Pharmacists must not be criminalised over puberty blocking hormones, warns RPS

This news story was published when the organisation was the Royal Pharmaceutical Society.  In light of confirmation by Judicial Review that the emergency prohibition order for puberty blocking hormones remains valid, the Royal Pharmaceutical Society is concerned about the potential criminalisation of pharmacists who dispense these medicines and calling for patients to have timely access to specialist care pathways for support. The emergency prohibition makes it a criminal offence to supply puberty blockers outside the terms of the order. RPS is concerned this may inadvertently result in pharmacists declining to supply these medicines at all for fear of prosecution, which will negatively affect patient care. For example, these medicines can still be legitimately supplied to under 18s for very early onset of puberty (usually caused by another condition), to people under 18 with gender dysphoria already in treatment, and to people aged 18 and over. The order also criminalises pharmacists who unknowingly break the law through no fault of their own, such as when a patient misleads the pharmacist about their clinical condition, age or identity. The speed at which the ban was issued could also mean there are some pharmacists who are not yet aware of it and inadvertently dispense a prescription. Normally a ban has an advance ‘run-in’ period so healthcare professionals can be made aware of it and understand their responsibilities. The absence of advance notice means a prosecution could take place which would not be in the public interest. RPS has raised concerns about the potential criminalisation of pharmacists with the Department of Health and Social Care on behalf of the profession and civil servants recognise this risk. We urge the Government to consider a solution which protects patients but doesn’t unfairly criminalise pharmacists. It is helpful that the Judicial Review has shone a spotlight on the need to support children and young people who were prescribed puberty blockers prior to the banning order and are now struggling to access UK registered health services. It is challenging for pharmacy teams to support children and young people with gender incongruence and gender dysphoria due to the lack of comprehensive regulatory or clinical guidelines. This means there is often no easily accessible referral pathway* to link people to the treatment and care they need, including mental health support.  In line with the Cass Review, RPS is calling on the Government to provide timely access to specialist care pathways to support patients who are awaiting consultation, or who cannot access medicines they were previously taking, so they receive the necessary care. Read our full position statement. *In England, Wales and Scotland, current NHS advice is for pharmacists to refer patients back to their GP. In England, GPs can then refer patients, if appropriate, to the National Referral Support Service for CYP Gender Services, where patients should be able to access to mental health support if they wish while waiting to be seen by the specialist service. In Scotland, patients can be referred to gender identity services by their GP. These services are located within NHS Greater Glasgow & Clyde, NHS Lothian, NHS Highland and NHS Grampian. Further information and contact details can be found on the National Gender Identity Clinical Network for Scotland website. In Wales, GPs can refer patients to the Welsh Gender service. These referral services all have extensive waiting lists. Read more RCPharm news stories.