FOI-03938

##Request I write to request the following information under the Freedom of Information Act 2000. I note NHS Business Services Authority's position that, whilst the Department of Health and Social Care is responsible for policy and the legislative framework, the interpretation and application of the National Health Service (Penalty Charge) Regulations 1999 in individual cases rests with NHSBSA as scheme administrator. In light of that clarification, I would be grateful for copies of, or details of, the recorded information held by NHSBSA concerning the interpretation and application of Regulation 2(3)(g)(ii) of the National Health Service (Penalty Charge) Regulations 1999, and in particular: 1) Any guidance, policy documents, manuals, decision-making frameworks, instructions or training materials used by NHSBSA staff when determining whether a person has acted "wrongfully" or with "lack of care" for the purposes of Regulation 2(3)(g)(ii).2 2) Any guidance, policy documents, manuals, decision-making frameworks, instructions or training materials relating to the application of concepts such as "patient responsibility", including any guidance concerning a patient's responsibility to: * check entitlement to free prescriptions; * verify the validity of exemption certificates; * orquestion decisions made by pharmacy staff. 3) Any guidance, policy documents, manuals, decision-making frameworks, instructions or training materials relating to the assessment of pharmacy error, administrative error, exceptional circumstances, discretion or waiver in connection with NHS prescription penalty charges. 4) Any recorded information, including correspondence, memoranda, briefing documents or guidance, which sets out the basis upon which NHSBSA interprets and applies the concepts of "wrongdoing" and "lack of care" contained within Regulation 2(3)(g)(ii). 5) Any recorded information held by NHSBSA concerning the respective roles of NHSBSA and the Department of Health and Social Care in interpreting and applying the National Health Service (Penalty Charge) Regulations 1999. Where any part of the requested information is considered exempt from disclosure, I would be grateful if NHSBSA could provide such information as may properly be disclosed, together with details of the exemption(s) relied upon. I appreciate that some material may be operationally sensitive. However, I would be grateful for disclosure of any high-level policy, guidance or interpretative material which informs NHSBSA's decision-making in this area. The NHS Business Services Authority (NHSBSA) received your request on 1 July 2026. We have handled your request under the Freedom of Information Act 2000 (FOIA). ##Our response ##Questions 1, 3 and 4 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 2 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 on the websites that are listed below. Please see the below links to PCN regulations. The National Health Service (Penalty Charge) Regulations 1999 https://www.legislation.gov.uk/uksi/1999/2794/contents/made NHSBSA Exemption Checking Services Knowledge Base https://faq.nhsbsa.nhs.uk/knowledgebase/category/?articlecategory=Exemption%20Checking%20Services%20%28ECS%29&id=CAT-01005&parentid= Check before you tick https://www.nhsbsa.nhs.uk/dont-get-caught-out-penalty-charges/check-you-tick Free NHS Prescriptions https://www.nhsbsa.nhs.uk/help-nhs-prescription-costs/free-nhs-prescriptions A guide to Help with health costs https://www.nhsbsa.nhs.uk/sites/default/files/2026-04/HC11%20%28V28%29%2004.2026.pdf Free NHS prescriptions – A guide for pharmacy teams in England https://www.nhsbsa.nhs.uk/sites/default/files/2026-04/Free%20NHS%20Prescriptions%20pharmacy%20guide%20booklet%20%28V4%29%2004.2026.pdf The below link includes digital resources, social media content, easy-read documents, printable posters and leaflets for stakeholders to share with the public. It also highlights the risk with claiming free NHS prescriptions when not entitled. Individuals who incorrectly claim could have to pay a penalty charge of up to £100. The content includes a guide for pharmacy teams, to ensure they are informed and can guide their patients appropriately. Primary care providers, local authorities and supporting organisations play a key role in raising awareness of help with NHS prescription costs. https://www.nhsbsa.nhs.uk/communications-toolkits Please see the following link to view the section 21 in full - https://www.legislation.gov.uk/ukpga/2000/36/section/21 ##Question 5 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. However the following directions may be of assistance in understanding the roles of NHSBSA and the Department of Health and Social Care: https://www.nhsbsa.nhs.uk/sites/default/files/2017-02/Section_2_-_B5_NHS_BSA_2015_Directions_payments_and_charges.pdf https://www.nhsbsa.nhs.uk/sites/default/files/2017-02/SI_2015_124_The_Social_Security_Regulations_2015.pdf ##Data Queries Please contact [email protected] 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 [email protected] . 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 2026”. 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.