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Script fraud checks could undermine trust in pharmacists

Numark MD John D'Arcy: Making pharmacists into "exemption policemen" could affect patient relationships

Pharmacy leaders, including Numark's John D'Arcy, have voiced fears over the Department of Health's planned "major clampdown" on prescription fraud

Government plans for pharmacists to electronically check if patients are eligible for prescription exemptions could undermine trust in the sector, pharmacy leaders have warned.


Under the proposals, due to be introduced in England in 2018, pharmacists would have access to an online system to verify which patients were entitled to free prescriptions at the “click of a button”, the Department of Health (DH) announced last week (December 30). It estimated the system& would save the NHS £150 million a year.


Numark managing director John D’Arcy said that, although it was “absolutely right” pharmacists should play their part in “clamping down on fraudsters”, he was concerned about the profession's increased involvement in exemption checking. 

The relationship between pharmacists and their patients was "complex" and relied "in large part on trust", Mr D'Arcy said. Encouraging pharmacists to become “exemption policemen” could undermine their relationship with patients and have a negative impact on patient care, he told C+D  yesterday (January 5).


Pharmacy Voice chief executive Rob Darracott agreed that relationships with patients could be "compromised" by “increased levels of scrutiny”. He called for an overhaul of the system to “do away with” prescription charges altogether.


PSNC said that, while pharmacists should “broadly co-operate” with counter-fraud initiatives, it was important that any “administrative burdens” were kept to a minimum so they could concentrate on spending time with patients. A full review of the charging system was required to see if the costs could be "more evenly distributed among those who can afford to pay", said PSNC chief executive Sue Sharpe.


Hertfordshire contractor Graham Phillips told C+D the proposals “sent all the wrong messages” to patients. “I’m not a policeman, this is not my role,” he tweeted.


Striking a balance


England's chief pharmaceutical officer Keith Ridge said the new system aimed to "strike the right balance" between discouraging the public from breaking the law and allowing healthcare professionals to provide "safe and effective care" for their patients.

Health minister Daniel Poulter, who unveiled the proposals, said the current system of requiring pharmacists to "rely on people's honesty" had led to "abuse". "Claiming a free prescription when you are not entitled takes money away from other frontline services and reduces the money available to spend on patient care," he added.


As part of the "major clampdown" on fraud in the health service, the current system of post-prescription checks would be expanded and patients who claimed free prescriptions fraudulently would face a penalty of up to £150, the DH said. Persistent offenders could face a court hearing, a £2,500 fine and a criminal record, it added.


How would these changes affect your relationship with patients?

We want to hear your views, but please express them in the spirit of a constructive, professional debate. For more information about what this means, please click here to see our community principles and information


Sally Gordon, Locum pharmacist

So, we will be 'trusted' to look at information about patients' benefits, but accessing their health records is still not possible.

Richard Hodgson, Community pharmacist

As one who has had a patient stomp out of the Pharmacy in a strop this week, just because she had been asked ' Do you have any evidence of your income support you can show me?', grumbling 'I've been coming here for 20 years and you don't believe me,' what do readers think will happen if she was told 'Just a minute. I will check your claim on the data base'?

Raj Samra, Community pharmacist

This news is a tragedy for the profession and is yet another example of pharmacists being expected to do more for less; when will those we have trusted in authority decide 'enough is enough' and actually help prevent extra workload/responsibility being placed on an already stressful job role.

geoffrey gardener, Community pharmacist

GPs issue prescriptions, why cannot they be the ones to collect the fees? They are quite happy to charge for holiday vaccinations, medical certificates, and signing passport forms. I am sure Cameron would reward them financially for it in a much more generous way than we could ever dream of.

THB _B, Community pharmacist

If psnc agree to this we should all have a vote of no confidence in them via the lpc. ... is such a thing even possible???

michael mustoe, Community pharmacist

I am, along with my staff, increasingly feeling like a Social Security Service policeman. This system MUST change. I am a healthcare professional. The DOH must wake up, and realise that, first, the nation's Community Pharmacists can and should have a far larger role in the delivery of health services in the UK, and secondly, we must not become 'policemen'. The country has far more to be gained by developing the former. Come on Mr Hunt, lets engage some grey matter and use our resources properly. The hour has come!!

David Moore, Locum pharmacist

So what do we do when the patient stands in front of us, with his proof of exemption, but the computer says NO. Patient is not exempt??

London Locum, Locum pharmacist

You brace yourself ready for hand to hand combat. And hope the patient is smaller than you.

London Locum, Locum pharmacist

If the 'profession' had any balls they'd refuse this ridiculous exercise. Do you reckon GPs would except this rubbish? I think you all know the answer. I know I certainly do.

Chris Locum, Locum pharmacist

Leaving aside individuals, the profession as a whole never had much backbone. I suspect that now we are becoming cogs in an ever bigger corporate pharmacy world it will not change. There will be endless chatter which amounts to very little with those who claim to represent us (with sound bites of working smarter not harder, delegate to staff etc.) . There is not point complaining after it has been brought in. I wonder why no such attention has been brought to bear on the issue of health tourism to these shores - easier to deal with soft touch pharmacists.

