NHS Penalty - Expired exemption cert - Help please!

NiJella

Hello

When my fella had a knee op he took out a prescription cert and told me so at the time, circa 2021.

2023 I collected a prescription for him and the pharmacist said to me, 'he has an exemption certificate' and she ticked the script and I was given the meds. I didn't sign anything.

My partner has now received a PCN letter to say that he claimed a free prescription when he may not have been eligible.

I checked with him and his certificate did lapse some time ago, which I was not aware of.

I only accepted the free script for him because the pharmacist told me, he had an exemption cert, I said 'ok, thanks'. And off I went!

A result on Google says:

The patient has a defence if there is no evidence that they acted wrongfully. This defence is based on fact: the patient (or their representative) either made the claim of they did not and the authorised/delegated officer either has evidence of this or they do not. 

I, the patients representative, did not act wrongfully. I did not make the claim that my partner had an exemption certificate, I was told that he did. Therefore do you think I/he has a defence here? Any further thoughts / advice very welcome.

Thank you

HillStreetBlues

How  the penalty works, I don't think silence is a defence. It's up to the patient or representative to correct  a statement if it isn't factual. 

NiJella

HillStreetBlues said:

How  the penalty works, I don't think silence is a defence. It's up to the patient or representative to correct  a statement if it isn't factual. 

Thank you, I wasn't silent, I was informed by the pharmacist and I accepted, I didn't know it wasn't factual unfortunately.

Muttleythefrog

Yeah you could try to argue case but I think it would be up hill battle as frankly I'm not sure a pharmacist would know whether someone was exempt unless the patient (or representative) presented evidence of exemption such as the certificate for such. They should rely on what you tell them otherwise if helping fulfil a prescription. It's possible the pharmacist was prompting a response rather than asserting a fact when you spoke.

I was in the past successful in arguing my wife should have NHS dental fees refunded (which she had paid for assuming she had to) as the NHS BSA accepted official advice (government website) had directly misled us in falsely thinking she (as a migrant subject to immigration control) would have to pay. So it is possible to 'change outcomes' but I think you start from a much weaker position here.

poppy12345

If it rang out quite sometime ago and they have regular prescriptions they are lucky they didn’t get caught before. 

It’s the patient’s responsibility to make sure they are exempt and no one else’s. 

NiJella

Muttleythefrog said:

Yeah you could try to argue case but I think it would be up hill battle as frankly I'm not sure a pharmacist would know whether someone was exempt unless the patient (or representative) presented evidence of exemption such as the certificate for such. They should rely on what you tell them otherwise if helping fulfil a prescription. It's possible the pharmacist was prompting a response rather than asserting a fact when you spoke.

I was in the past successful in arguing my wife should have NHS dental fees refunded (which she had paid for assuming she had to) as the NHS BSA accepted official advice (government website) had directly misled us in falsely stating she (as a migrant subject to immigration control) would have to pay. So it is possible to 'change outcomes' but I think you start from a much weaker position here.

Thank you. I rang the Pharmacy today and chatted with them about it, she actually said to me, 'I can see here that your partner has an exemption certificate' I clarified that I now know that he does not. It would seem that she was referring to something on her system, a note, a record?

It was from this that I was originally advised that my partner had the cert, when I collected the script, the Pharm didn't ask me rather let me know, I didn't dispute it because I thought it was fact. 

I shall attempt to explain this and hopefully it may be considered that I was misled. 

Thank you for sharing your story, I am so glad that you were victorious.

jlfrs01

NiJella said:

I shall attempt to explain this and hopefully it may be considered that I was misled. 

I'm not so sure it's a case of being misled, maybe a matter of an unintentional mistake on the Pharmacist's part who probably was reading off a note on their system. Let me put it this way - if they had said correctly at the time of collection that the certificate had expired, would you have paid as anybody else would have to? The NHS has written to your Partner because it is his responsibility and he is liable to pay for any medicine which should have been paid for. 

peteuk

It is likely that he had a prepaid exemption which he may have either paid for by direct debit or in a single payment.  The direct debt continues to roll over each year, until you get to a certain age.  It then stops.

I’m not sure if the yearly payments automatically renew.

Unless he has another disease/illness which allows for an exemption eg diabetes.  These are applied for via your Gp and have a five year validity.

What should have happened is you ticked and signed the back of the script accordingly.  But I know a lot of pharmacist don’t bother these days.

But in this instance if there’s no prepaid exemption then sorry, it’s the fee and fine.  If there is one then you send the evidence and it gets quashed.

DullGreyGuy

What type of exemption was ticked? Have they previously had such an exemption? Are they still entitled to it?

I know with medical exception just having the illness is sufficient, it's having the certificate that gives the waiver not the illness. If however you forget to renew, its only valid 5 years even on life long conditions, then you get the fine and charge but if you quickly get a new medical exemption cert then they waive the fine and you just pay the charge. 

NiJella

DullGreyGuy said:

What type of exemption was ticked? Have they previously had such an exemption? Are they still entitled to it?

I know with medical exception just having the illness is sufficient, it's having the certificate that gives the waiver not the illness. If however you forget to renew, its only valid 5 years even on life long conditions, then you get the fine and charge but if you quickly get a new medical exemption cert then they waive the fine and you just pay the charge. 

Thank you for your thoughts.

I assume the pharmacist ticked to say that my partner had a valid certificate, which neither the pharmacist nor I realised that he did not, as it had indeed expired with some time having passed.

NiJella

jlfrs01 said:

NiJella said:

I shall attempt to explain this and hopefully it may be considered that I was misled. 

I'm not so sure it's a case of being misled, maybe a matter of an unintentional mistake on the Pharmacist's part who probably was reading off a note on their system. Let me put it this way - if they had said correctly at the time of collection that the certificate had expired, would you have paid as anybody else would have to? The NHS has written to your Partner because it is his responsibility and he is liable to pay for any medicine which should have been paid for. 

Thank you. Without question I would have paid had I known the cert had expired. I agree the script is to be paid for, I don't agree that my partner should pay a hefty fine for (as you say) an unintentional mistake on the Pharmacist's part or on my part. I understand that it may be your opinion that in this case my partner should have to pay the fine, that is fair enough, I am here for people's thoughts on this case. 

However going back to my original post according to the research I found:

The patient has a defence if there is no evidence that they acted wrongfully. This defence is based on fact: the patient (or their representative) either made the claim of they did not and the authorised/delegated officer either has evidence of this or they do not. 

My partner (the patient) has not acted wrongfully as their representative (me) did not make the claim. I was advised that he had a valid cert, I believed this to be fact, I did not tick or sign anything on the script. 

If the conclusion is that my partner has to pay the fine then so be it, I shall explain what happened and see if there is any grace. I will let you know!

Thanks again.