Universal Credit update

Universal Credit update

November 3, 2015

Following our previous PSNC Briefing 022/13: A New Patient Exemption – Universal Credit (March 2013) (now expired), a decision has been made by the government which took effect from 1 November 2015 regarding eligibility to claim help with health costs and the wider roll-out of this benefit to other parts of England.

The new arrangements means that Universal Credit (UC) is still rolled out for people in certain areas and an updated list can be found here. Because patients can get their prescriptions dispensed from any NHS community pharmacy in the country, pharmacy teams outside of these areas should also be aware of these arrangements. Therefore, this means that those who live in these areas and entitled to UC, could get help with health costs if eligible (for example free NHS prescriptions). You are eligible if you receive UC and:

  • ‘had no earnings or net earnings up to £435 during the most recent assessment period’; or
  • ‘which includes an element for a child and/or limited capability for work or limited capability for work related activity, and had no earnings or net earnings up to £935 during the most recent assessment period’

Pharmacy staff must make sure that they:

  • Check, at the point at which the patient is asked to declare their exemption on the back of the prescription form, that the patient has a valid UC award letter notice bearing their name (either as the recipient or because they are a partner or child of the recipient) as evidence of valid entitlement.
  • Where patients do not have evidence or where there is doubt over whether the evidence provided is appropriate, the “Evidence not Seen” box on the back of the prescription should be marked with an X by pharmacy staff. Pharmacy staff need not refuse to dispense items on the basis that the patient does not provide evidence of their entitlement to free prescriptions.
  • Ask the patient to tick the “income-based Jobseeker’s Allowance” exemption, until the prescription forms are updated, and sign the declaration.
  • Remind the patient they should make sure they are still eligible each month i.e. in case their circumstances change or check if their earnings are still within the threshold limits during your most recent monthly assessment period.
  • Inform the patient that it is their responsibility to determine the accuracy of the declaration they make. NHS Protect have a responsibility to check for prescription charge exemption fraud and patients found to have wrongly claimed for free prescriptions, could face a penalty charge, the prescription charge required and in some cases prosecution.  

Until 31st October 2015 all those entitled to UC were entitled to help with health costs. If patients paid any NHS charges relating to prescriptions in the three months preceding that date, then they may be able to claim a refund if they obtained a valid FP57 at the time of paying the charge. The patient can contact NHS help with Health Costs by telephone on: 0300 330 1343 for further information. 

Some useful links

For further information visit the PSNC page on exemptions – psnc.org.uk/exemptions   

NHSBSA Help with Health Costs – www.ppa.org.uk/ppc

For further information about the Universal Credit please visit the Gov.uk website or NHS choices.

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