FOI-03398

Thank you for your request for information about the following: 
 
##Request 
 
You asked us: 
 
<i>I am making this as a request under the Freedom on Information Act. 
 
You provide a spreadsheet for the costs of each prescription exemption (Exemption category management information https://nhsbsa-opendata.s3.eu-west-2.amazonaws.com/pca/pca_exemption_categories_2024_25_v001.xlsx) but this only gives data for the whole of England. 
 
I would be grateful if you could send me this data - giving the year / exemption category / total items / total cost - but further broken down by Integrated Care Board. If it is possible to use the current ICB boundaries on data pre-2022 that would be very much appreciated, but if not I will accept it broken down by CCG for earlier years which predate the current ICBs. In any case I would like it to go back to the 2010-11 financial year, or as close as possible to this. 
 
I would like this response electronically in a spreadsheet format - either xlsx/ods or as a csv file.</i>
 
The NHS Business Services Authority (NHSBSA) received your request on 24 November 2025.  
 
We have handled your request under the Freedom of Information Act (FOIA) 2000. 
 
##Our response 
 
I am writing to advise you that we have established we do not hold prescription exemption data for the time-period of 2010/11 to 2014/15. We only hold prescription exemption data from 2015/16 onwards, which is attached. 
 
Please read the notes to ensure your correct understanding of the data from 2015/16 onwards. 
 
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 one 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. 
 
<b>Exclusions</b>
 
The data excludes:
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•	items not dispensed, disallowed and those returned to the contractor for further clarification. </span><br>
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•	prescriptions prescribed and dispensed in prisons, hospitals and private prescriptions. </span><br>
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•	items prescribed but not presented for dispensing or not submitted to NHS Prescription Services by the dispenser. </span>
 
<b>Data Source</b>
 
The data source was the NHSBSA Information Services Data Warehouse. 
 
<b>Time Period</b> 
 
April 2015 to March 2025 presented as financial years.  
 
<b>Items</b>
 
Items in this FOI response are limited to those dispensed in the community in England, presented at Integrated Care Board level. This includes items supplied as part of an NHS Pharmacy First Service consultation or service. 
 
<b>Exemption Category</b>
 
The overall high level exemption rate is as robust as it can be in terms of the data we hold. 
 
Please 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. This therefore means that "exemption from the per item charge" includes cases where a patient held a valid pre-payment certificate (PPC). 
  
However, the data quality 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 Service (EPS) that were determined 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: 

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•	prescriptions scanned from paper </span>
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•	manually entered EPS exemptions, </span>
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•	a fraction of EPS RTEC messages that are not able to be linked to an exemption category. </span>
  
Before July 2024, the data in relation to specific exemption categories has significant data quality limitations. 
 
This is due to how information was captured during our scanning process and even for prescriptions received via EPS, there was considerable uncertainty due to the use of 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 underestimates 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 reasons is not clear and can be misinterpreted by the our scanners. We do not perform validation or verification of which exemption category has been marked or recorded during scanning. 
 
##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: “Data Warehouse, 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: Prescription Exemptions
Organization: Freedom of Information Disclosure Log