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Pharmaceutical Services Negotiating Committee

Refunds

Pharmacy contractors in England are obliged to issue prescription charge refunds to patients on receipt of a valid FP57 receipt and refund form. Pharmacy contractors in England may also optionally make refunds against prescription refunds and receipt forms issued in Wales or Scotland (forms should be submitted to the NHS Prescription Services for payment as normal).

Pharmacists in Wales are obliged to make prescription refunds against Welsh Receipt and Refund Forms (WP57) but are unable to make refunds against receipt and refund forms issued in England or Scotland.

Form FP57 is valid for three months from the date of issue. In the event of late claims, patients will need to send the FP57 form to 'Patient Services, NHS Business Services Authority Prescription Services, Sandyford House, Newcastle upon Tyne,  NE2 1DB' and explain why they did not claim the refund within the 3 month time limit. Patient Services will review the claim and either authorise a refund by sending form LIS04(P) to the patient or advise the patient why they do not qualify.

When a patient presents a prescription refund and receipt form for payment, pharmacy staff should check the following:

  • The serial number on the form to ensure it is in the same format as the forms held by that pharmacy;
  • that there are no alterations to the amounts or quantities in Part A and the form appears genuine, e.g. there is no white border indicating that it is a "home produced" copy.
  • Check that the claim is being made within three months of the date the charge was paid, or the patient has an authorised form (LIS04(P)) from the NHSBSA
  • Request evidence of entitlement to exemption or sight of form LIS04(P) authorising payment
  • Check that the evidence relates to the patient
  • Check that the evidence covers the date the charge was paid
  • Note on the form what was produced, e.g. tax credit exemption certificate
  • Note on the form the reference number on the exemption document (where applicable) e.g. 1234365
  • Note on the form the LIS04(P) form reference number and date (where applicable)
  • The person claiming the refund must print their name and address (i.e. the representative's details where appropriate)

If all is in order, the pharmacy should pay the amount shown in Part A of the form and ask the patient or their representative to sign and date the form. A member of staff authorised to make refunds should also sign and print their name on the form.

In England, pharmacy contractors are required to submit forms to the NHS Prescription Services at the end of each month along with prescriptions being submitted for payment. Contractors should declare the number of FP57 refunds submitted to the NHS Prescription Services each month and the total amount refunded during the month on the FP34C Submission Document.

In Wales, paid forms should be sent to Powys LHB via the Business Services Centre local offices in the normal way.

For support on issuing refunds, please contact the PSNC Information Team.


Frequently Asked Questions


How much will I be paid per refund?

The Department of Health has added £200k to the global sum to fund prescription charge refunds. The payments will be distributed in proportion to prescription volume rather than a specific fee per refund. Contractors will be reimbursed for the amount refunded one month after the FP57 refund has been declared on the FP34C Submission Form. For example, if a refund was made during April and submitted to the NHS Prescription Services before the 5th of May, the contractor would be reimbursed for the amount refunded on the 1st June.

The volume of refunds processed is expected to be low; projected volume is 160,000 refunds per year. This amounts to approximately 16 refunds per pharmacy per year. The Department of Health has agreed that if volumes are greater than expected then the funding will be reviewed.

I haven't received the New Form yet from my PCT. What Should I do?

The FP57 receipt and claim form has been revised to describe the new procedure. Supplies of revised FP57s will be purchased and distributed to pharmacies by PCTs (the reference number of the new form is FP57 0405).

If you have not received the new forms, the old forms can still be issued as a receipt to patients but patients must be told to return to a pharmacy to collect the refund (not the post office as stated on the old forms).

Where can I obtain form LIS04(P)?

Pharmacies do not need to obtain form LIS04(P). In the event of late claims, patients will need to send the FP57 form to 'Patient Services, NHS  Prescription Services, Sandyford House, Newcastle upon Tyne, NE2 1DB' and explain why they did not claim the refund within the 3 month time limit. Patient Services will review the claim and either authorise a refund by sending form LIS04(P) to the patient or advise the patient why they do not qualify.

Do all pharmacies in England have to issue refunds against Form FP57?

Yes, the Terms of Service in the NHS (Pharmaceutical Services) Regulations 2005 states 'Where any person who is entitled to a repayment of any charge paid under the Charges Regulations presents a pharmacist with a valid claim for the repayment within three months of the date on which the charge was paid, the pharmacist shall make the repayment.'

A patient has visited my pharmacy with an FP57 receipt for payment of prescription charges. The patient did not have their prepayment certificate to show but they had the prepayment certificate reference number and the date issued. They had bought their certificate from the NHSBSA over the phone using their credit card but were waiting for the actual card to be sent to them. Can I issue a refund?

To issue a refund, it is necessary for you to see the actual prepayment certificate. The reference number and date issued is not definitive proof of exemption. FP57 forms are valid for 3 months and if the patient has recently applied for the certificate they should wait for the certificate to be received and then return to the pharmacy for a refund. The patient should receive the certificate well before the 3 months have expired.

My pharmacy is based in England, a patient has brought in Form WP57 (Welsh Prescription Charge Refund Form). Should I make the refund?

The regulations require pharmacies to make refunds against prescription charge receipts issued in England (FP57 Forms). There is not currently a regulatory requirement for pharmacies to make prescription charge refunds against prescription charge receipts issued in Wales (WP57 Forms) or Scotland.

However, the Department of Health have agreed with their counterparts in Scotland and Wales that cross-border flows will be permitted and the NHS  Prescription Services will reimburse pharmacy contractors for refunds made.

Community pharmacists in Wales must only make refund payments in respect of WP57 claim forms.

My pharmacy is based in Wales, a patient has brought in Form FP57 (English Prescription Charge Refund Form). Should I make the refund?

No, Welsh pharmacies will not be reimbursed for issuing cross-border refunds. If a patient presents a completed FP57 claim form for refunding at a Welsh pharmacy then the community pharmacist must inform the patient that they are unable to make a refund and that they should present the FP57 form at a community pharmacy in England for refunding.

Are dispensing doctors required to issue refunds?

No. Community Pharmacies in England are required to issue refunds as stated in the Terms of Service of pharmacists in the NHS (Pharmaceutical) Services Regulations 2005. There is no corresponding provision in the dispensing doctor's Terms of Service.

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