FOI-03291

Thank you for your request for information about the following: 

##Request 

<p><i>‘Under the Freedom of Information Act, I would like to request the following information:</i></p>

<p><i>In England, during the period 1 April 2024 to 31 March 2025:</i></p>

<p><i>How many people in total obtained medicines on prescription?</i></p>

<p><i>How many prescribed items in total were provided?</i></p>

<p><i>Of the total number of people obtaining medicines on prescription, how many of those people were over 60 and obtained medicines free on prescription?</i></p>

<p><i>Of the total number of items prescribed, how many of those items were provided to people over 60 for free?</i></p>

<p><i>Of the total number of people obtaining medicines on prescription, how many of those people were entitled to free prescriptions for reasons OTHER THAN because they were</i></p>
<p><i>(1) over 60 or</i></p>
<p><i>(2) under 16 or</i></p>
<p><i>(3) aged 16 to 18 and in full-time education or</i></p>
<p><i>(4) had a valid maternity exemption certificate?</i></p>

<p><i>Of the total number of items prescribed, how many of those items were provided to people entitled to free prescriptions for reasons OTHER THAN because they were</i></p>
<p><i>(1) over 60 or</i></p>
<p><i>(2) under 16 or</i></p>
<p><i>(3) aged 16 to 18 and in full-time education or</i></p>
<p><i>(4) had a valid maternity exemption certificate?</i></p>

<p><i>Of the total number of people obtaining medicines on prescription, how many of those people were entitled to free prescriptions BECAUSE they were</i></p>
<p><i>(1) under 16 or</i></p>
<p><i>(2) aged 16 to 18 and in full-time education or</i></p>
<p><i>(3) had a valid maternity exemption certificate?</i></p>

<p><i>Of the total number of items prescribed, how many of those items were provided to people entitled to free prescriptions BECAUSE they were</i></p>
<p><i>(1) under 16 or</i></p>
<p><i>(2) aged 16 to 18 and in full-time education or</i></p>
<p><i>(3) had a valid maternity exemption certificate?</i></p>

<p><i>How much was paid in total by people with prescriptions for items provided on prescription?’</i></p>

##[On 29 October 2025 you clarified your request as follows] 

<p><i>‘In each of questions 5, 6, 7 and 8 I am looking for one answer, encompassing all the 3 or 4 exemptions listed in the brackets-numbered categories; I do not need a split between the brackets-numbered categories. This means that, taking your example of question 5., I am looking for one answer, and similarly for questions 6, 7 and 8.’</i></p>

The NHS Business Services Authority (NHSBSA) received your request on 21 October 2025.  

We have handled your request under the Freedom of Information Act 2000 (FOIA). 

##Our response 

I can confirm that the NHSBSA holds the information you have requested, and a copy of the information is attached. 

Please read the below notes to ensure correct understanding of the data. 

##NHSBSA 

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. 

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 April 2024 to March 2025. 

##Data 

This dataset shows items dispensed in England including patient counts, the charge exemption status and the total charges (£) payable. 

Note that the charge exemption status(s) are for those specifically requested: The table supplied is arranged as below to better visualise the dataset. 

Question 1, 2 and 9 shows patient counts, items and the total charges payable (£) for all prescriptions dispensed (exempt and chargeable). 

Question 3 and 4 shows only the patient count and items for all those with a charge exemption of Aged 60 Or Over. 

Question 7 and 8 shows only the patient count and items for all those with a charge exemption of Under 16 / Aged 60 Or Over or Aged 16-18 And In Full Time Education or Maternity Exemption. 

Question 5 and 6 shows the patient count and items for those with a charge exemption status of OTHER THAN Aged 60 Or Over or Under 16 / Aged 60 Or Over or Aged 16-18 And In Full Time Education or Maternity Exemption 

##Organisation Data 

The data is for prescriptions dispensed in the community in England. 

##Items 

Items show the number of times a product appears on a prescription form, not the quantity prescribed. 

##Patient Identification 

Where patient identifiable figures have been reported they are based on the information captured during the prescription processing activities.  Please note, patient details cannot be captured from every prescription form and based on the criteria used for this analysis, patient information (NHS number) was only available for 97.81% of prescription items. 

The figures for the number of identifiable patients should not be combined and reported at any other level than provided as this may result in the double-counting of patients.  For example, a single patient could appear in the results for multiple exemption categories. 

##Prescription Charge/Exemption Category 

The overall high level exemption rate is as robust as it can be in terms of the data we hold. 

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) and HRT pre-payment certificate (HRT 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. 

The exemption (Category C) 'Aged 60 Or Over’, was merged in January 2020 with the Under 16 category (Category A) and the new category became ‘Under 16 / Aged 60 or over’ (Category A) on prescription forms. 

The NHSBSA categorises patients who are age exempt in the categories A (under 16) and C (60 and over). Where the patient age is captured, it is used to identify patients who are age exempt (category A or C). The exemption category on the prescription is only used if the patient age does not already identify the prescription as exempt. 

In practice this will mean that Under 16 / Aged 60 Or Over can be considered to be patients under 16 years, and Aged 60 Or Over can be considered to be patients 60 years or over.  

##Data Queries 

Please contact <a href=mailto:foirequests@nhsbsa.nhs.uk>foirequests@nhsbsa.nhs.uk</a> 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 <a href=mailto:communicationsteam@nhsbsa.nhs.uk>communicationsteam@nhsbsa.nhs.uk</a>. 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: “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: Exemptions, NHS Prescriptions, Prescribing, Prescription Exemptions
Organization: Freedom of Information Disclosure Log