Changes to giving free prescriptions to people aged 60 and over

The government is consulting on aligning the upper age exemption for NHS prescription charges with the State Pension age (SPA). In 2019, around £600 million was generated in revenue from prescription charges for frontline NHS services. Currently, people receive free prescriptions when they turn 60 in England, whereas the SPA is now 66.

The consultation is seeking views from the public and healthcare professionals on options for change including building in a period of protection so those aged between 60 to 65 can continue to benefit from free prescriptions if the upper age exemption rises.

History: Prescription charges were first introduced in 1952. They were abolished in 1965 but then reintroduced, with exemptions, in 1968 because of budgetary pressures. In 2019 approximately £600 million was generated in revenue from prescription charges which supported direct delivery of NHS services.

The Facts: In England out of 1.1 billion items dispensed in 2018, almost 90% of prescription items dispensed in the community in England were free of charge. Almost 63% of all items were dispensed free of charge because the patient was aged 60 or over. The prescription charge exemptions cover 3 broad categories:

• those of a certain age, that is those:
  • under 16
  • aged 16 to 18 in full time education
  • aged 60 and over
• those on low income, that is via certain Department for Work and Pensions (DWP) benefits and tax credits (which will largely be replaced by Universal Credit) and the NHS Low Income Scheme
• those with certain medical conditions and expectant or new mothers

There have been very few changes to the exemption arrangements introduced in 1968. The only change to the list of exempt medical conditions was the addition of cancer in April 2009.

Options for change

Changing the upper age exemption for prescription items would require amendment being made to the National Health Service (Charges for Drugs and Appliances) Regulations 2015 (the ‘Charges Regulations’). These regulations set out the applicable charges for prescriptions and some appliances and the various criteria for exemption from these charges that currently apply.

There are 2 options for change including the option to retain a period of protection for those already in the age range 60 to 65 (those who currently benefit from an age exemption).

Option A

Option A is to raise the qualifying age for free prescriptions to the SPA (currently 66) for everyone. This would mean that following changes to the Charges Regulations people aged 65 and under would have to pay for their prescriptions until they reach the age of 66, unless they qualified for another exemption.

Option B

Option B is to raise the qualifying age for free prescriptions to the SPA (currently 66) but with a period of protection, which would mean that people in the age range 60 to 65 would continue to receive free prescriptions. This would mean that anyone aged 60 and over when the changes to the Charges Regulations are implemented would continue to be exempt from prescription charges, whereas those aged 59 and under when the changes to the Charges Regulations are implemented would have to pay for their prescriptions until they reach the SPA (currently 66), unless they qualified for another exemption.

The above options would have varying impacts for people who need NHS prescriptions, and could raise additional revenue for the NHS. Option A would increase NHS revenue more quickly and by a larger amount than option B, but retaining a period of protection for those currently in the age group 60 to 65 (option B) could ensure that people have advance notice of a change and would not have to restart paying for prescriptions that they currently get free. Option A could lead to confusion about the rules, with some people potentially continuing to claim an age exemption and attracting penalty notices and penalty charges as a result and others potentially being deterred from collecting prescriptions by the unexpected cost. Option B, which would preserve entitlement for those in the 60 to 65 age group, would allow the Department for Health and Social Care (the department) to monitor any adverse impacts of a policy change.

Consultation questions (Below we show the questions in the consultation)

To enable the Government to take into account your views on these proposals, please answer the following questions which can be found in the online questionnaire that accompanies this consultation.

Question 1

Should the upper age exemption to prescription charges be aligned to the State Pension age?

• Strongly agree
• Agree
• Neither agree nor disagree
• Disagree
• Strongly disagree
• Don’t know

Question 2

If the prescription charge exemption age is raised to State Pension age should people in the age groups 60 to 65 at the date of change retain their existing exemption?

• Strongly agree
• Agree
• Neither agree nor disagree
• Disagree
• Strongly disagree
• Don’t know

Question 3

Do you think there will be any unintended consequences that a raise in the upper age exemption could have on people, pharmacies or other organisations?

• Yes
• No
• Don’t know

If yes, please specify.

Question 4

Do you think that aligning the upper age exemption with State Pension age could have a differential impact on particular groups of people or communities?

• Yes
• No
• Don’t know

If yes, please specify.

Question 5

Do you think that aligning the upper age exemption with State Pension age could adversely impact people from deprived backgrounds or between disadvantaged geographical areas?

• Yes
• No
• Don’t know

If yes, please specify.

This consultation is open for a period of 8 weeks and we welcome responses from members of the public, prescribers, pharmacists and other interested parties.

Responding to the consultation

This consultation is open for a period of 9 weeks.

The preferred method of receiving your response is via the online consultation questionnaire.

If you have any queries on this consultation or require an alternative format please email ageconsultation@dhsc.gov.uk.

Please submit your responses to the questions by 11:45pm on Thursday 2 September 2021.

If you do not have internet or email access, then please write to:

If you wish to do so, you can request that your name and organisation be kept confidential and excluded from the published summary of responses.

Click this link for the consultation and further information: https://www.gov.uk/government/consultations/aligning-the-upper-age-for-nhs-prescription-charge-exemptions-with-the-state-pension-age/aligning-the-upper-age-for-nhs-prescription-charge-exemptions-with-the-state-pension-age