Penalty notice system is dysfunctional, warns head of patients’ group
Hundreds of thousands of NHS patients are being wrongly accused of fraudulently claiming free prescriptions and are being threatened with fines.
Data released under the Freedom of Information Act shows that 1,052,430 penalty notices were issued to patients in England in 2017 – about double the level in the previous year.
The fines, which carry a maximum penalty of £100 and are issued to those who wrongly claim free medication, are issued after an NHS exemption certificate has expired.
But the data confirms that 342,882 penalty notices were subsequently withdrawn because the patient was entitled to the free prescription.
“These Freedom of Information requests appear to show a penalty system that is dysfunctional,” said Lucy Watson, chair of the Patients Association. “Any organisation issuing penalty notices and then having to withdraw nearly one in three because they were issued in error is not operating as it should. This compounds the unjust and haphazard nature of prescription charging in England, with some patients facing substantial costs to manage their conditions, and others being entitled to free prescriptions.”
Part of the problem stems from patients moving home and failing to update their records.
The NHS Business Services Authority, the agency in charge of issuing the fines, said it was continually reviewing its data-matching process and making improvements to ensure eligible patients were not wrongly pursued. It said it was also trying to educate patients on the importance of keeping the details on both their GP records and their exemption or prescription prepayment certificates up to date.
“The NHS loses millions each year through fraudulent and incorrect claims for free prescriptions,” said Alison O’Brien, head of loss recovery services at the authority. “On behalf of NHS England, and in discussion with the Department of Health and Social Care, the NHS Business Services Authority checks claims randomly and retrospectively to appropriately recover funds and return them to NHS services.”
Peter Burt, a patient who was wrongly issued with one of the penalty notices, said he worried about how certain patients would react to receiving one. “Some of the people who received these notices will certainly be in vulnerable situations and some will be receiving prescription medication for anxiety and mental health issues,” Burt said.
“They should not be receiving letters threatening court action just because the NHS can’t be bothered to check the records to see whether they have a prepayment card – especially if there is no intention of carrying out the threat. It’s hugely disappointing that, at a time when clinical services are clearly facing financial strains, the NHS bureaucracy is wasting money by sending out hundreds of thousands of inaccurate demands every year.”
Watson said more problems lay ahead if further planned changes to the way medicines were prescribed were introduced.
“The bureaucracy around prescriptions is unfit for purpose, and will only get worse if NHS England introduces its planned restrictions on prescribing over the counter medicines,” she said. “Serving notice of penalties for free prescriptions on patients who may be vulnerable and unwell and are then required to demonstrate their right to a free prescription cannot be a compassionate and caring way to manage this system.”