The National Health Service Counter Fraud and Security Management Service (NHS CFSMS) has an on-going programme of highly accurate risk measurement exercises (accurate to plus or minus 1 per cent.) designed to reveal levels of losses and, through repeated exercises, reduction in such losses. The National Audit Office have audited this process and are satisfied to its accuracy. Phase one of these exercises (examining patient fraud losses) included pharmaceutical patient fraud. The following table details the results.
|Pharmaceutical patient fraud|
|Year data selected||Fraud losses|
A statistically valid sample of those prescriptions prescribed during March 2003 has been taken for a further measurement exercise to be completed. Further fraud reductions are anticipated and the figures will be produced later this year.There was no accurate measurement of pharmaceutical patient fraud prior to the commencement of these exercises in 1998–99.Point of dispensing (PoD) checks were introduced in all community pharmacies on 1 April 1999 to help deter this type of fraud. The check requires pharmacists to ask patients, who are claiming free prescriptions, if they have evidence to support their claim to exemption from prescription charges.In 1998–99, pharmacists received an addition to their global sum, of £1.85 million, for set-up costs to enable PoD checks to commence. In 1999–2000, a sum of £12.25 million, (at 1998–99 prices) for undertaking PoD checks was incorporated within the overall figure, representing 1.67 per cent. of the global sum. This sum covers pharmacists' NHS remuneration and has been uprated annually since then. The proportion for PoD checks is not separately identified.Where a patient wrongly fails to pay any amount in respect of NHS charges or obtains goods or services to which they are not entitled, the amended National Health Service Act 1977 (sections 122A and 122B) provides for a civil penalty charge to be imposed. The penalty charge is calculated as five times the recoverable amount, up to a maximum of £100, in addition to the original charge. In cases of non-payment a surcharge of up to £50 may be imposed. Between 1 August 2001 and 31 March 2003 £1,362,000 has been recovered through the penalty charge system.