicines available to women at a reduced cost, but said that the negotiating body would go a step further and support making all HRT medicines free-of-charge items, similar to contraception.

‘We believe this would be easier to implement and more cost-effective,’ he said.

Mr Hockey added that PSNC was concerned that the implementation of a new type of prepayment certificate will cause additional workload and risks for community pharmacy team.

He told The Pharmacist in January: ‘We wrote to Ministers about this last November: we expect to meet with them soon about this. We still hope to work with Minister and the Department to mitigate these risks, although time is now getting worryingly short and we are still awaiting more details on the proposals from the Department.’

A recent survey by Healthwatch England found that one in ten patients have avoided taking up an NHS prescription because of cost.