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Digital checks for free prescription eligibility to be carried out in 10% of pharmacies

A pilot scheme checking patient eligibility is to be expanded from four pharmacies to one in ten pharmacies in England.

Computer in a pharmacy


The NHS will be launching a larger trial of a live prescription fee exemption-checking scheme in summer 2019

A pilot scheme allowing pharmacists to check patient entitlement to free NHS prescriptions will be rolled out to 10% of pharmacies in England “over the summer” of 2019, MPs have been told.

Speaking to a House of Commons Public Accounts Committee (PAC) hearing on prescription exemption penalty charge notices, Sir Chris Wormald, permanent secretary for the Department of Health and Social Care (DHSC), also admitted that changes to NHS prescription forms to include a tick box for people on Universal Credit (UC) to gain free prescriptions “was not prioritised highly enough” and it “should have happened by now”.

Sir Chris’s comments to the PAC on 1 July 2019 follow the publication of a National Audit Office report, which concluded in May 2019 that the eligibility rules for free NHS prescriptions are “complicated” and called for a “simpler system or better real-time checking” to deter fraud while not disadvantaging vulnerable people.

However, Sir Chris told the committee that the DHSC “is not proposing to change any of the entitlements as we speak, so our focus … is ensuring that we properly communicate what the various exemptions are”.

“We’ve currently just finished a very small trial of real-time entitlement checking — we’re going to be running a much bigger trial over the summer [of 2019] and, should those be successful, we’ll be rolling them out further,” he said, adding that the trial will involve one pharmacy IT system that supplies to “about 10% of pharmacies”.

According to the Pharmaceutical Services Negotiating Committee, the real-time exemption-checking service will be rolled out to pharmacies using the Positive Solutions Analyst pharmacy system.

NHS Digital had previously trialled a real-time checking service in four pharmacies in Oldham, Leeds, Cleethorpes and Manchester, with the pharmacists carrying out 8,495 entitlement checks — 3,762 of which were confirmed as having one of the five exemptions covered by the pilot.

The scheme is being rolled out in two stages, with exemption categories for maternity, medical exemptions, prepayment certificates, HC2 (NHS low-income scheme) and NHS tax credits included in stage one of the pilot.

The second stage will include all Department for Work and Pensions exemptions, including UC exemptions.

Wormald admitted to the committee that changes to prescription forms — adding a tick box for people on UC, which was first announced in October 2017 — “should have happened by now”.

“Although clearly this should have happened by now, we haven’t managed to identify anyone who has suffered as a result because there is a workaround and people just tick a different box,” he said, adding that the change “wasn’t prioritised because there wasn’t evidence of harm”.

Brendan Brown, director of citizen services at NHS Business Service Authority (BSA), told the committee that the second stage of the real-time exemption checking scheme, which would automatically check for UC eligibility, will begin later this year.

Brown also told the committee that “in the coming months”, NHS BSA would begin alerting patients before issuing a penalty charge.

He said the alert would tell the individual “that they have claimed an exemption that they may not be entitled to and it will give them an opportunity to get in touch with us so we can advise them accordingly”.

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2019.20206751

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