Thank you for your request for information about the following:

Request

‘I am writing to request a copy of the full calculation used in deciding whether a person is eligible for the NHSBSA Low Income Scheme’

[On the 27 May 2025 you clarified your request as follows]

‘I would be grateful if you would supply me with a copy of the claims manual referred to in your response.’

The NHS Business Services Authority (NHSBSA) received your request on 15 April 2025.

We have handled your request under the Freedom of Information Act 2000 (FOIA).

Our response

We have considered this request under the Freedom of Information Act 2000 (FOIA 2000) and are issuing a part refusal notice under section 17 of the FOIA.

I can confirm that we do hold the requested information, but this some of the information contained in the claims manual is exempt under section 31(1)(a) of the FOIA (law enforcement) as disclosure would be likely to prejudice the prevention of crime.

Withheld Information

Some of the information you requested is being withheld as it falls under the exemption in section 31(1)(a) of the Freedom of Information Act (law enforcement) as disclosure would be likely to prejudice the prevention or detection of crime.

The general principle of the FOIA 2000 is that disclosure is to the world at large. Consequently, when we are considering the prejudice outlined above, we focus on the consequences of disclosing the information to the wider public rather than just the requestor themselves.

Disclosure of the specific information would be likely to increase the vulnerability of the process by enabling applicants to manipulate the system.

Applicants may also be more likely to forge or alter documents to meet the criteria and submit incomplete or misleading information which meets the eligibility calculation. The provision of fake documents is becoming more prevalent and sophisticated within the NHSBSA services.

Section 31 is a qualified, prejudice-based exemption and is subject to the public interest test. This means that not only does the information have to prejudice one of the purposes listed, but before the information can be withheld, the public interest in preventing that prejudice must outweigh the public interest in disclosure.

Public Interest Test:

Considerations in favour of disclosure:

Public transparency and accountability of the NHS Low Income Scheme, which allows the public to understand how public funds are allocated and scrutinise whether the criteria are fair and consistent.

Contribute to public understanding of the NHSBSA’s procedures and actions.

Considerations against disclosure:

Disclosing the additional information could enable individuals to manipulate their applications to circumvent the rules to obtain a more favourable and fraudulent outcome, leading to the misuse of limited resources. 

The ability of applicants to misrepresent their application undermines the integrity and reliability of the assessment process. There is a public interest in maintaining a robust and effective system that accurately provides appropriate, means-tested funding based on the individual circumstances of the applicant.

If the application process is perceived as easily manipulated, it could subsequently erode public trust in the fairness and accountability of public spending. There is a public interest in ensuring that eligibility assessments are not compromised.

The inherent public interest in ensuring that public money is allocated fairly and lawfully.

Conclusion

The NHSBSA recognises that there is a public interest in the disclosure of information to promote transparency and assurance of how the NHS Low Income Scheme assesses entitlements to the scheme. However, the public interest in maintaining the exemption outweighs this as there is more weight afforded to ensuring the prevention of fraudulent claims to the NHS Low Income Scheme.

Please see the following link to view the section 31 exemption in full -

https://www.legislation.gov.uk/ukpga/2000/36/section/31

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”. 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.