NHS prescription fine

RAWS

Hi. I'm not sure if I'm posting this in the right section - apologies if not. If I'm in the right place and anyone can give some advice I'd be very grateful.

Until April this year we qualified for an NHS tax credits exemption certificate but because our estimated income (self employed) went up we didn't receive a new exemption letter. We still recieve tax credits and our income fluctuates. (We adjust the estimated income accordingly- I don't know if this is relevant but thought I'd mention it anyway.)

My daughter collected a prescription for my husband at the end of June this year.  The person serving her asked if my husband was still exempt. My daughter replied that she didn't know but he was still receiving tax credits. The pharmacy assistant filled the form in and didn't take payment.

He was unaware of this until he received a letter from the NHS business services authority with a potential £100 fine if he couldn't produce evidence of exemption. Of course he can't do this.

He has no problem paying for the missed prescription charge but will he have to pay the £100 fine? It seems a bit unfair considering it was a genuine mistake and has never happened before.

sheramber

If you are exempt you will recieve a n exemption certificate.

If you do not have a valid certificate then you cannot claim exemption.

if you are not sure if you are exempt or not then you should pay fo the prescription and request a payment receipt. You can then contact NHS and if you are exempt they will refund the charge. if you are exempt they will refund the charge.

You should consider whether you can apply for help due to low income

https://www.nhs.uk/nhs-services/help-with-health-costs/nhs-low-income-scheme-lis/

You can appeal the  charge but I wouldn't hold my breath 

https://www.nhsbsa.nhs.uk/respond-your-letter

DullGreyGuy

https://www.nhsbsa.nhs.uk/sites/default/files/2021-09/Patient%20exemption%20checking%20guide%20-%20pharmacy%20%28V3%29%20-%2008.2021.pdf

If you read the above guidance they state it's always the patients responsibility even if someone else signs the form for them. 

If its a single prescription then the they will have to pay the proper fee plus a penalty of 5x that fee. The £100 is a cap for if you are caught with multiple prescriptions or 3 items on one prescription. 

Did you get another exemption certificate after? Was it backdated?

Personally I'd take a bit of issue with the pharmacy over it as the official guidance if the person says they dont know is to tell them to pay and give them the form to claim it back if it turns out they were exempt. That said I know our pharmacist whenever they see diabetes medicines fill in as medical exempt whereas legally being diabetic doesn't make you excempt, having the certificate does and diabetics can get the certificate if they take meds not just diet (valid for 5 years at a time)

RAWS

Thank you for your replies.

No we didn't get another certificate although perhaps we should have. I'm guessing the exemption certificate is based on the last tax credits award rather than current estimated income but I can't find any clear guidance on that. Perhaps there would be an issue with our income estimate being updated throughout the year.

I guess it's only fair that the responsibilty is the patients, whoever collects the prescription, but there must be cases like this where an honest mistake is made. If someone is dealing with ill health then they're not always thinking clearly and have to rely on others. I guess we know more now and we won't make the same mistake again but it's really frustrating that we didn't know so we couldn't put it right.

Yes I will take it up with the pharmacy but they're hopeless and I don't think they'll help. I've had many issues with them and have asked for our surgery not to send prescriptions to them - but that's another story.

DullGreyGuy

Having been caught myself, though on medical exemption, I know if you get a new medical exemption certificate and its backdated to the incident (rarely will be given how slow they are) then the waive the lot. If you get it backdated but the incident is still before that then you have to pay the prescription charge but they waive the fine.

I dont know if you apply and get awarded a benefits related exemption again now if the same rules apply. Obviously there is a difference in that you dont develop diabetes, get better then catch it again whereas peoples economic situations do change over time. 

RAWS

I could try and see if we could have a backdated expemption certificate. We've got a few weeks anyway so I'll see what I can do. If we have to pay it then so be it. It's just come at a financially difficult time and an unfair amount considering what actually happened but that's life now I guess.
Thanks so much for your replies.

_Jem_

You can check if you have a exemption certificate

https://services.nhsbsa.nhs.uk/check-my-nhs-exemption/start

Spoonie_Turtle

RAWS said:

Yes I will take it up with the pharmacy but they're hopeless and I don't think they'll help. I've had many issues with them and have asked for our surgery not to send prescriptions to them - but that's another story.

Does your surgery have an online system where you can request medication?  If so, you can probably change where your prescriptions are sent via that.

Yamor

Legally, the NHS exemption is based on the latest current year tax credits award at the time of the treatment or taking out the prescription.
The household income on the award has to be £15,276 or lower, but taking into account the £2.5k disregard used by HMRC for tax credits purposes.
So, if your final income for last year was over £15,276, then you would need this year's to be no higher than £12,776.
Conversely, if last year's was £15,276 or lower, then this year's must only be £17,776 or lower.

The exemption certificate issued by NHSBSA to those on tax credits is not legally required. You simply need to fall within the exempt group.
This can often be relevant where you used the NHS very soon after your tax credits award was recalculated. In this situation, you should contact NHSBSA, and they will cancel the penalty.

On the other hand, the exemption certificate is beneficial in that it is sufficient even if your situation changes so that you no longer fall within the exempt group. You would then still be entitled to free prescriptions etc until the end date on the certificate.

andrewmp

Yamor said:

Legally, the NHS exemption is based on the latest current year tax credits award at the time of the treatment or taking out the prescription.
The household income on the award has to be £15,276 or lower, but taking into account the £2.5k disregard used by HMRC for tax credits purposes.
So, if your final income for last year was over £15,276, then you would need this year's to be no higher than £12,776.
Conversely, if last year's was £15,276 or lower, then this year's must only be £17,776 or lower.

The exemption certificate issued by NHSBSA to those on tax credits is not legally required. You simply need to fall within the exempt group.
This can often be relevant where you used the NHS very soon after your tax credits award was recalculated. In this situation, you should contact NHSBSA, and they will cancel the penalty.

On the other hand, the exemption certificate is beneficial in that it is sufficient even if your situation changes so that you no longer fall within the exempt group. You would then still be entitled to free prescriptions etc until the end date on the certificate.

What if you've had a pay rise and have told them that you expect to earn more than the threshold?  Will this still issue another one?

fryedslyce

RAWS said:

The pharmacy assistant filled the form in and didn't take payment.

Did your daughter sign the form?
If she didn't, then you should appeal stating that the form was not signed and therefore there is no evidence she acted wrongly.