Request

This enquiry is for data relate to patients claiming free NHS prescriptions.

On that, I would like the data on the following in the last 3 years:

1) How many PCNs you have issued for patients claiming free NHS prescriptions (i.e. free prescriptions that you were not able to confirm).

2) How many unique patients received PCNs (i.e. if a patient received 4 PCNs, they'd only count as one unique patient)

3) How many PCNs were successfully challenged (i.e. the PCN was overturned)

For those successful cases, please can you provide:

a) Reasons for those successful PCNs being challenged

b) The names of the pharmacies that supplied the medicines to the patient

I realise that some of these items may not be data you have readily available. In that case, please provide as much as possible and state what is not available. That may be that the time period is shorter (e.g. 12 months).

If you cannot do that, please provide the information you capture related to PCNs issued for prescriptions, including what IT system/software you record this information on.

Response

I can confirm that the NHSBSA holds some of the information you have requested.

Question 1 - How many PCNs you have issued for patients claiming free NHS prescriptions (i.e. free prescriptions that you were not able to confirm).

Please see a copy of the information attached.

Question 2 - How many unique patients received PCNs (i.e. if a patient received 4 PCNs, they'd only count as one unique patient)

Please see a copy of the information attached.

Question 3 - How many PCNs were successfully challenged (i.e. the PCN was overturned)

Please see a copy of the information attached.

Question 3a - For those successful cases, please can you provide: Reasons for those successful PCNs being challenged

Please see the below reasons why penalty charges may be overturned.

Proof of Entitlement

Following the issue of a penalty charge notice, entitlement to a remission will be confirmed if the patient proves entitlement to one of the appropriate benefits/or that the patient had been issued with a valid certificate at the time they signed the declaration on the prescription.

Exceptional Circumstances

There are exceptional circumstances where it would not be in the patient’s interest to apply a penalty charge, although the patient’s liability is established.

An administrative easement may apply to the penalty charge, only where the patient has a compelling reason for having claimed exemption incorrectly.

There is no liability for a penalty charge where a patient can show that they did not act wrongfully, or with any lack of care, in respect of the charge in question.

A person who acted with a lack of care is defined as follows:

The person avoided the original charge by being reckless or careless about their obligation to pay, i.e. they did not take the normal amount of care that could be expected of a person in their circumstances, for instance they did not check that they were getting the correct type of benefit, or that their certificate was still valid.

A person who acted wrongfully is defined as follows:

The wrongful act occurs when the patient or their representative claims help with NHS charges to which they are not entitled by completing and signing the declaration.

Vulnerable Patients

It is policy to recover prescription charges where exemption has been claimed incorrectly and to collect penalty charges and surcharges where appropriate. The NHSBSA will take into account the individual circumstances of patients and will deal sympathetically with patients who are in vulnerable groups.

Question 3b - For those successful cases, please can you provide: The names of the pharmacies that supplied the medicines to the patient.

Please see a copy of the information attached.

Data Queries

Please contact foirequests@nhsbsa.nhs.uk ensuring you quote the above reference if you have any specific questions regarding this response; or, if you feel you may be misunderstanding or misinterpreting the information; or, if you plan on publishing the data.

Reusing the data and copyright

If you plan on producing a press or broadcast story based upon the data please contact communicationsteam@nhsbsa.nhs.uk. This is important to ensure that the figures are not misunderstood or misrepresented.

The information supplied to you continues to be protected by the Copyright, Designs and Patents Act 1988 and is subject to NHSBSA copyright. This information is licenced under the terms of the Open Government Licence detailed at: http://www.nationalarchives.gov.uk/doc/open-government-licence/version/3/

Should you wish to re-use the information you must include the following statement: NHSBSA Copyright 2025” This information is licenced under the terms of the Open Government Licence:

http://www.nationalarchives.gov.uk/doc/open-government-licence/version/3/

Failure to do so is a breach of the terms of the licence.

Information you receive which is not subject to NHSBSA Copyright continues to be protected by the copyright of the person, or organisation, from which the information originated. Please obtain their permission before reproducing any third party (non NHSBSA Copyright) information.