Type 1: Prescription fine

noblehead

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Last week my prescription had been sent electronically to the pharmacy. When my husband went to collect it for me the pharmacist said he did not need to sign any declaration that I had exemption as it is all linked on computer..

I'm surprised Pipp as my prescriptions are now sent electronically to my pharmacy, I've always had to sign and date the back of the prescription and tick the relevant box that says I have a valid exemption certificate in place, my wife has had to do this too when picking up my prescriptions.
 
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CarbsRok

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Last week my prescription had been sent electronically to the pharmacy. When my husband went to collect it for me the pharmacist said he did not need to sign any declaration that I had exemption as it is all linked on computer.

Perhaps that is why some people are now being caught out for not having the valid exemption certificate. All the fault of a computer system? (Said with irony).
My normal pharmacy has my certificate number and expiry date on the computer, so not asked for it there. I went to the pharmacy attached to the surgery last week to collect non diabetic related prescription and was promptly asked for my certificate of exemption as soon as I had signed to say I had one.
 

elaine77

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This is exactly what I was told Pipp.

My DSN said that they have an "information sharing" arrangement with the pharmacy next door to my surgery and everything is done via computer. The pharmacy workers actually even collect repeat prescriptions for people from the surgery and then call people when they are ready to collect from the pharmacy so that patients don't have to go all the way to the docs to pick it up just to hand it in next door and have to wait or return for it later. I live in a village where a vast majority of people are elderly and so this arrangement has been in place for a long time now.

I had no reason to question my DSN when I was told this and I think it's ludicrous to suggest that people should go looking up legal legislation every time they are told something just in case it is wrong. What about times before the Internet?? What about the old people where I live who wouldn't know how to turn on a computer let alone look at a website?

The NHS have to take responsibility for this because, like any company, if incorrect information is given to a client then the company is liable. The NHS is no different and this is proven by the fact that they recently paid out £15000 to some woman in compensation just because she got pregnant whilst having the contraceptive implant.

If it is proven that a patient HAS been entitled to free prescriptions for the period they are trying to fine them for then the fact they didn't have a medical exemption card should be overlooked and a note made to say that they had now been informed they need one and so in future there will be no excuses if one is not held.
 

Pipp

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I'm surprised Pipp as my prescriptions are now sent electronically to my pharmacy, I've always had to sign and date the back of the prescription and tick the relevant box that says I have a valid exemption certificate in place, my wife has had to do this too when picking up my prescriptions.
It is my regular pharmacy. I had to sign up to it last year, but it has only just gone paperless. Strangely the steroids for my allergies are only allowed on paper prescription. Since I signed up with the pharmacy for electronic prescriptions I have come of diabetes medication, but when I checked with NHS medical exemption people was told it remains valid until date on it. (Think they are issued for 5years). Will have reached age were they are free before expiry date n certificate, so not worrying about it. Unless, of course any new government decides I am a rich pensioner, and they stop letting us have free prescriptions.
 

zand

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When I was first prescribed metformin, I told the pharmacy this was new to me and they told me that as it was for diabetes I was exempt from paying and got me to sign. I didn't have my specs with me because I had filled out the form already as if I was going to pay for the prescription. I asked them if I needed to do anything else and they said I didn't. The next time I got my prescription I read the form and asked about the certificate and was told I was already exempt and didn't need one. I wasn't sure about this so I asked at the doctors and they gave me a form. I am cross that the pharmacy misled me in the beginning. I don't believe it was my fault because I queried it and when I had the chance to read what I was signing I queried it again and then got the form and the exemption card, so I sympathise with elaine77, I can quite understand her situation.

As Pipp said, my card also is still valid even though I no longer take any diabetes drugs. The whole system is a farce.
 
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Pipp

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This is exactly what I was told Pipp.

My DSN said that they have an "information sharing" arrangement with the pharmacy next door to my surgery and everything is done via computer. The pharmacy workers actually even collect repeat prescriptions for people from the surgery and then call people when they are ready to collect from the pharmacy so that patients don't have to go all the way to the docs to pick it up just to hand it in next door and have to wait or return for it later. I live in a village where a vast majority of people are elderly and so this arrangement has been in place for a long time now.

I had no reason to question my DSN when I was told this and I think it's ludicrous to suggest that people should go looking up legal legislation every time they are told something just in case it is wrong. What about times before the Internet?? What about the old people where I live who wouldn't know how to turn on a computer let alone look at a website?

The NHS have to take responsibility for this because, like any company, if incorrect information is given to a client then the company is liable. The NHS is no different and this is proven by the fact that they recently paid out £15000 to some woman in compensation just because she got pregnant whilst having the contraceptive implant.

