Type 1: Prescription fine

[donnellysdogs]

The system is a complete farce @zand.
I am going to upset quite a few people here, but have to say those of us with diabetes medication are in a better position over free medication than those with some other chronic lifelong medical needs. Until recently people needing cancer drugs were not exempt. I also have several other lifelong medical conditions that do not qualify for free prescriptions, so before I had medication for diabetes I bought NHS pre-payment certificates on an annual basis. If I hadn't I would have needed a second mortgage to pay for my prescriptions. I have heard people ask "what is so special about diabetics that they should get free prescription meds when other conditions don't?" Not a view I subscribe to, but do have some sympathy for others who need a lot of medication and have to pay.

Agreed...

 

[elaine77]

I think it's just that diabetes affects literally every part of your body and almost always causes some sort of problem or complication at some point so any medication u might need could probably be linked back to the diabetes in some way..

There is also the fact that many conditions qualify for disability allowances but diabetes doesn't, despite being legally accepted as a disability and affecting day to day life.
The way they classify these things is rather too subjective at times in my opinion...

This is not to say other conditions are not deserving of free prescriptions though, just that diabetes most definitely is.

 

[smidge]

The only time I've ever been asked for my medical exemption card - and it is a card, not a certificate - was a couple of weeks ago in the hospital pharmacy when the consultant had prescribed a different insulin for me and I had to pick it up there rather than in my usual pharmacy. At my usual pharmacy I don't even tick the box on the back of the prescription - the assistant does that and I just sign.

I honestly believe the issues people are having now with fines are because the NHS has been told to clamp down on fraud and stop medication going free to those who are not entitled - unfortunately it is far easier to fine those who do not have the right paperwork than it is to properly clamp down on those committing fraud. If at the end of the accounting period, the department involved can say they've caught and fined Xx hundred fraudulent claims saving Xx hundred/thousand £s, they will have met their targets and justified their existence as no-one will look any further. The fact is of course, they will have saved no money whatsoever and cost hundreds or thousands of £s administering a completely futile piece of bureaucracy. Such is life with the NHS I'm afraid.

Smidge

 

[Jimski]

As a former HCP, I feel that I need to comment on some postings in this thread :

First of all, no HCP is infallible. We all make mistakes because we are human. Also, no matter what our personal beliefs are, there is a " party line " that has to be followed . And that party line seems to change like the wind ? Sometimes the advice given is outdated compared with other countries, and sometimes it's because we haven't been given the memo Incidentally, I must have missed the memo that said all HCP's over the age of 45 are now exempt from Continuing Education

Those memos are the bane of most Hp's lives, as often the information hidden in the great drift do not filter down to the troops on the ground. For example, these MEDEX forms. DSN's are as their title suggests, Diabetic SPECIALIST nurses. They are far more likely to be informed of beurocratic changes in regard to their speciality than a DN who is usually a practice nurse who runs the diabetic clinic at the local Health Centre as well as other clinics. The advice they give is only as good as the advice and information that they are given. You are more likely to be told about obtaining an exemption certificate from a DSN than a DN or GP because the latter are looking and concentrating on a much broader picture.

It used to be that prescriptions were rarely checked or randomly checked by the receiving prescription payment department, thus allowing many fraudulent claims to go through. This has tightened up considerably and is computer checked. Your number is cross checked with the database of who has claimed and received a MEDEX, and if there is no match, out goes the letter . The computer doesn't recognise that a person is diabetic because of insulin, needles, test strips etc, it goes by numbers. It doesn't recognise that a person SHOULD be exempt for whatever reason, so therefore doesn't send out an alternative letter with a gentle reminder that you should get a certificate. Sadly.

It would seem that many HCP's have not been informed about ensuring that those patients who are exempt obtain a certificate, and many more still are unfamiliar with the exemption process, wrongly assuming lol along that the exemption would be picked up on by the pricing authority. It wasn't, and now, never is unless you apply for a valid certificate and thus have the all important cross match on the database.

