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Pharmacies verify 4,000 prescription exemptions in real-time checking pilot

In the first stage of a pilot run by NHS Digital and the NHS Business Services Authority, prescription exemption checks were carried out by the patient medication record system across four pharmacies.

Pharmacist scanning medicine barcode


NHS Digital says the project shows that carrying out prescription charge exemption checks “has saved them time, as well as reducing the need for paper”

Nearly 4,000 prescription charge exemptions have been verified through the first stage of NHS Digital’s real-time exemption checking pilot scheme.

The scheme, which launched in February 2019 following a three-month delay, enabled pharmacists working in four pharmacies in Oldham, Leeds, Cleethorpes and Manchester to check patient entitlement to free NHS prescriptions at the point the prescription was supplied.

During the pilot period, which ended on 30 April 2019, the pharmacists carried out 8,495 entitlement checks, 3,762 of which were confirmed as having one of the five exemptions covered by the pilot. 

According to the Pharmaceutical Services Negotiating Committee, the checks are automatically carried out by the patient medication record (PMR) system “while the prescription is being processed in the PMR system” by collecting information stored by NHS Business Services Authority (NHS BSA) on exemption status.

A statement from NHS Digital, which is running the pilot in collaboration with the NHS BSA, said: “The system either returns an ‘exempt’ status or a ‘not known’ status — never a ‘not exempt’ status.”

The scheme is being completed 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 of the pilot will include all Department for Work and Pensions exemptions, including Universal Credit exemptions. There are currently 14 exemption categories, under which patients do not have to pay for NHS prescriptions.

NHS Digital said that out of the remaining 4,733 cases where exemption status was ‘not known’, pharmacies were expected to follow the usual process of asking patients if they pay for their prescription. 

According to a National Audit Office (NAO) report published on 14 May 2019, fee exemptions have been increasingly checked by NHS BSA over the past three years after the medicines have been dispensed.

However, the NAO called for “better real-time checking” of prescription exemptions to deter fraud, after it found that the NHS is owed £246m in unpaid penalty fees for free NHS prescriptions that had been incorrectly claimed. 

Richard Ashcroft, director of digital medicines for NHS Digital, announced that a digital exemption pilot would start in August 2018 at the Clinical Pharmacy Congress held in April 2018.

NHS Digital’s statement added that the pilot sites gave “very positive” feedback on the scheme, adding that it “has saved them time, as well as reducing the need for paper”.

“We are now reviewing the findings from the pilot and are working with the BSA and pharmacy IT suppliers to formulate a plan for further roll-out,” NHS Digital added.

The roll-out of the NHS Digital pilot was delayed from November 2018 to February 2019 because the same system suppliers were prioritising work on the Falsified Medicines Directive, which came into effect on 9 February 2019.

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2019.20206552

Readers' comments (1)

  • First, I like the 'not known' category. Does this help us in any way, as the exempt ones we know about already, but the 'I don't pay (reason not given)' ones are the ones we need help with. Is this any advance?
    Second, as this uses software that connects the PMR system with the NHSBSA system, aren't we tampering with patient confidentiality?

    Unsuitable or offensive? Report this comment

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