Chris Locum, Locum pharmacist


London Locum, Locum pharmacist

It just gets better doesn't it. With burden community pharmacists already have to carry they can now expect a punch in the mouth for their troubles when they refuse to hand over medicines. And all for an ever dwindling princely sum.

max falconer, Superintendent Pharmacist

Hmm, is that the same Sue Sharpe that negotiated us a stunning 2p per item to police the current checking regime....... The whole thing stinks of government incomptence. It's too difficult for them to check exemptions competently so they shift the burden onto the private sector. Rather like making employers responsible for checking whether employee are permitted to work in the UK. They are quite happy to issue NI numbers to anyone to rake the tax in but then punish employers who employee those they should never have registered in the first place! We should resist any further involvement lest we find ourselves ultimately legally responsible for accuracy of patient declaration.

Philip Sealey, Locum pharmacist

If I get on the bus without my bus pass, I am thrown off or I have to pay. If I get to the supermarket checkout without the means to pay, I leave with nothing. If I get to the chemist without proof of exemption, I can walk away with hundreds of pounds worth of drugs. If patients cannot prove exemption, they should get nothing, or pay and get a refund later. All this nonsense about patients coming to harm is rubbish, save, possibly for some A+E scenarios.

Chad Harris, Community pharmacist

Totally agree with Philip. Let's say from Jan 1st 2016. No card no medicine. That's how most of the western world works. People seem to manage with their oyster cards and bus passes. Let's even be kind and give it a running in period until June 30th 2016. If the NHS was a business it would have gone bust years ago.

Baba Akomolafe, Superintendent Pharmacist

I get that, however there is a small difference of the fact that they are not custodians of drugs and they don't have care provider relationship with their clients. I agree we need to check but wouldn't it be better for the GP system to have endorsed a payment/exempt status on the prescription before giving it to the patient? It is a lot of money and I would want to play my part but the proving of exemption should be done at their registered GP practice. This will also ensure Mr dodgy does not go around trying it out on all pharmacies in town

N O, Pharmaceutical Adviser

"""pharmacists should “broadly co-operate” with counter-fraud initiatives"""" Well Sue, what else can we expect from you but for this comment. Show me an instance where the Pharmacists have refused to co-operate in so many forced decisions, that now you are asking us to "broadly co-operate" ???

Stephen Eggleston, Community pharmacist

For me, it's simple - if we do not carry out the check, are we aiding in the defrauding of the NHS, which could lead to a FtP hearing? If electronic prescriptions are truly to work, link EMiS to the benefits system and let the GPs system endorse the exemption automatically!

Z ZZzzzz, Information Technology

Brilliant solution. Come on Sue, why did you not think of that? With that one idea you may have been forgiven for all the rest of the hairbrained ideas you put forward in the past that contractors "broadly co-operate" with.

N O, Pharmaceutical Adviser

"""""link EMiS to the benefits system and let the GPs system endorse the exemption automatically!"""" The best solution ever. But, do you think the GPs will even listen to such an idea ???? I would quit the profession even if I hear a news about they considering for exploring in to any such move !!

Dave Downham, Manager

£150m sounds a lot of money. However, what does it cost do monitor this and process with the prescriptions by the PPA? How much could be saved if the additional administration of filling in and checking the back of the prescriptions could be done away with, not to mention payment card handling charges, increased insurance for holding cash, time taken to process cash collection etc and other such incidental costs that get overlooked? I bet there wouldn't be much of a net loss overall - if any - if prescription charges were scrapped altogether.

And where would we stand legally if we were to refuse to hand over a medicine which the patient can't afford, and they then come to harm? The government really needs to be sure of the scale of the problem before it starts barging in with solutions. Have the costs of this scheme, including pharmacists' time, worsening of patients' conditions etc been compared to the actual costs incurred by prescription fraud? Or is it simply a gimmick to grab those Daily Mail headline readers who are convinced the entire country is swarming with benefit frauds when it really isn't?

Peter Mcdonnell, Community pharmacist

there will be no costs incurred for pharmacists time as they have no intention of paying us a penny for the extra work. it will simply be another contractual obligation along with all the other stuff.

N O, Pharmaceutical Adviser

at the “click of a button” Does this mean a similar System like EPS-2 ??? Then, we know what is going to happen. Or will we be connected directly to Jobcentre Plus ? Then, we may as well open a kiosk in all pharmacies for Jobcentre plus at no extra cost to the government, making more redundancies in public sector jobs and more burden on Pharmacies ??? Or If we start doing the fraud detection department's jobs, then will their staff be made redundant ??? Finally, who will pay for clicking this button ??? It is easy to make statements and spend billions in a new tracking system to save millions (???) but has anyone thought about the aftermaths of these actions ??? Typical headless chickens, me thinks.

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