Friend hasn’t paid prescription charges for 10 years - what will happen?

[Kat19899]

Please be kind, this was stupid but unintentional and now is beside herself and remorseful.
She was on JSA around 10 years ago and entitled to free prescriptions when she set up her delivery for repeat prescriptions from the local pharmacy. She became more ill and was out of work for a couple of years, didn’t receive JSA or any benefits during that time. However she forgot to tell the pharmacy she wasn’t entitled to free prescriptions anymore and I guess with the stress/depression of being ill and the pharmacy never querying it she just forgot about it. The other day she got a doctor’s prescription at an appointment, paid for the item at the pharmacy like normal and had the sudden realisation she has not paid for 4+ items per month for about 10 years!

She is beside herself, feels awful at costing the NHS money and very stressed that she will go to court and get a criminal record or jail time. Is this likely to happen?? What should she do? I think her options are to call/write a letter telling the truth and offering to pay in full (it would wipe out her savings but she has the money), tell the pharmacy she is no longer eligible and buy a prescription prepayment certificate and hope no one questions it, or say nothing and hope for the best.
She said she does her repeats online and they get sent to the pharmacy automatically. I’m confused about how this can go unnoticed for so long. She’s willing to fully pay but every time the post comes she thinks it’s going to be a court summons.

Sorry, didn’t realise that was so long until I posted it!

Depending on what the long term meds are for she may be exempt. It's worth checking that avenue.

from what I know it’s mainly different dosages of anti epileptics but they are for pain not epilepsy so I don’t think she would qualify

Why didn't she get jsa or benefits when she was out of work?

I don't know the rules - but with no income it may not be as simple as she thinks.

Plus it's been 10 years. I'm sure they'd have noticed by now.

I'd get her to speak to CAB for advice and make sure she gets all conversations confirmed in writing too so she can prove she realised and has come forward.

The NHS business authority dept check all free prescriptions against who is eligible. I don't know how she's gotten away with it, but it would have all been processed and through the system by now.

I was pregnant last year and I actually forgot to officially apply for my certificate but totally thought i had so i claimed a free prescription, and I got a letter about 3 months after fining me. So that's how quick they process them!

She would have got a letter and a fine already if it has been picked up - they are usually pretty hot on fining people (I got one for a similar mistake with benefits) so hopefully she's been lucky to avoid one.

www.nhs.uk/nhs-services/prescriptions-and-pharmacies/who-can-get-free-prescriptions/

Does she take anti convulsants for epilepsy? They are here on the medical exception page.

She may not have applied for the certificate but she may well be entitled. To the point she may not have had to pay for the one she just paid for!!!

If she has epilepsy as described in the attached then all her prescriptions are free

(I have Myasthenia Gravis and all my prescriptions are free whether they are for MG or something entirely unrelated)

I don't think anti epileptic count unless you have epilepsy. I have a medical exemption because of my epilepsy but I know someone who is on one of the same as mine and has to pay as theirs is for anxiety.

No she doesn’t have epilepsy, she takes them for neuralgia

I would move to a different pharmacy and not tell a soul.

Why didn’t she receive any benefits while she was too ill to work?

I'm just here confirming topamax isn't free if it's for neuralgia.

God knows what will happen though!

If nothing has been flagged up before then she may as well just buy a pre payment certificate and forget about it
The whole fines/ revenue recovery is outsourced to a third party

When I used to work in pharmacy I was told they check randomly. She's been very lucky to have got away with it for so long. If they investigate she will owe thousands.

@SlightlygrumpyBettyswaitress I'm with you

I think she “ran out of time” on JSA and hadn’t found a job within six months or a year or whatever the time limit was. Then with being unwell she wasn’t able to work so didn’t qualify, didn’t qualify for the illness disability payment, and had moved back in with her parents so I suppose didn’t need housing benefit

I wonder if switching now and paying at a different pharmacy might trigger some kind of check

Wouldn't they ask to see her proof of exemption? Not that I'm suggesting she carries on defrauding the NHS which is struggling anyway. How would you justify that?

I'm also surprised she hasn't been picked up, I thought that they were really hot on prescription fraud

She’s willing to pay but she’s worried about a criminal record for fraud, especially because it will be a big bill. Could I ask what you’d do in her situation with your knowledge of pharmacies/the system?

She must have been on contribution based jsa if it "ran out" after six months. That's not means tested so she wouldn't have been entitled to free prescriptions on it anyway

I did this…. Not for that long but probably a year as I honestly thought I was still exempt as had been for years. It was picked up when I went the dentist and thought it was free. They then trawled back through every repeat prescription I had for that year and I got fined for each one. Just tell her not to go the dentist for a while 😂

@Kat19899 I haven't worked in pharmacy for years to be honest. I'd probably just pay from now on. They would have contacted her previously if they had realised she wasn't entitled I would have thought.

I have a prepayment card and my understanding is that random prescriptions are picked for auditing and they check those to see if the correct box has been ticked, if it hasn't I think you have to pay the cost and maybe a fine on top but I don't know if that would trigger them looking into that person to see if they had done it before. If you have a friendly pharmacist it might be worth asking them a hyperthetical question about this and see what they say, they'd be the ones that know I assume. I hope your friend is okay.

Oh god, that’s even worse! 🤦‍♀️🤦‍♀️🤦‍♀️