Prescription exemption-simple query

[FuturePharm]

It's a very simple area but if someone can please clarify this i'd be grateful;

-When filling in the back of a prescription, i know that under 16's and over 60's are exempt from charges and dont have to sign;

-For those on income benefits etc or exemptions H, K, M or S with the asterix by them must complete the name, DOB and national insurance number right underneath;

-And those that pay obviously just write the paid amount and sign etc,

BUT MY QUESTION:

for those with other exemptions i.e D, E, F, G or L (maternity/medical/pre-payment etc) apart from ticking whichever box, and signing in Part 3, what else must you do for the prescription to correctly go through and not be switched? Do you need to write down the number on their exemption certificate/card? Do you just tick the box saying evidence not seen, or just tick the box and have them sign part 3? Basically when taking in prescriptions with exemptions, what must i make sure to do so it is valid?

Thanks in advance

[bobbin]

When filling in the back of a prescription, i know that under 16's and over 60's are exempt from charges and dont have to sign

Only if the script has a ***computer-generated*** DOB printed the front. If not, the script will be switched if the back is not ticked and signed. Handwritten DOBs/ages are not accepted by the PPA as evidence of exemption if the back of the script is not completed. A member of staff can tick/sign for patients, they do not have to sign for themselves.

Regardless of the exemption category, if a box is clearly marked and the script is signed in the correct place, it will not be switched. Not filling in the NI number will not cause the script to be switched......nor will the absence of the date or name/address of the person signing......nor will the script be switched if the pt ticks a box claiming that they are receiving a benefit which they actually do not receive.

The best policy is to ensure that ALL exempt scripts have a box clearly crossed and a signature in the correct place. The cross/tick must be clearly inside a box - not near it or next to it. A black biro should preferably be used so that the scripts can be easily processed by the computer. It is often necessary to re-cross boxes because patients have carelessly ticked next to the box, but not inside it.

[bobbin]

Do you need to write down the number on their exemption certificate/card? Do you just tick the box saying evidence not seen, or just tick the box and have them sign part 3?

You don't have to write down the card number/expiry, although you can do if you wish to store it on the PMR. If you have not seen any evidence, you are supposed to tick the 'evidence not seen' box, although it seems that there's little point because the PPA almost never check up. The 'evidence not seen' box doesn't have anything to do with script switching. If the pt has ticked a box and signed, the script will not be switched.

The system of NHS prescription charges is pretty much a farce........

1. Most scripts are exempt, which encourages the ordering of huge amounts of unneccesary repeat medication by certain patients.
2. The list of exemptions is unfair.
3. There are some ridiculous double charges eg. for a pair of compression hosiery.
4. Patients do not have to show evidence, and can readily obtain free scripts fraudulently by pretending to be on income support, or whatever.
5. 'Script switching' leads to theft of money by the DoH from community pharmacies.
6. Pharmacies receive no payment for all the time taken explaining and taking charges, and using the card machine.
7. The bizarre fixed charge per item means that patients have no appreciation of the true value of their medication.

[FuturePharm]

Thank you very much for your reply Bobbin, all much clearer now.

[Pharmanaut]

You don't have to write down the card number/expiry, although you can do if you wish to store it on the PMR. If you have not seen any evidence, you are supposed to tick the 'evidence not seen' box, although it seems that there's little point because the PPA almost never check up. The 'evidence not seen' box doesn't have anything to do with script switching. If the pt has ticked a box and signed, the script will not be switched.

The system of NHS prescription charges is pretty much a farce........

1. Most scripts are exempt, which encourages the ordering of huge amounts of unneccesary repeat medication by certain patients.
2. The list of exemptions is unfair.
3. There are some ridiculous double charges eg. for a pair of compression hosiery.
4. Patients do not have to show evidence, and can readily obtain free scripts fraudulently by pretending to be on income support, or whatever.
5. 'Script switching' leads to theft of money by the DoH from community pharmacies.
6. Pharmacies receive no payment for all the time taken explaining and taking charges, and using the card machine.
7. The bizarre fixed charge per item means that patients have no appreciation of the true value of their medication.

It is problematical, but everything suggested also has its problems.
I'm left wondering that Wales, Scotland and NI can reduce then abolish them but England increase them in line with inflation.
An analysis should be done on how much the real cost to collect and process charges, police the system for fraud actually costs and make a decision based on that.
The counter-fraud service would still be needed, but less so for bogus exemptions.

The biggest problem would be over-use of a free service.
Its too easy for busy practice staff to hit "Repeat all", we then dispense and deliver and the patient puts a third of it (my guess) into their 'store cupboard'.
That's we we come in with our 'not dispensing fee' for checking if the repeat is necessary.
A whole service could be based on compliance monitoring.
The mountain of waste medicines could then be reduced to a hillock, with more money saved.

Anyway, that's my two tablets worth.

[johnep]

The 'all in' hotels have discovered that costs are actually reduced as no need for cash to be handled, no need for tills, no need for staff to police other staff, time is saved by not having to register cash, give change etc. However, if charges abolished and staff no longer required, the public service unions would be raging. The Labour government found that bringing in more regulation created jobs that they could then boast about. After all, if no taxes, then no need for the 000s of staff in IR. In many cases the collection costs costs more than the income eg The Dog Licence. Hong Kong has shown the way forward, according to the TV prog. More government leads to poverty, less government leads to wealth.
johnep