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Revealed: £11m swiped from pharmacies since 2020 over patient paperwork errors

The NHS Business Services Authority (NHS BSA) reclaimed over £3 million from pharmacies just last year due to patients failing to sign their prescription exemptions, C+D can exclusively reveal. 

A single “entirely bureaucratic error” has cost English pharmacies almost £11m since 2020, C+D can reveal.

If the NHS BSA does not agree that a paper prescription should have been processed as exempt from payment, it will reclaim the cost of the prescription from the pharmacy that dispensed it through a process known as switching.

“Over 95% of NHS prescriptions are now electronic, considerably reducing the occurrence and impact of switching,” Community Pharmacy England (CPE) drug tariff and reimbursement manager Suraj Shah told C+D earlier this year (March 22).

But now, C+D can reveal that exemption forms left unsigned by patients in England cost pharmacies £3,034,942.50 last year alone.

A C+D freedom of information (FOI) request to the NHS BSA found that between January 1 2020 and February 28 2024, the NHS BSA clawed back a total of £10,923,633.10 from English pharmacies.

All reclaimed cash was due to “the signature of the patient or patient’s representative [being] missing”, the NHS BSA said. 


“Penalising pharmacy” 


Commenting on the reclaimed cash, contractor Mark Bartley asked why “in the digital age” patients have to “physically sign scripts”.

“Things like prepayments and medical exemptions are done online,” he said.

“Why if the person holds a digital exemption can the two not automatically be linked up without penalising the pharmacy?” he added.


“All it can take is just one slip of somebody forgetting to get a prescription signed and if it's a big prescription, it could cost the pharmacy quite a lot,” Bartley told C+D.

He added that if an exemption is “unclear”, pharmacies “should be allowed some kind of return on it” after checking the patient’s status rather than the NHS BSA “simply charging the pharmacy”.

“It makes you wonder what happens that money,” he said. “Does it go back into the global sum in some way, or just get drifted off into government?”


“Perilous financial strain”


Reacting to the data yesterday (June 6), pharmacist Ben Merriman told C+D that the clawback is “completely unacceptable”.

He added that it is “unfair” that pharmacies already under “perilous financial strain are being punished for what is an entirely bureaucratic error”.

“A single missed tick in a box or signature in the wrong place could lead to tens of pounds being deducted from a pharmacy's monthly payment,” he said.

Deeming prescription charges a “tax on sickness”, he added that they must “be abolished and abolished soon to ensure that our patients do not have to make the awful decision of choosing which of their medicines…is worth more to them”.

C+D approached the NHS BSA and the Department of Health and Social Care (DH) for comment.

In April, the government announced it would hike prescription charges in England by 25p – the second year in a row it has increased the levy. England remains the only country in the UK to charge a levy for NHS prescriptions.

Meanwhile, the National Pharmacy Association (NPA) this week (June 4) announced a “day of protest action” to highlight the “emergency across the community pharmacy sector”.

The membership body revealed that it chose the date of June 20 for the event because this represents “the day from which the average pharmacy across the four nations will be lossmaking overall”.

“There is typically only enough NHS funding to cover costs for the first three weeks of any month – after which the pharmacy service is effectively subsidised by the business,” it said.

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