FOI-03353

Thank you for your request for information about the following: 

##Request 

<p><i>‘Please provide information held by NHSBSA about Penalty Charge Notices (PCNs) for NHS prescription exemptions from 1 October 1999 to present.</i></p>

<p><i>The number of PCNs issued, cancelled in full, and reduced (penalty waived but charge paid) in each financial year.</i></p>

<p><i>The recorded reasons or grounds for cancellation or reduction, including expired PPCs, misadvice, administrative error, reasonable belief of entitlement, hardship, retrospective evidence or other exceptional factors.</i></p>

<p><i>Copies of internal guidance, policy documents, standard operating procedures or frameworks used to decide when to cancel or reduce a PCN.</i></p>

<p><i>Any training materials or bulletins issued 1999-present showing how staff should assess discretion, reasonable belief or exceptional circumstances.</i></p>

<p><i>Any internal or external audits, reviews or evaluations about fairness or consistency of PCN cancellations.</i></p>

<p><i>Confirmation of whether automated or algorithmic systems have ever been used to decide PCN issue or cancellation, and any related guidance.</i></p> 

<p><i>Annual figures showing how many written appeals or complaints led to cancellation, reduction or no change, and any later reversals after referral to the Parliamentary and Health Service Ombudsman.’</i></p>

The NHS Business Services Authority (NHSBSA) received your request on 11 November 2025.  

We have handled your request under the Freedom of Information Act 2000 (FOIA). 

##Our response 

I can confirm that the NHSBSA holds some of the information you have requested, and a copy of the information is attached. 

##Question 1 - The number of PCNs issued, cancelled in full, and reduced (penalty waived but charge paid) in each financial year. 

The NHSBSA began the Prescription Exemption Checking Service (PECS) in 2014, so this is the earliest data we have available. 

Please note, we stopped issuing penalty charge notices in 2020 due to the Covid pandemic and began issuing again in 2022. 

##Question 2 - The recorded reasons or grounds for cancellation or reduction, including expired PPCs, misadvice, administrative error, reasonable belief of entitlement, hardship, retrospective evidence or other exceptional factors. 

I can confirm that the NHSBSA holds the requested information; however, the requested information contains information which could be used to avoid paying charges and therefore commit fraud.  

This information is exempt under section 31(1)(a) of the FOIA (law enforcement) as disclosure would prejudice the prevention or detection of crime.  

Section 31 is a qualified, prejudice-based exemption and is subject to the public interest test. This means that not only does the information have to prejudice one of the purposes listed, but before the information can be withheld, the public interest in preventing that prejudice must outweigh the public interest in disclosure.  

##Public Interest Test:  

##Considerations in favour of disclosure:  

Public interest in openness and transparency of public authority dealings. 

Contribute to public understanding of the NHSBSA’s procedures and actions regarding dental and prescription charges and penalty charge notices.  

##Considerations against disclosure:  

Public interest in avoiding prejudice to the prevention or detection of crime. 

The legal duty to ensure that fraud is prevented against services provided by the NHSBSA.  

Releasing the information would provide the public with information which could be used to avoid paying charges and therefore commit fraud.  

There would be a financial impact to the NHS if correct charges are not being paid.  

##Conclusion:  

The NHSBSA recognises that there is a public interest in disclosure of the information to promote transparency and assurance of NHSBSA's exemption checking service processes. The NHSBSA releases Knowledge Base articles publicly which provide information and transparency regarding penalty charges. These Knowledge Base articles coupled with information already in the public domain (https://www.nhsbsa.nhs.uk/nhs-penalty-charges-and-enquiry-letters), contribute significantly to public transparency and understanding of the service. However, with regard to the requested information the public interest in maintaining the exemption outweighs the public interest in disclosing the information as more weight is afforded to the arguments outlined above to avoid prejudice to the prevention or detection of crime.  

Please see the following link to view the section 31 exemption in full - https://www.legislation.gov.uk/ukpga/2000/36/section/31 

##Question 3 - Copies of internal guidance, policy documents, standard operating procedures or frameworks used to decide when to cancel or reduce a PCN. 

##Question 4 - Any training materials or bulletins issued 1999-present showing how staff should assess discretion, reasonable belief or exceptional circumstances. 

Under Section 21 of the FOIA we are not required to provide information in response to a request if it is already reasonably accessible to you.  

The information you requested is available from the below links: 

https://opendata.nhsbsa.net/dataset/foi-02930 

https://opendata.nhsbsa.net/dataset/foi-02949 

https://opendata.nhsbsa.net/dataset/foi-03080 

Please see the following link to view the section 21 in full - https://www.legislation.gov.uk/ukpga/2000/36/section/21 

##Question 5 - Any internal or external audits, reviews or evaluations about fairness or consistency of PCN cancellations. 

I am writing to advise you that following a search of our paper and electronic records, I have established that the information you requested is not held by the NHSBSA. 

##Question 6 - Confirmation of whether automated or algorithmic systems have ever been used to decide PCN issue or cancellation, and any related guidance. 

The exemption checking process used to verify the validity of claims for free prescriptions is an automated process. The automated process checks those claims against NHSBSA databases for any exemption certificates held. If none are found these claims are then sent to DWP to check for any qualifying DWP benefits. Where no exemptions can be confirmed the Enquiry Letter is issued. The check attempts to match using NHS numbers first if they are present, if not we will try to match using name, date of birth and address/postcode. Not confirmed can occur if the patient has changed details such as address or name but either not updated NHSBSA to amend their exemption or the GP to update their records. 

If a patient believes they do have an exemption they can call or email the contact centre and deal with an agent who can assist, or they can use our online tool Respond to you Letter to update information and request a re-check. 

##Question 7 - Annual figures showing how many written appeals or complaints led to cancellation, reduction or no change, and any later reversals after referral to the Parliamentary and Health Service Ombudsman. 

I am writing to advise you that following a search of our paper and electronic records, I have established that the information you requested is not held by the NHSBSA. 

##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: Penalty Charge Notice, Prescription Exemption Checking Service
Organization: Freedom of Information Disclosure Log