Penalty charge notices in healthcare Contents


Penalty charge notices (PCNs) are supposed to discourage people from claiming free prescriptions or dental treatment when they are not entitled to do so. But the current PCN process is a heavy-handed rush to judgement which penalises those who fail to navigate the overly-complex exemption criteria and neglects clear evidence of abuse by repeat offenders. It is not fit for purpose.

The Department and NHS England have been shockingly complacent about the fundamental problems with the PCN process, justifying their approach because most exemptions are claimed correctly and the system generates additional revenue for the NHS. But they seem to have lost sight of the fundamental importance of helping people claim what they are entitled to. The NHS Business Services Authority (NHSBSA) has not attempted to identify those who are entitled to an exemption but pay for treatment and the Department recognises that some people may not seek treatment because they are worried about getting a PCN. They are only now beginning to trial basic improvements. However, we remain highly sceptical about the speed with which these can be rolled out, particularly where they depend on new IT systems.

We fully support efforts to deter fraud and the pursuit of those who deliberately claim exemptions to which they are not entitled. However, we simply do not believe that the current system achieves this efficiently. The Department and NHS England need a fundamental reappraisal of how they can more effectively and humanely pursue these goals.

Published: 20 September 2019