The NHS prescription charge in England is currently £8.60 per item. At this level, many commonly prescribed drugs will cost less than the prescription charge and so some NHS patients may occasionally ask if they can have a private prescription rather than an NHS prescription.
In the past, some GPs have been advised that they could issue both an NHS FP10 and a private prescription, and let the patient decide which to use. But the British Medical Association’s General Practice Committee has obtained legal advice that said under the current primary care contract, GPs in England may not issue a private prescription alongside or as an alternative to an NHS FP10 prescription. In any consultation where a GP needs to issue an FP10, the concurrent issue of a private prescription would be a breach of NHS regulations.
The issuing of a private prescription in such circumstances could also be seen as an attempt to deprive the NHS of the funds it would receive from the prescription charge. Furthermore, for private prescriptions, the pharmacist is free to add a dispensing fee to the cost of the drug and so the patient might end up paying the same or even more than the NHS prescription charge for their private prescription. Finally, trying to explain NHS guidance on prescribing and its implications to the patient makes the issuing of a private prescription impractical in the time available.
Hence, I would advise GPs not to issue a private prescription to NHS patients in place of an NHS FP10 prescription in these circumstances. This advice should be communicated to the other prescribers in the practice so that they all follow the same policy.
Of course, the Department of Health could update its guidance and make it easier for NHS GPs in England to issue private prescriptions but there is no currently sign of this happening.
This article was originally published in the medical journal, Pulse.