NHS harassing patients over prescriptions

MPS demand reforms to system after sharp rise in penalty charge notices for those entitled to free drugs

THE NHS is harassing millions of vulnerable patients by threatening them with fines for validly claiming free prescriptions and dental treatment, an investigation has found.

MPS last night called for urgent reform after a National Audit Office report (NAO) revealed there had been a significant increase in penalty charge notices (PCN) over the last five years.

The forms are intended to crack down on patients fraudulently claiming to be exempt from the standard £9 prescription charge. Exemptions apply to under-16s and over-60s.

However, the NAO investigation found that 30 per cent – around 1.7 million – since 2014 were subsequently withdrawn because a valid exemption was confirmed.

Under the current system patients are often not asked to prove they are exempt when they visit the pharmacy. This means they may subsequently receive a letter challenging them to prove their status and threatening a penalty of five times the prescription charge plus the charge itself if they cannot.

The NAO warned that this was panicking patients, both people who claimed an exemption validly and those who have made honest mistakes based on an “overly complicated” system.

This year it was revealed that Aimee Morrow, a severely disabled teenager, was fined £100 and threatened with debt collectors for claiming free dental treatment that she was entitled to.

The report found there had been a 32-fold increase in prescription checks from 2014 to 2015, when 750,000 checks were made, to 24 million in 2018-19. But the proportion of cases in which this had resulted in a PCN being issued decreased from one in four to one in 20.

Meg Hillier, chairman of the public accounts committee, said: “The NHS must take urgent steps if it is to avoid causing unnecessary distress to patients tripped up by an overly complex system, who end up facing large penalty charges.”

She added: “It is right that the NHS tackles prescription and dental fraud, but the NAO’S report makes for concerning reading; the rules around entitlement are complicated, leading to confusion and genuine mistakes.

“Almost a third of prescription and dental penalty charges issued to patients were later revoked, because they had a valid exemption. This is not a system that is working as it should.”

The NHS estimates that it lost around £212million in 2017-18 from patients incorrectly claiming exemption.

Sir Amyas Morse, head of the NAO, said that while free prescriptions and dental treatment were a “significant cost”, “the NHS also needs to have due regard to people who simply fall foul of the confusing eligibility rules”.

“It is not a good sign that so many penalty notices are successfully challenged,” he said.

Since 2015, the PCN regime has been run by NHS Business Services Authority.

Brendan Brown, of the authority, said: “The rules around entitlement can be complicated and we recognise that genuine mistakes happen. We strongly believe in educating patients and ultimately removing error.

“In conjunction with NHS England, we have invested £1.6 million in the national ‘check before you tick’ campaign.”

‘Almost a third of penalty charges issued were later revoked. This is not a system that is working as it should’