NHS England bars puberty blockers U18s: Pharmacists to navigate new regulatory hurdles

Pharmacy professionals asked to "advise, prescribe, dispense and administer medicines within limits" for cases related to gender incongruence or dysphoria

NHS England's decision to forgo commissioning puberty suppressing hormones (PSH) for children and young people, citing insufficient evidence of their safety and clinical effectiveness, follows a comprehensive review conducted by the National Institute for Health and Care Excellence (NICE) in 2020.

The clinical report underscores that "PSH treatment options will not be part of routine commissioning" for people under the age of 18 in England grappling with gender incongruence or dysphoria.

The NHS England review analysed nine observational studies on Gonadotrophin Releasing Hormone Analogues (GnRHa) and found no statistically significant difference in gender dysphoria, mental health, body image, and psychosocial functioning among children and adolescents treated with GnRHa.

Duncan Rudkin, chief executive of the General Pharmaceutical Council (GPhC), acknowledged the challenges faced by pharmacy professionals regarding prescriptions for puberty suppressing hormones, stating:

"We understand that some pharmacies are being presented with prescriptions for puberty suppressing hormones, and other medications relating to treatment for gender incongruence, that have come from prescribers working for private clinics based in Great Britain or overseas."

Rudkin emphasised identifying vulnerable individuals and offering support to lessen the negative effects of long waiting periods. He also stressed the need for clear referral pathways and shorter waiting times to discourage seeking unsafe alternatives online or through overseas clinics.

Directing pharmacy professionals in Scotland and Wales to adhere to relevant policies and seek guidance from local health boards if necessary, he highlighted the importance of delivering person-centred care within their training and competence.

"We expect health and care professionals to take account of relevant national and local policies and guidance, alongside our standards and guidance.

"For pharmacy professionals in England, this includes familiarising themselves with this clinical policy from NHS England and ensuring they take account of it when making decisions in relation to puberty suppressing hormones," Rudkin added, urging professionals to integrate the NHS England clinical policy into their decision-making processes.

In conclusion, while NHS England's decision not to commission puberty suppressing hormones reflects current evidence, pharmacy professionals are reminded of their duty to provide inclusive and compassionate care to all patients, including those with gender incongruence or dysphoria.