QIPP, Efficiency & Savings

15.05.19

NHS lost £212m from prescription fraud last year whilst 1.7m people wrongly fined, NAO finds

Around 1.7 million fines have been wrongly handed out to patients and then overturned in the last five years, whilst the NHS also lost £212m last year due to wrongly claimed exemptions, the National Audit Office (NAO) has found.

The new report revealed that thousands of “innocent” NHS patients were slapped with incorrect healthcare fines over dental treatment and prescription charges since 2014, worth a total of £188m.

The government’s spending watchdog investigated the NHS’s use of penalty charge notices (PCNs) which can be issued to those who claim a free dental prescription or dental treatment either fraudulently or in error.

Elderly, under 16s, disabled and some people who receive certain benefits are normally exempt, but the NAO found that nearly a third of PCNs issued since 2014 have been subsequently withdrawn after they were challenged.

Around 400,000 dental patients a year, including those on low incomes, with disabilities and the elderly, have received £100 fines for simply ticking the wrong box.

The British Dental Association (BDA) welcomed calls for clarity on NHS penalty charges and said the report identifies multiple sources of mistakes and confusion, as well as raising “deep concerns” that an increasingly aggressive approach to penalty charges has fuelled a drop in attendance.

The NAO investigation also revealed that the NHS estimates it lost around £212m in 2017-18 from people incorrectly claiming exemption from paying prescription and dental charges.

Since April 2014, The NHS Business Services Authority (NHSBSA) has attempted to recover NHS funds from incorrect claims by managing the distribution of 5.6m PCNs worth a total of £676m, of which £133m has been collected, £297m resolved without a penalty being paid and £246m still outstanding.

The NAO said it recognised that free prescriptions and dental treatment are a significant cost and that it is important to reclaim funds from people who are not exempt and to deter fraud, and there has been a significant increase in exemption checks and PCNs since 2014.

But it criticised the “complicated and difficult to understand” system and rules, and said the NHS “also needs to have due regard to people who simply fall foul of the confusing eligibility rules.”

Chair of the BDA’s England Community Dental Services Committee, Charlotte Waite, said: “There can be no excusing the fact innocent people, fully entitled to claim free care, have been slapped with over £180m in fines.

"Patients deserve real clarity when making a claim. Sadly, all the government has done is spend a fortune on campaigns simply discouraging them from seeking the help they need and are entitled to.”

She added that the England system was “built on a presumption of guilt” that leaves vulnerable patients being chased by debt collection agencies, whilst other UK nations have taken a different approach.

Image credit - MJ_Prototype

Comments

There are no comments. Why not be the first?

Add your comment

 

national health executive tv

more videos >

latest healthcare news

Policing the private hospital sector

22/10/2019Policing the private hospital sector

David Rowland, director of the Centre for Health and the Public Interest (CHPI), argues that in order to protect patients, the Ian Paterson Inqui... more >
Cancer patients’ health could be at risk due to NHS staff pressures, report warns

22/10/2019Cancer patients’ health could be at risk due to NHS staff pressures, report warns

A new survey carried out on cancer patients by Macmillan Cancer Support has found that their physical and mental health is being harmfully impact... more >
Almost £2m Rough Sleeping grant awarded for health of homeless

22/10/2019Almost £2m Rough Sleeping grant awarded for health of homeless

A Rough Sleeping grant of £1.9m has today (Oct 22) been awarded to 6 projects involving partnerships between Local Authorities (LAs) and Cl... more >

editor's comment

25/09/2017A hotbed of innovation

This edition of NHE comes hot on the heels of this year’s NHS Expo which, once again, proved to be a huge success at Manchester Central. A number of announcements were made during the event, with the health secretary naming the second wave of NHS digital pioneers, or ‘fast followers’, which follow the initial global digital exemplars who were revealed at the same show 12 months earlier.  Jeremy Hunt also stated th... read more >

last word

Haseeb Ahmad: ‘We all have a role to play in getting innovations quicker’

Haseeb Ahmad: ‘We all have a role to play in getting innovations quicker’

Haseeb Ahmad, president of the Association of the British Pharmaceutical Industry (ABPI), sits down with National Health Executive as part of our Last Word Q&A series. Would you talk us th... more > more last word articles >

the scalpel's daily blog

Providers are delivering – and here’s how

09/10/2019Providers are delivering – and here’s how

It has been a challenging few years for healthcare providers, yet they have continued to deliver high quality care despite the conditions. Adam Brimelow, director of communications at NHS Providers, outlines just how providers are managing to deliver despite the financial squeeze.   It is inevitable that the NHS’ fun... more >
read more blog posts from 'the scalpel' >

comment

NHS England dementia director prescribes rugby for mental health and dementia patients

23/09/2019NHS England dementia director prescribes rugby for mental health and dementia patients

Reason to celebrate as NHS says watching rugby can be good for your mental health and wellbeing. As the best rugby players in the world repr... more >
Peter Kyle MP: It’s time to say thank you this Public Service Day

21/06/2019Peter Kyle MP: It’s time to say thank you this Public Service Day

Taking time to say thank you is one of the hidden pillars of a society. Being on the receiving end of some “thanks” can make communit... more >
Nurses named as least-appreciated public sector workers

13/06/2019Nurses named as least-appreciated public sector workers

Nurses have been named as the most under-appreciated public sector professionals as new research reveals how shockingly under-vauled our NHS, edu... more >
Helpforce to launch training programmes for NHS volunteers

10/06/2019Helpforce to launch training programmes for NHS volunteers

Kay Fawcett OBE, clinical advisor and education lead at Helpforce, and Lynn Twinn, talent development consultant, outline the new national traini... more >

interviews

NHS dreams come true for Teesside domestic

17/09/2019NHS dreams come true for Teesside domestic

Over 20 years ago, a Teesside hospital cleaner put down her mop and took steps towards her midwifery dreams. Lisa Payne has been delivering ... more >
How can winter pressures be dealt with? Introduce a National Social Care Service, RCP president suggests

24/10/2018How can winter pressures be dealt with? Introduce a National Social Care Service, RCP president suggests

A dedicated national social care service could be a potential solution to surging demand burdening acute health providers over the winter months,... more >
RCP president on new Liverpool college building: ‘This will be a hub for clinicians in the north’

24/10/2018RCP president on new Liverpool college building: ‘This will be a hub for clinicians in the north’

The president of the Royal College of Physicians (RCP) has told NHE that the college’s new headquarters based in Liverpool will become a hu... more >
Duncan Selbie: A step on the journey to population health

24/01/2018Duncan Selbie: A step on the journey to population health

The NHS plays a part in the country’s wellness – but it’s far from being all that matters. Duncan Selbie, chief executive of Pu... more >

health service focus

View all News