FOI-02715

##Request

You asked us:

I would like information on the number of items and the cost of the items dispensed at each community pharmacy in England by exemption category for a recent quarter/financial year.
 
The data would be available for all pharmacies in the consolidated list (https://opendata.nhsbsa.net/dataset/consolidated-pharmaceutical-list) and should be in the categories as for this excel work book (https://nhsbsa-opendata.s3.eu-west-2.amazonaws.com/pca/pca_exemption_categories_2022_23_v001.xlsx) 
 
The file will therefore have around 10,000 rows (one per pharmacy) and 2 sets (pound amount and number of items) of 18 (dash to Z) columns.
 
You clarified the time period to be as follows:

Ideally I would like 12 months’ worth of data to reflect any seasonality in the data. The financial year April 2024 to March 2025 (which is very recent I know) broken down by quarter will have the limitation in quarter 1 (April to June) and in one month (July) in quarter 2. So, can you provide quarterly data for the April 2024 to March 2025 financial year within the 20 day threshold?

The NHS Business Services Authority (NHSBSA) received your request on 31 March 2025. 

We have handled your request under the Freedom of Information Act (FOIA) 2000.

##Our response

###April to December 2024

I can confirm that the NHSBSA holds the information you have requested and a copy of the information and notes explaining it is attached.

Please read the below notes to ensure correct understanding of the data.

NHS Prescription Services process prescriptions for Pharmacy Contractors, Appliance Contractors, Dispensing Doctors and Personal Administration with information then used to make payments to pharmacists and appliance contractors in England for prescriptions dispensed in primary care settings (other arrangements are in place for making payments to Dispensing Doctors and Personal Administration). This involves processing over 1 billion prescription items and payments totalling over £9 billion each year. The information gathered from this process is then used to provide information on costs and trends in prescribing in England and Wales to over 25,000 registered NHS and Department of Health and Social Care users.

###Data Source: ePACT2

Data in ePACT2 is sourced from the NHSBSA Data Warehouse and is derived from products prescribed on prescriptions and dispensed in the Community. The data captured from prescription processing is used to calculate reimbursement and remuneration. It includes items prescribed in England, Wales, Scotland, Northern Ireland, Guernsey / Alderney, Jersey and Isle of Man which have been dispensed in the community in England. English prescribing that has been dispensed in Wales, Scotland, Guernsey / Alderney, Jersey and Isle of Man is also included.

###Exclusions

The Data excludes: 

•	Items not dispensed, disallowed and those returned to the contractor for further clarification. 

•	Prescriptions prescribed and dispensed in Prisons, Hospitals and Private prescriptions.

•	Items prescribed but not presented for dispensing or not submitted to NHS Prescription Services by the dispenser.

###Time Period

Financial Year 2024/2025 (first three quarters only)

###Data

Includes all items and Net Ingredient Cost (£) split by exemption category.
Please note- in instances where no dispensing is recorded for a pharmacy contractor for the respective quarter, they are not included within the data for that quarter.

Organisation Data: The data is for prescriptions dispensed in England by English Pharmacy and English Appliance Contractor account types. LPS dispensers are indicated (Y/N). A date with the letter 'C' in brackets - example (C 06-FEB-24) against Dispenser name indicates that this organisation is closed as of the date stated.

Items: Items shows the number of times a product appears on a prescription form, not the quantity prescribed.

###Net Ingredient Cost

Net Ingredient cost (£) (NIC) is the basic price of a drug as stated in Part II Clause 8 of the Drug Tariff but please note that where a price concession for items listed in Part VIII of the Drug Tariff has been agreed between the Department of Health and Social Care (DHSC) and Community Pharmacy England the NIC will reflect the concession price rather than the Drug Tariff price. 

###Prescription Charge Exemption Category 

The overall high level exemption rate is as robust as it can be in terms of the data we hold.

Note that the term "exemption" for the purposes of NHSBSA processing means that no 'per item charge' was collected from the patient at the time of dispensing - and therefore "exemption from the per item charge" includes cases where a patient held a valid pre-payment certificate (PPC). 

