Government should consider ways to prevent ‘inappropriate overseas prescriptions’ of hormone drugs, review recommends

The final report of the Cass Review into Gender Identity Services (GIDS) will see the Department of Health and Social Care (DHSC) working with the General Medicines Council (GPhC) to examine how the law will prevent inappropriate prescribing overseas. We recommended that we consider whether this can be prevented.

The Independent Review of Gender Identity Services for Children and Young People, led by Hilary Cass, former Dean of the Royal College of Paediatrics and Child Health, was commissioned by NHS England to Recommendations were made to ensure that gender dysphoria is available to those who use it. High standards of care are available to those who need support regarding their gender identity.

The review’s final report, published on 10 April 2024, includes feedback from focus groups, with some respondents stating that they were “not eligible for private provision while on the GIDS waiting list”. “Families are trying to balance the risk of obtaining unregulated and potentially dangerous hormones.” Traumas that have been waiting for long-term evaluation are available on the Internet. ”

The report said this was “less than a hope[that]NHS regulations are It is considered a “forced choice” (because of unavailability).

The report also states that “clinicians who identify that young people are receiving drugs from unregulated sources need to make young people and their families aware of the risks of such treatment.” There is.

As a result, the review recommended that “DHSC should work with GPhCs to define pharmacists’ dispensing responsibilities for private prescriptions and consider other legal solutions to prevent inappropriate prescribing overseas.” are doing.

In response, GPhC stated as follows: of pharmaceutical journal “We will carefully consider the report and identify any further communications or actions we should take accordingly.”

On 21 March 2024, the GPhC issued a statement stating that due to the lack of clear referral routes for people experiencing gender dysphoria, unregulated products are sourced online and through private clinics outside the UK. They warned that they may seek alternative options, such as

This comes after NHS England announced on 12 March 2024 that it no longer recommends the use of puberty-suppressing hormones, also known as puberty blockers, as a routine option in the treatment of children and young people with gender dysphoria or gender issues. This follows the presentation of the clinical policy. Discomfort.

In May 2021, the Care Quality Commission (CQC) introduced legislative changes to improve its ability to regulate independent primary care providers, including those who dispense medicines prescribed overseas in the UK. However, he said this would “put people’s lives at risk”.

In July 2023, the Government’s response to a review of CQC’s activities stated: ‘DHSC will work with CQC to ensure “We are discussing and identifying whether there are any activities being carried out.” ”.

GPhC chief executive Duncan Rudkin told the House of Commons Health and Social Care Select Committee Inquiry into the Future of Pharmacy in January 2024 that the pharmacy regulator is reconsidering the area and is considering its own changes to the law. He said he is considering issuing a recommendation. .

In a statement given to pharmaceutical journal After the committee hearing, Rudkin said: “We understand that the CQC is calling for legislative changes to effectively regulate independent providers of online primary care services and protect patients from harm.

“This includes in scope CQC regulated providers who only employ prescribing pharmacists to provide non-NHS prescription services that are not linked to the provision of pharmacy services at or from a registered pharmacy. Contains suggestions.

“We are mindful that our powers do not permit us to regulate or inspect services provided by pharmacists who do not have a registered pharmacy, and we support the expansion of the CQC’s powers in this respect. I support you.”