Health secretary Victoria Atkins has vowed to “curtail any loopholes” allowing online providers to supply puberty suppressing hormones (PSH) to under-18s in England following recent NHS guidance stating that PSH should no longer be “routinely available”.

In a House of Commons debate this week following the publication of Hilary Cass’s review of gender identity services for children and young people, Ms Atkins said: “It is morally and medically reprehensible that some online providers not registered in the UK have stated their intention to continue to issue prescriptions to children in this country.

“I am looking closely at what can be done to curtail any loopholes in prescribing practices, including legislative options. Nothing is off the table, and I will update the House in due course as we progress that work at pace.” 

The Cass review referred to concerns about “the use of unregulated medications and of providers that are not regulated within the UK” and stated that GPs should not “be expected to enter into a shared care arrangement with a private provider, particularly if that private provider is acting outside NHS guidance”.

“Pharmacists are responsible for ensuring medications prescribed to patients are suitable,” the review stated, adding that the Department of Health and Social Care “should work with the General Pharmaceutical Council to define the dispensing responsibilities of pharmacists of private prescriptions and consider other statutory solutions that would prevent inappropriate overseas prescribing”.

In the Commons debate on Monday April 15, Ms Atkins warned clinicians that prescribing is “a highly regulated activity” and that the Care Quality Commission “has not licensed any gender clinic to prescribe hormone blockers or cross-sex hormones to people under the age of 16”.

In addition to the revised March 12 NHS England policy on PSH, which states that the treatment should only be available under a research protocol, on April 10 – the date of publication of the Cass review – NHSE stated that it “is stopping children under 18 from being seen by adult gender services with immediate effect,” said Ms Atkins.

On March 21 the GPhC published a statement in light of the policy change in England and urged pharmacy professionals there and in Scotland and Wales to “take account of relevant national and local policies and guidance” as well as the regulator’s own standards and guidance.

The GPhC urged pharmacy professionals to be aware of the “impact of waiting times on mental health and the role of pharmacy professionals in identifying children, young people and families who may be vulnerable at risk, and signposting them to appropriate support services”. 

In meeting papers published this week, the regulator said it will “carefully consider” the Cass report and “identify any further communications or actions that we may need to take in response”.