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Letters to the Editor
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Prescription checking
Complex exemption system can lead to misunderstanding
From Mr P. Walton, MRPharmS
Last year the pharmacy of which I am a director saw the fallout of having
prescription batches checked by the compliance unit of the Prescription
Pricing Authority.
We have heard of the distress caused to families receiving letters regarding
exemption claims made by their recently deceased relatives.
We have seen the effect of correspondence on a person who was so sick
with pneumonia that she unusually asked for her medicines to be delivered,
and the person who delivered them for her mistakenly made a false claim
that she was medically exempt. If the PPA had not accepted our version
of what happened, the “fine” for the mistake would have been
equivalent to the tax on five times the number of items.
Most recently, we had an epileptic patient who had suffered cerebral
palsy at birth. He had no advocate and was unable to comprehend the difficult
exemption criteria. When asked he simply told me that he received £147.50
incapacity benefit, which I assumed to mean income support. When I telephoned
the compliance unit, a member of staff told me that he had telephoned
the patient three times regarding exemption. The compliance unit claims
not to telephone GPs to verify exemptions in order not to overwhelm them
with work. What, then, of telephoning patients with limited understanding
and grilling them about medical reasons for exemption? Does this square
with Caldicott regulations? Had the patient understood and obtained the
correct certificate there would have been no problem.
Taxing those who become sick at times when they are least able to pay,
because they are off work, has always worried me. We now appear to be
in a realm where our NHS not only taxes them, but threatens some with
potentially huge fines for misunderstanding the extremely complex exemption
system.
Philip Walton
Manchester
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JOHN ELLNER, director of operations, NHS Counter Fraud and Security
Management Service, replies:
I am shocked to read of the incidents
described by Mr Walton. I am unaware of these incidents being the
subject of any complaint to my organisation. I would be grateful
if Mr Walton could supply me with further information on these
incidents so that they can be investigated.
The NHS Counter Fraud and Security Management Service (CFSMS) became
operational in April 2003, taking over responsibility for the compliance
unit, previously
part of the Prescription Pricing Authority. Since then we have been working
hard to review, revise and improve the systems used by the compliance
unit. We will
be consulting with the Pharmaceutical Services Negotiating Committee on how
these systems can be improved in the best interests of patients
and pharmacists alike.
All those who work for the CFSMS are obliged to work within a clear professional
and ethical framework incorporating principles of professionalism, propriety,
fairness, objectivity, vision and expertise. Any breaches of these principles
will be dealt with robustly.
It is important to note that since the introduction of point of dispensing
checks in April 1999 and the penalty charge scheme in August 2001, as part
of the long-term
solution to pharmaceutical patient fraud (prescription fraud), both have proved
a successful deterrent. Since 1999 we have seen a 41 per cent reduction in
losses to pharmaceutical patient fraud from £117m to £69m and we
expect to announce further reductions shortly.
This money is now being spent where it was intended: on NHS frontline services
and the delivery of better patient care. |
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