Via @quarridors, it appears as if Nottinghamshire are blocking Trans patients from accessing HRT and in the process rather unnecessarily burning money.

Late last year and rather quietly, a number of GID-related medications including Testosterone, Estrogen and Goserelin were added to the “Red list” of drugs which cannot be prescribed by GPs. This came to light when one GP refused (Or was unable) to prescribe Testoserone to one Transman.

The intent here seems clear. It’s not just that GPs require specialists to recommend the drug, as otherwise it would be on one of the “Amber” lists. Instead, any prescription must be written by the Gender Identity Clinics.

This has two effects. In the short term, the GIC has no prescription budget so can’t prescribe and patients are not getting the treatment they need.

Secondly is what happens post-surgery. Typically, a patient would be looked after by their GP, who will write a prescription. In the case of transwomen this will often make the NHS money, as Estrogen costs less than the NHS Prescription charge.

Under Nottinghamshire’s rules, it appears that patients will need to continue seeing their GIC to get prescriptions, at a cost of a couple of hundred pounds a time. There is an FoI request in the pipeline to try to find out why this has happened, but I cannot conceive of any clinical reason. It does seem that Nottinghamshire are trying to save money and are not only risking patients health but have not thought through the consequences of their actions and will end up costing themselves more in the long run.

(The other option is that they’ve read too much Daily Mail and are just trying to block Trans treatment at all… but no PCT would act unlawfully to do that now, would they…?)