‘Script charges must be scrapped during the COVID-19 outbreak’
Checking patient prescription exemption claims is an unnecessary burden on pharmacy teams in England during the COVID-19 pandemic, says Mike Hewitson
We must scrap prescription charges for the duration of the COVID-19 outbreak. After all, NHS England has said it is keen to “remove routine burdens” so that frontline workers can focus on ensuring that patients have access to their essential medicines.
In my pharmacy in Dorset, it takes at least one week of staff time each month to quality-assure the process. For each mistake made, either my business ends up paying £9.15 or the patient risks a fine. Clearly, we don’t want either of these things to happen, so we spend hours making sure that electronic prescription service claims match paper scripts.
Only pharmacies in England have to complete this mindless task. The other UK countries have scrapped the prescription charge permanently.
Apart from the principle that pharmacists should not be tax collectors, we know that only a minority of patients actually pay the charge. Policing them requires a huge amount of effort – we have a totally lopsided system.
For the purposes of COVID-19, let's focus on the specific problems and risks. Firstly, to administer the charge to patients receiving deliveries we are going to have to be very careful to call every one we believe should be paying for their prescriptions, to ask them if they can pay over the phone before we deliver the medicine. This is a massive logistical challenge.
Alternatively, we wait for the patient to pay retrospectively, which leaves us with the risk that they don’t do that. Or we risk our drivers or volunteers – if you’re brave enough to use them – accepting cash from sources that are potentially contaminated with COVID-19.
This is madness in the current environment, but there is a straightforward fix. Health secretary Matt Hancock could simply set the prescription charge to £0 for the duration of the crisis. This is the right thing to do and wouldn’t tie up our precious staff or telephone capacity with people worrying about ticking the right box.
That’s before you even get to the question of whether the charge is fair. A huge number of people have been furloughed from their jobs, and are potentially receiving a reduced income or no income at all. Someone who could have quite comfortably paid the charge six weeks ago might be in very different circumstances now.
I have heard one or two colleagues say that they’re concerned about patients over-ordering their prescriptions or seeking over-the-counter medicines rather than paying for them. However, in my mind there is very little risk of this happening, because there isn’t the capacity in the GP system to write more prescriptions, and there are a set of policies that discourage OTC medicines from being prescribed.
We also have to be a little bit circumspect, because we do not know the circumstances that individual families are dealing with right now. A person could be living on donations from a food bank for all we know. We must be careful not to judge others at these incredibly difficult times.
Mike Hewitson owns Beaminster Pharmacy in Dorset
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