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Real-time exemption checking may have problems


Real-time exemption checking may have problems

The English Pharmacy Board chair Sandra Gidley has warned there could be problems with a new system the government wants to introduce that will allow pharmacists to check if someone is exempt from prescription charges.

Ministers hope the real-time exemption checking system (RTEC), which is expected to be piloted in pharmacies next month, will reduce fraud in the NHS, with some £256 million a year lost to the health service because of free prescriptions that are wrongly handed out.

Gidley told BBC Radio 4’s Moneybox programme that whilst “nobody will condone fraud of any kind…very often, it is a genuine mistake.” The prescription charge in England is £8.80 per item.

RTEC will see the electronic prescription issued and pulled into the pharmacy’s patient medication record (PMR) system. The pharmacy team processes the prescription on the PMR system and while the prescription is being processed, information will be automatically pulled from the NHS Business Services Authority on the exemption status of the patient.

The patient’s RTEC exemption status will then be added automatically to the electronic prescription claim message sent by the pharmacy.

“It will help because at the moment, it takes time to sometimes go through this with people. Not all exemptions I believe will be checked in the first phase but the NHS already collects data on whether you have a medical exemption for example or whether you’re pregnant and that you’ll be able to align with the existing NHS systems,” Gidley (pictured) said.

“That will be helpful but I can foresee that there could be problems ahead because not everybody realises they have to renew their medical exemption and sometimes people fall foul of this system because the haven’t gone back to the GP and asked them to sign up again.

“We have some concerns that although in the long-run it will be easier, if the computer says no, you then get into an unfortunate situation where the pharmacist says no and ‘well, the computer say no, you’ve got to pay’ and the patient is absolutely convinced they don’t. That’s the sort of thing we need to avoid.”

People in certain groups, including those aged 60 years and over, under 16 and pregnant women, are entitled to free prescriptions but Gidley said she was concerned by the complexity of the prescription charges system and insisted many fines issued were the result of genuine mistakes by patients instead of intentional fraud.

“We’ve noticed a big increase in the last couple of years in the number of penalty notices that are being issued and that’s problematic because, very often, people sign believing they are exempt and for some technical reason the computer doesn’t think they are. When people are not well, that’s the last thing they need,” she said.

“The benefits is a real nightmare because increasingly, pharmacists are handing out a prescription to somebody who is picking up on behalf of the person who’s ill.

“The person will say ‘oh, Mrs Bloggins gets her prescriptions free because she’s on benefits’ and very often there’s confusion and people will just tick a box and hope for the best.

“That’s not a very sensible thing to do because you could be fined, so my advice to anybody who doesn’t know exactly whether they are exempt or not is to pay, get an NHS receipt and when they have the proof, they can be refunded at any pharmacy.”

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