If it is proven that a patient HAS been entitled to free prescriptions for the period they are trying to fine them for then the fact they didn't have a medical exemption card should be overlooked and a note made to say that they had now been informed they need one and so in future there will be no excuses if one is not held.
Right, so this sounds to me as if there is a glitch in the new system.
If you have never signed to say you have an exemption certificate, they cannot say you have made a fraudulent claim and fine you for it, surely.
If, before the electronic, paper free system was in place, someone has signed the back of a paper prescription, which clearly states 'has a valid medical exemption certificate' but even though they have diabetes medication on their prescriptions, have not obtained a medical exemption certificate, then technically they could be committing fraud.
However, I still believe this to be unjust, particularly as if your diabetes is controlled by medication you are entitled to free prescriptions. Any DSN should be communicating this to patients, as by definition they are trained specifically to treat people with diabetes. Anyone newly diagnosed has enough to deal with emotionally as well as physically and practically, so this should be included in the advice given. I understand your anger and frustration at the situation @elaine77 , and think your DSN should be helping you sort this with the prescription issuing authority, and helping you to get the correct paperwork in place and having the fine rescinded. Hopefully, you won't also be looking for compensation?
 

tim2000s

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Guys, what I find incredible about this whole situation is the lack of understanding of the requirement to get a certificate. While there had clearly been misinformation, the fact that you sign something that says you have a medical exemption certificate, regardless of what you have been told, the blame lies with you. You have signed that you have this "certificate". It might not be fair and it is certainly unjust, but it's also how it works.

As has been suggested, write a grovelling letter and do your best to persuade them to rescind the fine.
 
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elaine77

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Actually that depends on what you class as a "certificate". The actual certificate is not a certificate at all but a card and also, if everything is electronic, as we are being told, then what is to say that the exemption "certificate" is not in an electronic format shared to the pharmacy via the surgery?? This is certainly what my DSN had me believe.

The words on the prescription are open to interpretation and with everything going "paperless" and "electronic" then no, I think you are wrong, and that it is absolutely not as simple as saying someone has been fraudulent. No mens rea and no clear guidance as to what an exemption certificate actually is says to me - no fraud.

Luckily, I have not been told I have to pay a fine, but if I did I would not be paying it; I would not be eating any "humble pie" and I would not be grovelling either. I take responsibility for my own mistakes but I do NOT take responsibility for other people's. Especially since I took the initiative to ask my DSN (directly) if I needed a form and a signature to get a certificate and was told no. Then there is also the fact that my pharmacy have never ever asked to see the certificate or asked if I have one. When I was first diagnosed and had to get an immediate prescription I also asked them about the free prescription for diabetics and they said all I had to do was "tick medical exemption and that's it". So they are clearly lacking in correct procedure too.
 
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Pipp

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Actually that depends on what you class as a "certificate". The actual certificate is not a certificate at all but a card and also, if everything is electronic, as we are being told, then what is to say that the exemption "certificate" is not in an electronic format shared to the pharmacy via the surgery?? This is certainly what my DSN had me believe.

The words on the prescription are open to interpretation and with everything going "paperless" and "electronic" then no, I think you are wrong, and that it is absolutely not as simple as saying someone has been fraudulent. No mens rea and no clear guidance as to what an exemption certificate actually is says to me - no fraud.

Luckily, I have not been told I have to pay a fine, but if I did I would not be paying it; I would not be eating any "humble pie" and I would not be grovelling either. I take responsibility for my own mistakes but I do NOT take responsibility for other people's. Especially since I took the initiative to ask my DSN (directly) if I needed a form and a signature to get a certificate and was told no. Then there is also the fact that my pharmacy have never ever asked to see the certificate or asked if I have one.
Ah, I misunderstood. I thought you had been issued a fine. I would sympathise with the view that this would be overzealous action by prescription issuing authority. As you haven't been fined, I hope you now have enough information to avoid this happening by making sure you have an exemption certificate / card or evidence that a 'virtual certificate' has been issued.
I still believe that the onus is on the patient to make sure that everything is in order. Also, that if your DSN is giving out wrong information she/he needs to be told. It hardly inspires confidence in her/his advice if something so fundamental has been misinformed.

Hope that you can get it all sorted and that you keep well.
 
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tim2000s

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Sadly, since the NHS has been online, the details relating to what is an exemption certificate have been easy to find.

More to the point, I left full time education some 17 years ago and was made aware then that I needed one.

