Earlier this month (October 14), the Department of Health and Social Care (DH) announced a pilot – due to begin next year – which would see “data-matching technology” used in pharmacies to check whether a patient is exempt before medication is dispensed.

According to the NHS Business Service Authority’s annual report, it issued 1.3 million penalty charge notices to patients in 2017-18 for incorrectly claiming free NHS prescriptions, and recovered over £19m from prescription checks.

Alastair Buxton, director of NHS services at the Pharmaceutical Services Negotiating Committee (PSNC), said the introduction of the technology could “save patients and pharmacy staff time”.

The “real-time exemption checking” technology will enable pharmacy staff to digitally check a patient’s exemption status and apply it to their electronic prescription service (EPS) prescription, PSNC explained.

This will “reduce the number of EPS tokens which require signing by a patient, saving patients and pharmacy staff time”, Mr Buxton told C+D.

It will also reduce the risk of “contractor loss” caused by pharmacy staff accidentally submitting prescriptions with a ‘paid’ status, he added.

“I expect these benefits to contractors and their teams, alongside the potential to reduce the amount of token printing in pharmacies, will be seen as a positive development.”

RPS: Checks “could damage patient trust”

However, Royal Pharmaceutical Society (RPS) English board chair Sandra Gidley said pharmacists should “not be expected to police the prescription exemptions system”.

“There is a real concern that this move could damage patient trust in the profession,” she said.

“It also puts pharmacists in an invidious position, as we can’t deny access to life-saving medicines to someone who qualifies for free medicines just because they haven’t completed the right paperwork,” Ms Gidley added.

The RPS would like to “revisit the idea of having prescription charges at all in England”, Ms Gidley also told C+D.

“Fines, along with prescription charges in general, disproportionately penalise those on low incomes,” she added.

CCA: Workload concerns

The Company Chemists' Association (CCA), which represents the UK's largest multiples, said both patients and community pharmacy teams have a role to play in tackling prescription charge fraud.

However, expecting pharmacists to digitally check prescription exemptions could “undermine the unique relationship that pharmacy teams have in giving trusted and independent healthcare advice”, chief executive Malcolm Harrison said.

“We are concerned that checking a patient’s status and collecting the fees essentially adds to a pharmacist’s workload without benefitting patient care.

“There is a risk that the professional relationship between patients and pharmacy teams may be compromised by what patients regard as increased levels of scrutiny,” he warned.

NPA: Promote pharmacists' clinical skills instead

The National Pharmacy Association (NPA) told C+D it “understands” why the government wants to cut prescription fraud, and why it wants pharmacies to check exemptions.

However, “supporting pharmacists to fully deploy their clinical skills in the community would deliver a far greater financial return, because optimal medicines use leads to improved health outcomes and reduced spending overall”, the NPA said.

Prescription charges “should not act as a barrier to care for those on low, fixed incomes, who don’t qualify for exemptions”, it added.