SCHEDULE 7Mandatory terms for LPS schemes

Preliminary matters before providing ordered drugs or appliances

5.

(1)

If a person specified in paragraph (2) asks the LPS contractor (C) to do so—

(a)

C must give an estimate of the time when the drugs or appliances will be ready; and

(b)

if they are not ready by then, C must give a revised estimate of the time when they will be ready (until they are ready).

(2)

A person specified in paragraph (1) is a person—

(a)

presenting a non-electronic prescription form or non-electronic repeatable prescription; or

(b)

requesting the provision of drugs or appliances in accordance with an electronic prescription form or a repeatable prescription.

(3)

Before providing any drugs or appliances in accordance with a prescription form or a repeatable prescription, C must ask any person who makes F1or duly completes a declaration as or on behalf of the person named on the prescription form or repeatable prescription that the person named on the prescription form or the repeatable prescription does not have to pay the charges specified in regulation 3(1) F2or (2) of the Charges Regulations M1 (supply of drugs and appliances by chemists) by virtue of either—

(a)

entitlement to exemption under F3regulation 10(1) of the Charges Regulations M2 (exemptions); or

(b)

entitlement to remission of charges under regulation 5 of the Remission of Charges Regulations M3 (entitlement to full remission and payment),

to produce satisfactory evidence of such entitlement, unless the declaration is in respect of entitlement to exemption by virtue of sub-paragraph (a), (c), (d), (e), (f) or (g) of F3regulation 10(1) of the Charges Regulations or in respect of entitlement to remission by virtue of regulation (5)(1)(e) or (2) of the Remission of Charges Regulations, and at the time of the declaration C already has such evidence available to C.

F4(3ZA)

For the purposes of sub-paragraph (3), satisfactory evidence includes evidence derived from a check, known as a real time exemption check, of electronic records that are managed by the NHS BSA for the purposes (amongst other purposes) of providing advice, assistance and support to patients or their representatives in respect of whether a charge is payable under the Charges Regulations.

F5(3A)

In any case where no satisfactory evidence, as required by sub-paragraph (3), is produced to C, C must ensure before the drugs or appliances are provided that the person who was asked to produce that evidence is advised, in appropriate terms, that checks are routinely undertaken to ascertain entitlement to—

(a)

exemption under the Charges Regulations; or

(b)

remission of charges under the Remission of Charges Regulations,

where such entitlement has been claimed, as part of the arrangements for preventing or detecting fraud or error in relation to such claims.

(4)

If, in the case of a non-electronic prescription form or non-electronic repeatable prescription, no satisfactory evidence, as required by sub-paragraph (3), is produced, C must endorse the form on which the declaration is made to that effect.

(5)

In the case of an electronic prescription, C must F6ensure that the following information is duly entered into the records managed by F7NHS England that are accessible as part of the Electronic Prescription Service (if either it is not already recorded in those records or a check, known as a real time exemption check, has not produced satisfactory evidence as mentioned in sub-paragraph (3))—

(a)

in a case where exemption from or remission of charges is claimed for all or some of the items included in the prescription, a record of—

(i)

the exemption category specified in F3regulation 10(1) of the Charges Regulations or the ground for remission under regulation 5 of the Remission of Charges Regulations which is claimed applies to the case, and

(ii)

whether or not satisfactory evidence was produced to C as required by sub-paragraph (3);

(b)

in any case where a charge is due, confirmation that the relevant charge was paid; and

(c)

in a case of a prescription for or including contraceptive substances, confirmation that no charge was payable in respect of those substances.

F8(6)

Sub-paragraphs (3) to (5) apply to the provision of a drug or appliance in accordance with a SSP as they apply to the provision of a drug or appliance in accordance with a prescription form or a repeatable prescription (or an associated batch issue), and for these purposes the prescription for product reimbursement purposes, as mentioned in paragraph 3A(4)(a), is treated as being the prescription in accordance with which the drug or appliance is provided (even though the supply is not in pursuance of that prescription).