Reminder: Completing patient declarations for age exempt patients

PSNC’s Pricing Audit Team have noted seeing an increase in unsigned patient declarations for patients who are age exempt where the date of birth is handwritten. Pharmacy teams are reminded that where the date of birth is handwritten the patient declaration on the reverse of the prescription MUST be completed in full, i.e. exemption box clearly marked and there is a signature in the signature box.

Only patients over 60 years or under 16 years with a printed date of birth on the prescription do not need to provide any proof of age or make a declaration on the reverse of the form.

Pharmacy staff must mark every electronic prescription to indicate whether a prescription charge was levied, and where relevant indicate the prescription charge exemption category and whether evidence of exemption was seen.

The Pricing Authority base payment solely on information contained in the electronic prescription message, therefore it is essential that prescription charge exemption information is recorded accurately in the electronic message to ensure correct payment.

Pharmacy teams must ensure that exemption and paid declarations on paper prescriptions and tokens are completed in full and forms placed in the correct groups (see Prescription sorting requirements) to avoid prescriptions being switched between chargeable and exempt groups.

For details of eligible reasons for exemption from NHS prescription charges see our page Exemptions from the prescription charge

TOP TIPS: How to prevent prescriptions from being switched
  • Check the reverse of every exempt prescription (ideally at the time of handing over the medication to the patient) ensuring that:
    1. the amount levied has been entered in the ‘if you paid’ section, or
    2. an exemption box has been clearly marked (for example tick or cross)
    3. there is a signature in the signature box of the declaration (this is especially important when a patient is signing multiple prescriptions at a time)
  • Please note: a pharmacy stamp is not accepted as a signature in a declaration of exemption. If a prescription is submitted without a valid signature in part 3, it could be switched.
  • Ensure that all prescriptions are filed correctly in the paid or exempt sections at the end of every day.
  • If possible, double check the exempt prescriptions for misfiled paid prescriptions before submission at the end of the month.
  • You do not need to use a particular coloured pen to complete exemption declarations; this has no impact on whether an item is switched.

Prescription switching statistics can be found on page 2 of your FP34 Schedule of Payments. It details the number of switches made by the Pricing Authority and the reasons why. It is important to monitor this closely, for example to ensure that the Pharmacy Team are following prescription receipt SOPs and ensuring exemption declarations are completed correctly, where required.

For more information on prescription switching see our page here.

Q. Does the Pricing Authority have lawful authority to deduct charges from a pharmacy’s reimbursement for a prescription where the reverse of the form has not been completed?

A. The National Health Service (Charges for Drugs and Appliances) Regulations 2000 as amended requires a pharmacy (and other NHS suppliers ) to collect the prescription charge unless there is a valid claim for exemption (other than the exceptions, such as for oral contraceptives, or the age-related exemptions where the date of birth is printed on the form).

Under Regulation 3(7) of those Regulations, any sum payable by the local NHS England teams to the Chemist (i.e. reimbursement and remuneration to the pharmacy) shall be reduced by the amount of charges which are required to be made. This requirement to deduct the amount equivalent to the charges for all chargeable prescriptions is mandatory, and therefore the Pricing Authority not only has lawful authority to deduct the charges, but is required by the Regulations to do so.

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