The Department of Health (DH) did not conduct an impact assessment or consult with pharmacy bodies before announcing plans for pharmacists to carry out prescription fraud checks, C+D has learned.

The government said an assessment had “not been required” before deciding that pharmacists would take responsibility for policing free prescriptions, in a response to a Freedom of Information request from C+D, received last week.

When announcing the plans in December, the DH estimated it would save the NHS £150 million by enabling pharmacists to check electronically for fraud “at the click of a button”.

The DH said it had not conducted an assessment on the proposals – due to come into force by 2018 – because no action had been taken to create the IT system needed to conduct the checks.

An impact assessment would be conducted “in tandem” with the development of this system, the DH told C+D.

It also revealed it had failed to consult any pharmacy bodies when formulating the plans - only discussing them with NHS England, the NHS Business Services Authority, the Department of Work and Pensions, cabinet office and Health and Social Care Information Centre. 

The DH refused to divulge how much time it estimated pharmacists would spend conducting the checks, what alternatives to the proposals it had considered, or the details of any meetings it held to formulate its policy. Although it admitted it did hold information relevant to C+D’s request, the DH argued that the public interest lay “in protecting the policy-making process”.
 

Patient impact

Pharmacy Voice chief executive Rob Darracott branded the lack of an impact assessment “short-sighted” given the potential effect on pharmacist workloads. “If the plans take up more of pharmacists’ time, there is a risk patient care could suffer,” he told C+D.

Graham Phillips, owner of Manor Pharmacy (Wheathampstead) Ltd, Hertfordshire, said the DH’s decision not to conduct an assessment of the impact of the checks on patient relationships revealed its “attitude problem” towards pharmacists. “It’s a failure to appreciate that pharmacists have clinical relationships. [The DH] wouldn’t do that with nurses or doctors,” he told C+D.

The Royal Pharmaceutical Society told C+D it wanted pharmacists to be able to focus on patient care instead of “policing prescription charges”. “It seems a false economy to have prescription charges full-stop, especially for those with long-term conditions,” it argued.

PSNC head of NHS services Alastair Buxton said the negotiator could not assess the impact of the government’s proposals on pharmacy teams, as PSNC had “no specific details about the new system”. It repeated its call for pharmacists to “broadly co-operate with counter-fraud initiatives”.
 

The Department of Health’s response in full

Q Was an impact assessment conducted before the decision was made?

A An impact assessment has not yet been required, as no action has been taken in respect of the electronic point of dispensing checks, which will have an impact on providers, businesses or the public. As the development of the electronic system is taken forward, the impact assessment will be developed in tandem with it.

Q Could you tell me how much time you estimate pharmacists will spend conducting the checks and what alternatives were considered? Could you also send me the details of meetings held about the checks that led to the decision being made, including a list of attendees and minutes taken?

A I can confirm that the department holds information relevant to your request. The department recognises the general public interest in making this information available for the sake of greater transparency and openness. However, the Department believes that the public interest lies in protecting the policy-making process and preserving the ability of officials to engage in free and candid discussion of policy options without apprehension that suggested courses of action may be held up to scrutiny before they have been fully developed or evaluated.

Q Who was consulted on the plans outside of the Department of Health and the Department of Work and Pensions?

A The Department of Health has discussed the proposals with the NHS Business Services Authority, NHS England, the Department for Work and Pensions, Cabinet Office, and the Health and Social Care Information Centre.

Source: Freedom of Information request response, Department of Health, February 17

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