However, the quality of the data in relation to the specific exemption categories being used does have significant limitations that have changed over time depending on the submission and processing systems in place at the time.

From July 2024 onwards most prescriptions submitted using the Electronic Prescribing System (EPS) that were determined to be exempt from the per item charge - using the Real Time Exemption Checking service (RTEC) can be reported with a specific reason that the single per item charge was not paid. Although some issues do remain for prescriptions that are scanned from paper, manually entered EPS exemptions, or from a fraction of EPS RTEC messages that are not able to be linked to an exemption category.

Prior to July 2024 the data in relation to the specific exemption categories has significant data quality limitations.

This is due to how information has been captured during our scanning process and even for prescriptions received via the Electronic Prescribing System, there was considerable uncertainty due to the use of the Real Time Exemption Checking service (RTEC). Exemptions determined using RTEC used to be classified as “No Declaration/Declaration Not Specific” as no specific code was available - this is likely to be represented as a large but unknown number of prescriptions for those standalone exemption categories. And significant under-estimates of the true number of times that those specific exemptions were used.

The processing of paper prescriptions may also have resulted in inaccuracies of exemption categories. In many cases, the mark(s) on the rear of the form intended to indicate one, or more, exemption reason(s) is not clear and can be misinterpreted by the NHSBSA scanners. NHSBSA do not perform validation or verification of which exemption category has been marked or recorded during scanning.

###January to March 2025

We have considered this request under the Freedom of Information Act 2000 (FOIA) and are issuing a refusal notice under section 17 of the FOIA. 
 
The NHSBSA does hold the requested information; however, we estimate that the cost of compliance with the request would exceed the appropriate limit under section 12 of the FOIA.

We estimate that the cost of complying with your request at this time would exceed the non-central Government limit of £450. The limit has been specified in The Freedom of Information and Data Protection (Appropriate Limit and Fees) Regulations 2004 and represents the estimated cost of one person spending 18 hours in determining whether the NHSBSA holds the information, and locating, retrieving, extracting and checking the information.  

We have determined that the cost of compliance would exceed the non-central government limit for the following reasons:

•	While the information for the month of January to March 2025 is held by the NHSBSA, it is not held in an accessible format. 

•	Pharmacists formally submit their electronic prescriptions in the 6 days after month end and also bundle up their paper prescriptions and send them to the NHSBSA for scanning and putting through an OCR engine. Once everything is in an electronic format it is validated, sent back for clarifications where required, and then it all goes through the pricing engine and finally uploaded into the data warehouse (we then refer to it as "processed"). This process takes approximately 7 weeks.

The NHSBSA is therefore unable to answer any FOI requests relating to this data before it is processed.

##Advice and assistance

The NHSBSA publishes a data release calendar, available from the following link Data release calendar | NHSBSA, which indicates when information is planned to be available.

In line with this published schedule, we would therefore advise that you resubmit your request after 19 May 2025.

##Data Queries

Please contact foirequests@nhsbsa.nhs.uk ensuring you quote the above reference if you have any specific questions regarding this response; or, if you feel you may be misunderstanding or misinterpreting the information; or, if you plan on publishing the data.
##Reusing the data and copyright

If you plan on producing a press or broadcast story based upon the data please contact communicationsteam@nhsbsa.nhs.uk. This is important to ensure that the figures are not misunderstood or misrepresented.

The information supplied to you continues to be protected by the Copyright, Designs and Patents Act 1988 and is subject to NHSBSA copyright. This information is licenced under the terms of the Open Government Licence detailed at:

http://www.nationalarchives.gov.uk/doc/open-government-licence/version/3/ 

Should you wish to re-use the information you must include the following statement: “ePACT2, NHSBSA Copyright 2025”. Failure to do so is a breach of the terms of the licence.

Information you receive which is not subject to NHSBSA Copyright continues to be protected by the copyright of the person, or organisation, from which the information originated. Please obtain their permission before reproducing any third party (non NHSBSA Copyright) information.


Tags: Exemption, NHS Prescription Services, epact2
Organization: Freedom of Information Disclosure Log