In England, patients pay for their NHS prescriptions and NHS dental treatment. This is an important source of funding for the NHS.
Each year the NHS loses significant funds due to people claiming free prescriptions or dental treatment they weren’t entitled to. This directly reduces the money available for core patient care.
We carry out checks on patient claims. If we cannot confirm that a patient was entitled to claim free NHS prescriptions or NHS dental treatment, they will be sent a Penalty Charge Notice.
Who gets free NHS prescriptions or NHS dental treatment?
Some people can claim free NHS prescriptions or free or reduced NHS dental treatment. Find out if you are entitled to claim.
The role of the NHS Business Services Authority (NHSBSA)
We're responsible for checking claims for free NHS prescriptions and NHS dental treatment, and recover charges from patients who incorrectly claim they do not have to pay.
NHS Penalty Charge Notices are issued in accordance with the National Health Service (Penalty Charge) Regulations 1999.
How we check claims
What happens to your prescription or dental treatment claim form after it’s been signed
At the end of each month, pharmacies and dental practices send their NHS prescriptions and NHS dental treatment claim forms to the NHS Business Services Authority (NHSBSA). These forms are scanned into our processing system.
After scanning, we calculate how much each pharmacy or dental practice needs to be reimbursed by the NHS.
Every day more than four million prescription items are scanned.
We carry out monthly randomised checks on the prescription forms and dental treatment claim forms to check for fraud.
If your entitlement to free NHS prescriptions or dental treatment cannot be confirmed, you will be sent a Penalty Charge Notice.
Matching your details
During the checking process, your personal details on the prescription or dental form (including first name, surname, date of birth, first line of address and postcode) will be checked against our records using ‘matching’ criteria.
Where they do not match our database, a Penalty Charge Notice will be issued.
You can reduce the risk of getting sent a Penalty Charge Notice by keeping your personal details at your GP surgery, dental practice, benefits organisations and the NHSBSA, up to date.
After a Penalty Charge Notice has been issued
If you can show us that there has been a mistake (you were exempt from NHS prescription or NHS dental charges at the time), the Penalty Charge Notice will be cancelled.
If you have an exceptional reason not to pay, the penalty charge could be eased or removed, but you will still have to pay the original NHS prescription charge or NHS dental treatment charge.
If you cannot challenge the Penalty Charge Notice, you must start paying the charges listed on the letter as soon as possible.
How penalty charges are calculated
If you are sent a Penalty Charge Notice you will be asked to pay the original NHS prescription or dental treatment charges, and an additional penalty charge. The penalty charge is five times the original amount owed, up to a maximum of £100.
Once a Penalty Charge Notice has been issued, if no payment has been made within 28 days a surcharge of £50 will be added to the fine.
These charges are outlined in the National Health Service (Penalty Charge) Regulations 1999.