While most of us may not see them in this way, NHS prescription forms should be considered an asset that has a financial value. Even if it is blank, a prescription form could be used to commit fraud, resulting in a significant impact on the NHS. This can be in the form of a financial loss for medicines fraudulently obtained, or the potential harm to the health of individuals using medicines without medical supervision.
This article explains the fraud risks associated with prescription forms, discusses preventative measures and explains how to report concerns about fraudulent prescriptions.
You can find more detailed information about this in the NHS Counter Fraud Authority's (NHSCFA) guidance for prescribers and organisations on the management and control of prescription forms, which was published in March this year.
As part of the NHSCFA's organisational priorities for 2018-19, we are now focusing on fraud risks related to bulk blank prescription forms in the supply chain process, i.e. from when they are securely printed in bulk to when they are delivered. We are working with NHS England and the NHS Business Services Authority to address fraud risks in this area and deliver a range of fraud prevention solutions to mitigate these risks.
What are the fraud risks?
Prescription forms have an obvious value to the patient, but they also have a financial value to the NHS since the costs of the medicines prescribed are met by the NHS and the medicines have a resale value.
Prescription forms in the wrong hands are blank cheques with a high street value. In the wrong hands, stolen prescription forms or whole prescription pads can be used fraudulently to obtain controlled drugs and other high-value medicines either for illegitimate personal use, or for the purpose of selling them on. Blank prescription forms can also be resold, as they can be items of value for third parties.
A fraudulent prescription can be a prescription form which:
- has been forged or counterfeited
- has been amended by changing quantities/dosages
- has been collected by an individual pretending to be someone else in order to obtain their prescription
- has been written for a 'ghost' patient
- has been obtained through multiple registration at GP practices using false IDs to obtain several prescription forms
- has not been signed by an authorised prescriber
How to prevent these frauds
Measures to prevent the fraudulent use of prescription forms are included in the NHSCFA's guidance for prescribers and organisations on the management and control of prescription forms. The key messages in the guidance are around developing a culture of awareness among staff and prescribers of the issues and risks surrounding the management and control of prescription forms and ensuring that robust policies and procedures are in place. It is also important that clear records on prescription stock received and distributed are maintained, supported by regular audits where irregularities are looked into. Finally it is important that prescription form stock is securely stored at all times. Pharmacists and dispensing doctors should also be vigilant in scrutinising prescriptions for any signs of alterations that are not authorised (i.e. initialled and dated) by the prescriber and follow up with the prescriber about this
Patients can also play their part by keeping prescription forms secure and reporting lost prescriptions to the medical professional that provided the original prescription such as the GP or nurse prescriber.
Reporting fraudulent use of prescription forms
If you have any suspicions or concerns about prescription forms being fraudulently used, you should report this to the NHSCFA. You can call our free, 24hour reporting line 0800 028 4060 or report online at https://cfa.nhs.uk/report-fraud. All reports are treated in confidence and you have the option to report anonymously.
Only fraud related incidents concerning prescription forms should be reported to the NHSCFA. When reporting, it is important to include as much essential information as possible, including:
- date/time of incident, and as much detail as possible regarding the place where the incident occurred
- serial number(s) of the prescription form(s)
- details of who may have allegedly fraudulently used the prescription form(s), and how
- whether the police has been notified
- (if you are a pharmacy or GP surgery) details on whether an alert has been issued to other local pharmacies or GP surgeries
If you need to report instances of stolen or lost prescription forms (but no fraudulent use is suspected), please contact the police, Controlled Drugs Accountable Officer (CDAO) and Local Counter Fraud Specialist (LCFS).
For more details on how to respond to and report incidents relating to prescription forms, please refer to our guidance on the management and control of prescription forms.
If you have any queries relating to this article please email prevention@nhscfa.gsi.gov.uk.