Real-time exemption checking (RTEC)

Real-time exemption checking (RTEC)

To date, there has not been a ‘live’ technical solution for a pharmacy team to check a patient’s active prescription exemption status. Soon, real-time exemption checking (RTEC) will enable pharmacy PMR systems to automatically check a patient’s exemption status in the background while the prescription is being processed in the PMR system.

Where RTEC identifies the patient as being exempt from prescription charges, the patient will not need to complete a declaration on an EPS token.

How will RTEC work?

The system uses data on people’s prescription charge exemption status, held by the NHS Business Services Authority (NHS BSA). The check of the NHS BSA data will usually occur automatically at the time the prescription is being processed in the PMR system to produce dispensing labels, but PMR suppliers have some flexibility about the point that the data will be requested from the NHS BSA using an Application Programming Interface (API) built into the PMR system.

Pharmacy staff will not normally need to check the patient’s exemption status more than once, but a second check will be possible, if the patient queries the initial status returned by the NHS BSA system. If the patient believes they are exempt from prescription charges, but RTEC returns no exemption information, the patient will complete a declaration on an EPS token in the normal way.

If a prescription is confirmed by RTEC as exempt, it will be treated as such by the NHS BSA and no further prescription exemption checks will be applied and the patient will not need to complete a declaration on an EPS token.

The benefits of RTEC

Through the operation of the system described in the above diagram, it is expected that RTEC will:

  • reduce the risks of contractor loss caused by pharmacy staff inadvertently submitting EPS prescriptions with a paid status when the category should have been exempt;
  • enable a reduction in the number of EPS tokens which have to be printed, completed by patients and then be sent from pharmacies to the NHS BSA;
  • provide a more efficient digital process for pharmacy staff, reducing the time spent helping patients complete declarations, checking physical evidence of exemption status and sorting tokens for submission to the NHS BSA;
  • reduce the risk to the NHS of prescription fraud due to a decrease in false prescription exemption claims; and
  • increase convenience for patients, as there will be less need for them to provide physical proof of exemption from prescription charges.

Roll-out plans

The system will be rolled out in phases:

  • Phase One will comprise maternity, medical, pre-payment, low income scheme and HMRC exemptions;
  • Phase Two will include all Department for Work and Pensions (DWP) exemptions, including Universal Credit when they become available; and
  • Once the first two phases are complete, NHS Digital plans to conduct a prioritisation and costing exercise to explore the possibility of including the Education and Ministry of Defence exemptions in the system.

Testing

NHS Digital and NHS BSA are working with several PMR suppliers to test this functionality; a pilot with one supplier is scheduled for late 2018. It is expected that all PMR system suppliers will work to update their systems to incorporate RTEC during 2019.

PSNC will provide further information on progress with the testing and rollout of RTEC as it becomes available.



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