Easier HRT switches held up by GPs’ local rules

HORMONE replacement therapy campaigners and pharmacists have welcomed moves allowing women to switch between different types of treatment more easily – a month after The Mail on Sunday launched its ‘Fix the HRT Crisis’ campaign.

But they warned that, despite official assurances, local rules are still deterring GPs from prescribing the brands of HRT many women want.

On Friday, Government officials issued a Serious Shortage Protocol (SSP) enabling pharmacists to hand out substitute forms of HRT without the patient having to go back to her GP for a fresh prescription.

Dr Leyla Hannbeck, head of the Association of Independent Multiple Pharmacies, described the easing of the rules as ‘certainly a step in the right direction’ but said that GPs remained under pressure to limit the types of HRT they prescribe by local rules dictating which drugs they can routinely hand out.

NHS England guidance is meant to ensure prescribers are not restricted to drugs that appear on local health authorities’ ‘formularies’. Some authorities pare down these drugs, including types of HRT, for cost reasons. Others are slow to add new ones because of the bureaucracy needed to approve them.

One new form of HRT, Bijuve, which could act as a stopgap for women struggling to get hold of their normal treatment, has been approved in only a handful of areas so far, including Norfolk, Oxford and Somerset.

Dr Hannbeck said: ‘As healthcare professionals, the rule of thumb is, “If you act in your patient’s best interest, you should be fine.” But a lot prefer to stick to the local rules. It makes it easier for them.’

She believes that ‘everybody would benefit, patients most of all’ from a national HRT formulary making it clear exactly what GPs could prescribe everywhere.