Yes, it's been handled badly, and sadly that is not unusual.

Signy

I liked this post a great deal. My only addition is that it is a shame there is no appeal process with the automated letter.

I have a response back from the BSA to my 'feedback / appeal' email which I will post here when I have had some time to digest its contents.

 

[catherinecherub]

Prescription fraud clampdown plan heavily criticised.
http://www.bbc.co.uk/news/health-30622544

"You can get a free NHS prescription if you have a specified medical condition and have a valid exemption certificate"

 

[Pipp]

I heard this news item on BBC Breakfast this morning, @catherinecherub

So, it seems there is a new database in use that checks to see if anyone claiming medical exemption has a valid exemption certificate. If you don't have the valid exemption certificate, regardless of whether or not you have one of the eligible conditions you can expect to receive a fine.

Unfair? Yes, and unjust. BUT at least now we know what they are up to, and can defend ourselves by getting the correct documentation immediately.

I do believe this is another way to improve statistics for the government. I.e. x amount of fraud detected, and so many people fined, 'saving' so much money. It stinks!

 

[donnellysdogs]

Also on radio 4 talk this morning. But their chat ended up talking about why diabetics in England get scripts free and people with asthma and MS don't...

First time today that one if my lical chemists actually asked to see my card.

 

[Brunneria]

What I find interesting is that only 10% of scripts are subject to the charge!

Kinda begs the question whether the bureaucratic system, admin, time and effort monitoring (office, surgery and pharmacy), establishing and enforcing the fines for non compliance, etc. are worth the effort!

 

[Emmotha]

I do actually agree about asthma and MS! they should be free too

 

[Sancho panza]

The simple way to sort this out is if England followed the lead of Northern Ireland, Wales and Scotland and issued all prescriptions free of charge!
But thats a whole other discussion

 

[Pipp]

I do actually agree about asthma and MS! they should be free too

And cystic fibrosis?

 

[catherinecherub]

There is a petition for people with long term conditions asking for them to be exempt from prescription charges.

http://www.prescriptionchargescoalition.org.uk

The Prescription Charges Coalition is a group of more than 30 organisations campaigning to end unfair prescription charges for people with long-term medical conditions.

 

[phoenix]

In a different system, I get 100% reimbursement for diabetes related drugs and treatment (ALD) .There is a fairly long list of other conditions that this also applies to because many conditions require a lot of drugs and treatments (all sorts for example TB ,Multiple Sclerosis,Rheumatoid arthritis , Asthma , Parkinson's ,haemophilia, leprosy, bilharzia, disabling stroke ) http://www.ameli.fr/professionnels-...ction-de-longue-duree/les-ald-exonerantes.php
There is also a clause that enables the doctor/patient to apply for an ALD if the treatment is costly and expected to last for more than 6months.
It doesn't apply to every chronic condition so though I need thyroid drugs for life, they are relatively cheap and don't qualify ( I would get 70% reimbursed but each packet costs less than 2€)
There is an expiry date on each 'certificate'. Because of the condition (ie T1) mine expires 25 years after diagnosis and presumably if I'm still around it will be renewed.
It seems a more sensible way to do it than the very limited list that the UK has (there is a downside though, you don't get exonerated from contributions when you are of pension age unless you are on a very low income)

 

[andybates]

I'm just so flabbergasted that any fine can be tied to the number of medical items required. I have received a £96 notice today and to base it and upscale the fine based on the quantity of essential medical items required is shameful.

Hi,
I'm another "offender" in the eyes of the NHS BSA for a prescription submitted on the 28th August. According to the letter I didn't pay for a prescription when I had no exception certificate in place and therefore now owe
Prescription charge of £32.20
Penalty Charge of £100.00
Total £132.20 now due.

If I don't respond by 6th Jan the charge will increase by 50%!!

