Request

‘figures requested for the last three completed 12 month periods

• Please confirm the number and value of Prescription Exemption Charge penalties applied

• Please confirm the number and value that were in respect of incorrect claims made within 3 months of the end of a Maternity Exemption Certificate

• Please confirm the total costs in respect of collecting penalties

• Please confirm the proportion of penalties issued which are subsequently withdrawn or overturned

• Please confirm what proportion of cases had no signature on the prescription form

• Please confirm what proportion of patients claimed that the pharmacy had misadvised them as to their right to a free prescription

• Please confirm what proportion of cases are in respect of patients with mental health issues, or collecting medicine commonly prescribed for mental health issues.’

On 2 November 2022 you clarified your request as follows:

To clarify, I'm asking (in third bullet) for the costs incurred in total in COLLECTING the penalties. I.e. what is the administrative cost of collecting the actual amounts received.

My presumption was that the actual amount received in total ought to be identifiable based on the combination of answers to bullets 1, 2 and 4; however, on reflection it may also be useful to identify the total actually received (i.e. as opposed to the value of penalties raised but not necessarily received) so Id be grateful if you could please provide that figure separately as well.

Response

Figures cover the last 3 years, as requested.

Question 1

563,004 penalties applied, the total value was £41,421,402.

Question 2

I can confirm that the NHS Business Services Authority (NHSBSA) holds information meeting the description specified in your request.

The Prescription Exemption Checking Service (PECS) systems match patient details on prescriptions against valid exemptions which were in place at the time the prescription was dispensed. The system does not consider whether an exemption was previously held, as this would not affect the decision on whether to issue a Penalty Charge Notice (PCN). Therefore the information you have requested is not held in a way which is easy to extract as there is no business need to hold the information in this way.

As a result the NHSBSA would need to conduct an exercise to match patient data on previously issued PCNs with Help with Health Costs (HwHC) systems to determine whether an exemption had previously been held by the patient. The NHSBSA’s Data Analytics and Learning Laboratory (DALL) did a similar data matching exercise, linking PECS data to the HwHC systems in the past. This exercise took several weeks to complete so it is reasonable to assume that the work required to link the data held to answer this request would take a substantial amount of time, and certainly more than the 18 hour appropriate limit. An analysis would have to be undertaken to link the required datasets, ensure the links are correct and the information accurate, consider the best matching approach, apply a matching algorithm, pull findings together and quality check – this would require multiple weeks’ work as opposed to hours.

Therefore, I estimate that the cost of complying with your request would exceed the non-central Government limit of £450. The limit has been specified in The Freedom of Information and Data Protection (Appropriate Limit and Fees) Regulations 2004 and represents the estimated cost of one person spending 18 hours in determining whether the NHSBSA holds the information, and locating, retrieving and extracting the information. Under Section 12 of the Freedom of Information Act, the NHSBSA is not obliged to comply with your request and I will not be processing this part of your request further.

Question 3

£17,377,555 is the full cost to deliver the service, not just the cost to administer collections. We are unable to provide the administrative cost of collection as the breakdown of this information is not held.

£7,735,854 has been received.

Please note that, for a period during the coronavirus pandemic, no penalty charges were issued, which is why the cost of delivering the service is greater than the monies received.

Question 4

36% - This is a combination of Exemption Confirmed and Cancelled. Cases are closed based on providing a valid exemption or other significant evidence at the time of claiming the prescription.

Question 5

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 below web link sets out the exemption in full.

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

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 need 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 it.

Factors for Withholding

• Disclosure of sampling methods would allow an increase in fraudulent claims by patients of entitlement to prescription charge exemptions; • Increased cost to the tax payer 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.

Question 6

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 record statistics on patients which claim they have been misadvised.

Question 7

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 record information on patients’ mental health.

Data Queries

If you have any queries regarding the data provided, or if you plan on publishing the data please contact nhsbsa.foirequests@nhs.net ensuring you quote the above reference. This is important to ensure that the figures are not misunderstood or misrepresented.

If you plan on producing a press or broadcast story based upon the data please contact nhsbsa.communicationsteam@nhs.net. 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 2022” 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.