You don't pay prescription charges via the link between the surgery and the pharmacist, and pre-payment certificates are not communicated between the surgery and the pharmacy. Why would the exemption certificate be any different?

I agree that the communication for many people has been poor, but the onus is on the individual and not the medical profession, whether that is right or wrong!
 
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portlander

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Hi I have just received a letter saying i have to pay a £96 fine for not having a valid medical exemption certificate. I was diagnosed Type 1 in 1998 and have never paid for prescriptions since. Nobody has ever told me about this. Has anyone else had the same thing and if so what was the outcome?
Hi Mate do you drive and if so have you notified the DVLA as if you have'nt you could lose your licence and get a £1000 fine
 
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rubold

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As I don't tick the box now (over 60) what is the exact wording against the box?
 

Pipp

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As I don't tick the box now (over 60) what is the exact wording against the box?
A couple of boxes. First to state that you are patient or patient's representative
Second 'holds a valid medical exemption certificate'.

If you are referring to @elaine77's situation she has said all electronic and not form or box to tick for prescription (I think)
 

Sancho panza

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It seems to me that this is a problem that's occurring more often.
Whether it's the drs or the pharmacys faualt who can say as every case seems to differ.
The salient facts are that you need to apply and possess a medical exemption card or you could be fined.
Perhaps @daisy1 could look at this and amend her great post for the newly diagnosed to point this out.
 
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elaine77

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Prepayment? I've no idea what that is and no, sorry, the onus is only to ask my HCPs what I should do following a diagnosis such as diabetes and trust that they will inform me correctly as they are the experts on medical conditions, not me. They told me about the DVLA and everything else so why not this? What reason did I have to doubt both them and the pharmacy?

I know nothing of prepayment or anything else and would not automatically assume my DSN was giving false information and therefore decide to google everything she told me just to double check. When you are diagnosed with diabetes there are far more pressing matters to worry about and far more going through your head! The least we should expect is that we are being given the correct information from the medical professionals regarding what our diagnosis means for us and what we need to do going forward. Particularly over prescriptions as we are clearly going to need many of them!

I concede that ignorance or omittance over a matter is no excuse but when you ask a medical professional directly and then do as they say, it is completely futile to suggest that any further responsibility lies with the patient.

I absolutely will be bringing this up with my DSN at my review on the 19th but I think it is just ridiculous to suggest any diabetic would try and defraud the medical exemption by deliberately not applying for a certificate. It doesn't cost anything and is completely free so it is silly to think that people who were entitled to exemption would just deliberately not apply for a certificate if they had been told they needed one. It is far more reasonable to suggest that the NHS need to be giving proper information and guidance when they are handing out diagnoses. At the very least they should be expected to hand out a leaflet with exemption information on or ask you to make sure you definitely check the website for those with Internet access. In my first few weeks following diagnosis I was given many leaflets but not a single one was about the medical exemption.

Not everyone has Internet access and not everyone would automatically think they had to google or search every single thing they had been told by a nurse just to make sure she was correct. One of the main things with our HCPs is apparently that we trust them and so therefore suggesting every patient should automatically decide to read all NHS PDF documents is, frankly, obsurd.
 
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tim2000s

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And yet every time you pick up a prescription you tick a box on the form you sign saying you hold a certificate, and you hadn't wondered what that might be?
 
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Sancho panza

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And yet every time you pick up a prescription you tick a box on the form you sign saying you hold a certificate, and you hadn't wondered what that might be?

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.
 
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tim2000s

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Hmm, that's interesting. I've not seen that, and I'm very surprised that you are able to take the prescription meds without signing for them!

Pharmacy guidance is that if they have seen the certificate and have recorded the details, they don't need to see it again, until your certificate has been renewed.
 

elaine77

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No Tim, as I have already explained numerous times, I HAVE seen the mention of a medical exemption and I DID ask my DSN for a form and a signature and she TOLD me I didn't need it as the surgery have an information sharing policy with the pharmacy next door. I mentioned it to the pharmacy as well and THEY told me the same and said I just needed to tick the box as they had access to everything from the surgery.

This is not a case of pleading ignorance, I specifically ASKED my DSN about the exemption cert and the form and was told I didn't need it due to the information sharing policy which I KNOW exists because they have a system in place for repeat prescriptions too.

I had no reason whatsoever not to trust the nurse or any reason to start googling legal legislation! I trusted what she told me as they are supposed to be the experts! I knew very little about diabetic procedures as no one in my family had ever had diabetes so everything I needed to know I trusted my DSN to tell me. I had enuff to take in with being told I had an incurable lifelong degenerative disease, never mind worrying about bureaucratic form-filling on top of that.
 
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