I am T1 diabetic and have been since 1991. Like others it never even crossed my mind that this life long medical condition would have a time limited exception in place.
In all these years since 1991 I have NEVER been asked for the certificate. NEVER. I think the assumption by Chemists is that having T1 you have an exemption in place.

It is a disgrace that I am being penalised when there is no mechanism in place to issue reminders. I have never been reminded that my exemption is due to expire.

In the eyes of the NHS BSA I am a fraudulent claimer and therefore must pay the charge and associated penalty, there is no appeal process. It's black and white, in their eyes I claimed a free prescription when I did not have an active exemption in place.

I have spoken to Diabetes UK Care line (lovely lady), and the Patients Association. It is something they are aware of, but at the moment there is no resolution. Basically watch the Diabetes UK home page for news.

If you are in this position please let these organisations know to bolster our case.

I have paid £1.00 to ensure that my penalty charge doesn't increase to £150 on the 6th Jan.

I have since filled in a form to have my exception put in place, but once I have this I can only claim back 30 days of fees. Annoyingly their fine is for a transaction outside of this period. I can only wonder whether this is a deliberate act.

I will be writing to my MP.

Thanks,

Mark

 

[Spiker]

So, if you have a card and can't find it call 0845 601 8076 and they will send you a new one, as the nice lady on the phone did for me earlier.

Thanks Tim - constructive and helpful.

 

[Spiker]

they said all I had to do was "tick medical exemption and that's it".

Except to be fair there is no such box. There is no box to tick that you have a medical exemption. There is only a box to tick that you have a VALID medical exemption CERTIFICATE.

Like you I was told not to bother getting one. I move around GPs a lot and eventually I hooked up with a GP who said I should get one. The card sat in a drawer for ten years, never once asked for, but at least I ticked the box with a clear conscience since I was in fact in possession of the card. Though at some point it presumably became invalid. Fair enough, I guess the NHS wants a sanity check every 5 years to see if they've cured T1D. :-/

I'll phone the number and get a new card. Thanks DCUK for the heads up. And I hope there isn't a £124 fine waiting in my pile of unopened post.

 

[Spiker]

Not necessarily Tim
I have my repeat prescription in front of me I don't get the full one for some reason just the half with the actual prescription on I post it in the box at the drs and two days later collect my meds from the chemist which admittedly is in the Drs I give them my name they give me a bag with my meds and another prescription in it and that's it I always offer my certificate but they say they don't need it as its on their system.
The half of the prescription I get doesn't have anything to sign or date or any check boxes.
I may enquire next time I'm in why I don't get the full document anymore.

That's how you order a repeat prescription, with just half the form. But when you fill the prescription you need the full form and you need to tick the box. No ticky no scrippy.

 

[Spiker]

As a former HCP
[...]
Yes, it's been handled badly, and sadly that is not unusual.

Signy

Ah, so it's all YOUR fault, Signy!
;-)

 

[iHs]

That's how you order a repeat prescription, with just half the form. But when you fill the prescription you need the full form and you need to tick the box. No ticky no scrippy.

Until just recently, whenever I picked up my prescription from my pharmacy, my pharmacist signed on my behalf so all I had to do was just collect the items with the repeat form. It was only on my last prescription collection that the counter staff asked if I was exempt and could I sign the declaration. As far as I know my pharmacist is aware of my exemption card as my details are on the database.

 

[Sancho panza]

That's how you order a repeat prescription, with just half the form. But when you fill the prescription you need the full form and you need to tick the box. No ticky no scrippy.

Until just recently, whenever I picked up my prescription from my pharmacy, my pharmacist signed on my behalf so all I had to do was just collect the items with the repeat form. It was only on my last prescription collection that the counter staff asked if I was exempt and could I sign the declaration. As far as I know my pharmacist is aware of my exemption card as my details are on the database.

since my Drs opened an in house pharmacy I don't get the full prescription form now when I collect my scrippy only the repeat half is in the bag with the meds I haven't seen the half to sign since I started with free prescriptions so I can only presume that the pharmacy is filling the form in. I'm certainly not.