Q: We had a 20 year old university student present with a prescription and proceeded to tick the box stating he was 19 and in full time education. This is in order to claim a prescription charge exemption. When asked about this, he replied “It’s up to me isn't it!”.  What is our position in this case?

A: You will have to dispense the prescription. The NHS pharmacy contract obliges pharmacists to dispense a prescription without undue delay.

Pharmacists are also not responsible for the accuracy of the declaration of exemption made by the patient on the back of the prescription, this responsibility remains with the patient. We can only refuse to dispense a prescription if it is professionally and clinically inappropriate for the patient.

To avoid complicity where a potential fraud is witnessed by the pharmacy team, there are a number of steps the pharmacy can do.

1. Tick the box on the back of the prescription stating “Evidence not seen.
2. You could  provide the student with a “Help with the cost of NHS prescriptions” form to claim exemption as this student is likely to be entitled to free scripts due to low income.
3. If the alleged fraud is obvious and blatant,  you could report it directly to the NHS Fraud and Corruption Reporting Line (FCRL) on 0800 028 40 60.

This scenario is an interesting take on the current debate about checking patient’s exemption status. Pharmacists already carry out basic exemption checks when receiving prescriptions.

When the patient is unsure about their exemption status, current advice is to ask them to pay for the prescription and provide them with a receipt to claim the money back. It could also be useful to have access to a database that confirms the exemption status. However there are some concerns about pharmacists acting in a policing role.

The publication of point of dispensing checks by the NHSBSA is a useful document to understand about exemption status. It may help patients to avoid being penalised for claiming the wrong exemption.

Download 'Point of dispensing checks' PDF

Please note that all prescriptions are exempt from charges for patients in Northern Ireland, Scotland and Wales. However, pharmacies in these countries might need to be aware of the exemption rules when receiving English prescriptions.

Tariff Tip written by Sue Swift, UK Drug Tariff and Information Technician