MPs investigate prescription exemption and penalty charge notice system

MPs investigate prescription exemption and penalty charge notice system

September 20, 2019

The Public Accounts Committee (PAC) has today published a report of its investigation into penalty charge notices in healthcare, calling for an overhaul of the system which it considers “not fit for purpose”.

The PAC is made up of a group of cross-party MPs; the Committee launched an inquiry after it became concerned that penalty charge notices were being handed out to patients too readily.

The inquiry found that many patients find it difficult to understand whether or not they are entitled to free prescriptions. Whilst measures are underway to make this easier, i.e. the use of real-time exemption checking (RTEC) in pharmacies, the MPs were concerned that these measures have not been implemented quickly enough.

The MPs also felt that more could be done to evaluate the impact that charge notices may have on people seeking medical treatment.

PSNC submitted evidence to the inquiry outlining the role of community pharmacy teams in explaining the prescription exemption system to patients and the value that RTEC will bring. Going forwards, PSNC wants to see the process of clarifying patients’ exemption status made as streamlined as possible for both patients and pharmacies.

Read PSNC’s written submission to the PAC inquiry

The inquiry report by the PAC recommends:

  • Exemptions be made easier to understand;
  • DHSC informs PAC of when it plans to introduce a planned additional checking stage in the penalty charge notice process;
  • Information about the consequences of prescription charges and penalty charge notices is actively sought;
  • Real-time checking should be pursued as a priority, with a timetable for implementation confirmed;
  • The cost-effectiveness of spending more time and resources pursuing repeat offenders is evaluated;
  • NHS England and NHSBSA report back to PAC in a year’s time to explain how they have made the process more humane and cost-effective.

Read the Penalty charge notices in healthcare report in full

PSNC Director of NHS Services, Alastair Buxton, said:

“PSNC was pleased to assist the PAC in this inquiry and agrees that more needs to be done to make prescription charge exemptions clearer to patients.

Pharmacy teams regularly help patients to identify whether they are eligible for free NHS prescriptions, but this can be a time-consuming process in a busy environment. Last year’s ‘Check before you tick’ campaign from the NHSBSA raised awareness of the exemption criteria, providing a tool patients could use to determine their eligibility. This positive step received a lot of support from pharmacies, and the campaign is due to be re-run shortly.

The full rollout of RTEC will not only provide assurance that the patient is entitled to free NHS prescriptions, but will also reduce the risk of pharmacies losing out financially due to inadvertent submission of prescriptions with a paid status when the patient had declared they were exempt. The feedback from the RTEC pilot pharmacies has been very positive, but whilst we support the national rollout of RTEC and would like to see it rolled out as quickly as possible, this must be subject to the successful conclusion of a wider pilot, beyond the current four pharmacies.

We recognise that progress on developing PMR systems to incorporate RTEC functionality has been slower than DHSC and NHS Digital would have wished, but system suppliers have had to manage significant changes to their systems over the last year, not least the introduction of the Falsified Medicines Directive (FMD), which had to take priority. We fully support their ongoing work with PMR system suppliers to add RTEC functionality as quickly as possible, as this will bring clear benefits to patients and pharmacy teams.

It is our hope that, in future, consideration can be given to investigate exemption issues with patients and pharmacy teams first, providing an opportunity to complete any missing declarations, to avoid patients or pharmacies from incurring incorrect penalties. Overall, PSNC believes that any exemptions system should be as simple as possible as the current processes run the risk of those most in need not getting their medicines – adding to the NHS bill elsewhere.”

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