Request

[In response to FOI-02689 https://opendata.nhsbsa.net/dataset/foi-02689 ]

1. How many of the PCNS in each of those years were paid without any challenge per year

2. For those who challenged successfully, can you give me the reasons each was successful? You have provided general reasons for success but I'm looking to understand specific reasons that I can quantify (e.g. how many people successfully challenged because they were entitled).

I'd like to have a list of more specific reasons that fall under 'exceptional'- do you have any more of a breakdown on what reasons patients have given that have been accepted as 'exceptional'?

3. Thank you for the pharmacy list. Please can you let me know the time range it covers and include how many PCNs were made for each (so I can see PCNs related to each as well as how many were successful)

4. Are you able to provide data on the reasons for successful claim per pharmacy (e.g. how many successful claims from Boots were because the patient was entitled)

I'd appreciate if you could send me as much of this as if available and let me know if there is anything you are unable to answer.

Response

Question 1

I am writing to advise you that following a search of our paper and electronic records, I have established that the information you requested is not held by the NHSBSA. We do not hold how many penalty charge notices (PCNs) are challenged. We only data on how many PCNs are successfully challenged.

Questions 3 and 4

I can confirm that the NHSBSA holds the information you have requested and a copy of the information is attached.

The data attached covers the years 2022, 2023 and 2024.

Question 2

Section 31(1) – Crime Prevention

Some of the information you requested is being withheld as it falls under the exemption in section 31(1) of the Freedom of Information Act. In applying this exemption, we have balanced the public interest in withholding the information against the public interest in disclosing the information. The annex at the end of this letter sets out the exemption in full, as well as the factors considered when deciding that in all the circumstances of the case, the public interest in maintaining the exemption outweighs the public interest in disclosing the information.

The web link below sets out the exemption in full.

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

Please see the below factors in favour of maintaining the exemption, and in favour disclosure of the information.

Factors for Disclosure

•Provide the public with an opportunity to challenge the basis of the processes used by the NHS to check patient prescription charge exemption claims.

•NHS Business Services Authority needs to be held to account to ensure its resources are being used effectively to detect fraud.

•The public needs to know that there is a rigorous system in place to detect fraudulent claimants of free prescriptions and ensure that proper checks are carried out.

•Where people are receiving free prescriptions when they should not be, this is a misuse of public funds, and therefore the public should be made aware of it.

Factors for Withholding

•Disclosure would allow an increase in fraudulent claims by patients of entitlement to prescription charge exemptions;

•Increased cost to the taxpayer of paying for any increase in fraudulent prescription exemption changes;

•There is a strong public interest in avoiding the likely prejudice to the prevention of crime.

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: “Dental Services, 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.