I am writing to confirm that I have now completed my search for the information which you requested.
Request
You asked us:
a) What is the total number of current recipients of the HRT PPC?
b) What is the total number of current recipients who were born male sex (or if not, some other definition for men who ""identify"" as women)?
c) What are the average numbers of prescription items for each of female sex born and of male sex born recipients?
d) What is the average cost to the NHS/DHSC per HRT PPC?
We requested clarification on 10 October 2025:
Question D: What is the average cost to the NHS/DHSC per HRT PPC
Please can you confirm if you mean the average number of prescriptions gained under each active certificate?
You responded on 10 October 2025:
May I clarify:
The annual HRT PPC costs the purchaser £19.80, but covers an unlimited number of some HRT medicines (listed here https://www.nhsbsa.nhs.uk/help-nhs-prescription-costs/nhs-hormone-replacement-therapy-prescription-prepayment-certificate-hrt-ppc/medicines-covered-hrt-ppc ) during that period. I want to know how much each HRT PPC costs the NHS/DHSC - presumably more than £19.80.
Given there are many different prescriptions (by type and amount) which can be claimed under the HRT PPC , then the average number of prescriptions gained under each certificate wouldn't be much help to me (without detail of how much each prescription costs the NHS/DHSC. I think that would be an unreasonable request!). Rather, I reckon it is better to calculate that average cost as the total value of all prescriptions claimed under HRT PPCs divided by the total number of HRT PPCs.
I'll leave you to deliver a consistent method on active or total-used certificates.
For what it's worth, I presume I would be able to calculate 'the average number of prescriptions gained under each active certificate' from your answers of (a) to (c).
It can be useful to explain one's intent in requests to clarify what information is being request. Part of what I want to do is work out the total cost of HRT PPCs to the tax payer, and to split that cost (on average) by female sex born and of male sex born recipients.
The NHS Business Services Authority (NHSBSA) received your request on 30 September 2025.
We have handled your request under the Freedom of Information Act (FOIA) 2000.
Our response
Question A
As of 10th October 2025, there are 518,009 active HRT PPC certificates.
Question D
Under Section 21 of the FOIA we are not required to provide information in response to a request if it is already reasonably accessible to you.
The information you requested is available on the NHSBSA website
https://www.nhsbsa.nhs.uk/statistical-collections/prescription-cost-analysis-england/prescription-cost-analysis-england-202425
Please locate the Exemption category management information data under the title ‘Management information’.
Please see the following link to view the section 21 in full - https://www.legislation.gov.uk/ukpga/2000/36/section/21
Questions B and C
I am writing to advise you that following a search of our paper and electronic records, I have established that the information you requested is not held by the NHSBSA. ePACT2 does not capture or report on 'sex at birth' data.
Advice and assistance
However it is possible that NHS England may hold some or all of the information you require. They can be contacted at:
england.contactus@nhs.net
Please write 'Freedom of Information' in the subject line. If you have difficulty making a written request, please call the Customer Contact Centre on 0300 311 22 33.
NHS England
NHS England
PO Box 16738
Redditch
B97 9PT
Telephone 0300 311 22 33
Email: england.contactus@nhs.net
https://www.england.nhs.uk/contact-us/foi/
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