GP workload warning as NHS set to double checks on free prescriptions

The NHS Business Services Authority (NHSBSA) will carry out twice as many checks on patients who claimed free prescriptions in 2016/17 as it did in the previous financial year and has urged GPs to make sure patients understand eligibility rules.

NHSBSA plans to carry out 5m checks on eligibility of patients who claimed free prescriptions in 2016/17, compared with 2.25m in 2015/16. Ineligible patients found to have claimed free prescriptions could be asked to repay the cost of the prescriptions plus a fine of five times the prescription charge, up to a maximum of £100.

GPs have a 'key role to play' in making sure patients understand when they can claim free prescriptions, the agency said.

But GP leaders warned against 'adding more bureaucracy onto overstretched GPs' and called for an overhaul of the rules to increase equal access to free prescriptions for all patients with long-term conditions.

Free prescriptions

An NHSBSA statement said that some patients 'remain unaware of the eligibility criteria for exemption from prescription charges and rely on medical professionals to relay this information'.

It added: 'GPs can help reduce the risk of those patients claiming free prescriptions incorrectly by notifying patients of their eligibility, signing and submitting applications for exemption certificates as soon as the qualifying condition is diagnosed or pregnancy is confirmed, and explaining to patients the importance of keeping their certificate up to date.'

But GPC deputy chairman Dr Richard Vautrey said: 'Discussing prescription charges and eligibility for free prescriptions would primarily be done with the patient and the pharmacist.

'The complexity and unfairness of the current system, where some long-term conditions lead to free prescriptions for all items whilst patients with other long-term conditions have to pay regular and increasingly expensive charges, needs a radical overhaul rather than just adding more bureaucracy onto already overstretched GPs.'

Patient behaviour

An NHSBSA spokeswoman told GPonline that a 'significant driver' behind ramping up checks on free prescription claims was to recover NHS funds that were being lost, but that the process also aimed to deliver 'behaviour change'.

'We’re working to educate patients, prescribers and dispensers on the rules around exemption from prescription charges to prevent genuine mistakes from being made,' she said.

She added that not all patients found to have claimed a free prescription they were not entitled to would face fines.

'Where we cross-check a claim with our records and don’t find an exact match, we’ll write to the patient and ask them to either confirm their entitlement or pay the outstanding prescription charge(s) plus a penalty charge,' she said. 'This means that not every mismatch results in charges being paid  - for example, it could be that the patient has forgotten to update the address linked to their exemption certificate.'

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