End to temporary suspension of signatures on prescription forms and token submission requirements

On 31 August 2021, the temporary suspension of the need for signatures on prescription forms and/or EPS tokens comes to an end, ten months after it was first introduced. This will also mean an end to the temporary suspension of the requirement to submit certain EPS tokens to the NHS Business Services Authority (NHSBSA). As Ministers remain keen for public policy priorities to return to normal, the easing of wider COVID-19 restrictions coupled with the slowing in the number of infections did not support a case for any further extensions to this suspension period.

From September 2021, patients (or their representatives) will be required to sign the reverse of NHS prescription forms or tokens for all prescriptions presented at the pharmacy on or after 1 September 2021. However, patients or their representatives are not required to make a declaration or sign the reverse of forms for any automatic exemptions which include prescriptions for age exempt patients, prescriptions where only free-of-charge (FOC) items are prescribed, where Real Time Exemption Checking (RTEC) confirms an exemption, or where a smaller quantity (in comparison with the prescription) of a drug is supplied in accordance with a Serious Shortage Protocol (SSP). Unless an automatic exemption applies, contractors will be required to submit relevant tokens (for prescriptions presented at the pharmacy on or 1 September) to the NHSBSA together with their monthly prescription bundle.

In preparation for the end of the temporary suspension period, contractors are advised to make plans to return to capturing of signatures on NHS prescriptions/tokens and review current submission processes to include relevant tokens with monthly bundles from September. Contractors should check their current stock levels of tokens and only order additional tokens if required. Tokens can be ordered from Primary Care Support England (PCSE) by following the token ordering process outlined here.

Important information following the lifting of the temporary suspension of signatures on prescription forms and token submission requirements

The dispensing process:

• Ask patients who do not have a valid reason for exemption from NHS prescription charges to pay the relevant number of charge(s) and sign the reverse of the form (prescription or token);
• Patients claiming to be exempt from prescription charges must be asked for evidence of their entitlement to free prescriptions and the patient (or their representative) must sign the reverse of the form declaring their reason for exemption. The “Evidence Not Seen” box on the reverse of the form must be marked with an ‘X’ if patients claiming exemption from prescription charges cannot provide any evidence of their entitlement to free prescriptions, or where there is doubt over whether the evidence provided is valid.
• For electronic prescriptions, ensure the correct paid or exempt declaration made on the token is applied to the electronic message before it is submitted for payment to the NHSBSA. This is because in EPS, deduction of any prescription charge(s) is made against the declaration submitted in the electronic message and NOT the associated token submitted to the NHSBSA.
• Patients or their representatives are not required to make a declaration or sign the reverse of forms for any automatic exemptions which include prescriptions for age exempt patients, prescriptions where only free-of-charge (FOC) items are prescribed, where Real Time Exemption Checking (RTEC) confirms an exemption, or where a smaller quantity (in comparison with the prescription) of a drug is supplied in accordance with a Serious Shortage Protocol (SSP).

The end of month submission process: 

• Check the reverse of every paper prescription or token (ideally at the time of handing over the medication to the patient) is complete:
  • for exempt prescriptions (except for any automatic exemptions), the correct reason for exemption and signature box must be marked.
  • for paid prescriptions, the amount paid must be declared and signature box must be marked.
• Pharmacy staff must ensure that FP10 paper prescriptions forms (including those submitted using red separators) are sorted into their correct groups (exempt, paid or paid at old charge rate), taking extra care that exempt prescriptions are NOT inadvertently submitted with the paid bundle or vice-versa. This is important because any unsigned prescriptions marked with a reason for exemption will be switched from the exempt to chargeable group by the NHSBSA and the relevant number of prescription charges will be deducted from the contractor’s account.
• To avoid any movement or mixing of prescriptions between patient charge groups during transit, elastic bands should be used to secure prescriptions in their relevant group for submission. If you are submitting a small number of forms, a paper clip may be used to secure the prescriptions in their relevant group.
• Submit tokens for non-payment (except for age exempt patients, prescriptions where only FOC items are prescribed and where RTEC confirms an exemption). The tokens to submit must be kept separate from FP10 paper prescription forms when preparing the end of month submission bundle. See PSNC’s page on prescription sorting requirements.
• Tokens used to claim payment for supplies made against Serious Shortage Protocols (SSPs) must be placed in the red separator on top of the relevant paid/exempt prescription bundle in a secure manner.

Background

As part of the social distancing measures to limit the spread of the coronavirus and to avoid cross contamination by minimizing the handling of any paperwork when patients collect their prescription medicines, Ministers in England agreed to temporarily suspend the need for patient signatures on NHS prescription forms. The suspension, which came into effect from 1 November 2020 was initially expected to end on the 31st March 2021 and was further extended until 31 August 2021.

Whilst the suspension of signature requirements remained in place, contractors were NOT required to submit EPS tokens (other than those used for SSP claims) to the NHSBSA.