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Community pharmacy

Community pharmacists to police entitlement to free NHS prescriptions

Community pharmacists in England will in future be able to confirm whether a patient is entitled to free prescriptions by accessing a Department of Work and Pensions database, according to the NHS Business Services Authority (NHSBSA).

The NHSBSA is developing a system that will allow pharmacists to access the database to help them verify a patient’s prescription charge exemption status.

The NHSBSA says the initiative, which is part of its ongoing campaign to clampdown on prescription fraud by patients, is in its early stages of development.

The move has been strongly criticised by the Royal Pharmaceutical Society (RPS), which says that the move will “disrupt and distort the relationship between pharmacist and patient”.

“We are opposed to any move that adds to the bureaucratic burden of pharmacists without improving patient safety in any way,” says RPS English Pharmacy Board chair David Branford.

“This new system puts pharmacists in an invidious position where they will be asking patients to pay or risk prosecution. Our job is to put the needs of vulnerable people first and make sure they get the care they need.”

A survey by the Prescription Charges Coalition, which campaigns for prescription charges to be abolished in England, carried out earlier in 2014 found that of the 5,000 people questioned with long-term conditions, 37% said that the cost of their medicines meant they were not taking the drugs as prescribed and 70% said this had led to them having to take time off work.

 

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2014.20067492

Readers' comments (4)

  • Personally I have the opposite view. This development has the potential (depending how it is implemented) to save time and resource in the pharmacy rather than 'adding to the bureaucratic burden'.

    Setting aside that it's a contractual matter rather than a professional one and therefore it's interesting that the RPS sees fit to take a view on it, the PSNC has reported it slightly differently in their objection to the proposal, giving the impression that contractors will be required to check exemptions rather than just facilitated to as this article is written.

    If it is the case that the NHS will contractually require pharmacies to enforce exemption checks then the NHS must be required to provide the IT resources and technology needed to carry out the checks. Such a system ought to consist of a simple one step data entry and feedback of exemption status yes/no. I would propose data entry to be the patient's NHS number and DOB. The NHS would be required to maintain the centralised database of exemptions and have liability for the accuracy - if the patient disputes the exemption status on the system, it's for the patient to take it up with an appropriate NHS exemption helpdesk.

    Most importantly, such a check at the prescription receipt or prescription handout stage must eliminate the filling in of a handwritten prescription exemption declaration. Not only will this save time and resource in the pharmacy for checking and filing prescriptions, it will also eliminate the need for printing dispensing tokens for EPS2 prescriptions in pharmacies that have the capability to go paperless where their IT systems are capable of supporting paperless dispensing.

    Ultimately if and when we are able to go to ubiquitous EPS2 deployment and paperless reimbursement, it could see the end to posting large packages of valuable paper to NHS Prescription Services each month - reducing financial and environmental cost and clinical governance risk through confidentiality exposure.

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  • Graham Phillips

    I agree with Tariq in that the PJ reporting here is leff than helpful. For the PSNC "version" look here: http://psnc.org.uk/our-news/plan-for-electronic-system-to-monitor-prescription-charge-exemption-checks/ But the way the NHSE just assumes community pharmacists will take responsility for policing the system just shows the disdain in which they hold our profession. I'm Interested in my patients' health not their income. This is a role for the police not community pharmacists. Lets just say "no" like the GPs would..

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  • I suppose we would need a dedicated and provided computer or a chip/pin type reader at the desk, always logged in otherwise it will be at cost to ourselves. There would also be time wasted in the dispensary and our broadband time!
    I for one don't fancy this at all, I really don't want to be an unpaid policeman, I don't want any more kit on my desk and I don't want to harass my patients. This is just plain nasty!!!!!

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  • The system is in early development so it is still not clear what role the pharmacist will have in the exemption checking process and whether it will add a layer of bureaucracy. We will report on developments as they arise - News editor.

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