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Over £200k spent on giving private patients "high-cost" prescriptions for free

Over £200k spent on giving private patients

Tuesday 12 November 2024

Over £200k spent on giving private patients "high-cost" prescriptions for free

Tuesday 12 November 2024


The Hospital Pharmacy spent over £200,000 providing free medication to private patients who should have been paying for their prescriptions, it has emerged – but an investigation to establish the full cost of the error will not be carried out.

So far, 25 private patients have been identified as having incorrectly received prescription drugs for free.

In September, a joint statement from the Health Minister and his department explained that the error came to light after a new electronic prescribing system was introduced in the Hospital Pharmacy earlier this year.

But at the time, Deputy Tom Binet was unable to confirm how many patients had been impacted by the issue.

It has now emerged that the Health Department has so far identified 25 patients who were prescribed treatment while under a consultant acting in a private capacity which were not flagged as private prescriptions.

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Pictured: It became evident that "a small group of patients were receiving high-cost private prescriptions for free" earlier this year.

These patients have collectively received medicines with a total cost of at least £200,000 during the period since February 2021, according to a response to a request made under the Freedom of Information Law.

No way to differentiate prescriptions 

The error came about as, prior to the introduction of the the Electronic Prescribing and Medicines Administration, some private prescriptions were written on Health and Community Services-branded paper.

This meant that, unless the prescriptions were specifically marked as private by the prescriber, there was no obvious way for Hospital Pharmacy staff to identify them as distinct from public prescriptions.

According to the FOI response, the Health Department became aware of the issue when a member of staff noticed the error and brought it to the attention of senior management.

This was subsequently raised with the executive team on 3 May 2024 – but the policy to ensure that all private patients were charged for their prescriptions was not updated until 1 October 2024.

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Pictured: Health Minister Tom Binet previously told Express that he believed that the issues started during the pandemic.

The FOI response also confirmed that "the information identified so far has come about through review of the use of biologic agents" was prompted by the Royal College of Physicians' damning review of Jersey's rheumatology department.

Biologics are a group of powerful drugs derived from natural sources such as human, animal, fungal or microbial cells. These drugs work by suppressing the immune system and disrupting the inflammation process that leads to joint pain. However, they can make patients more susceptible to life-threatening infections.

In the report, the reviewers criticised the fact that there were "no mechanisms in place" for Hospital Pharmacy staff to understand whether the prescriptions they filled for high-cost biologic drugs were for public or private rheumatology patients.

"This would be viewed as fraud in the NHS" 

When the review was discussed by the Health Advisory Board in February, members echoed concerns that "patients seen privately were issued with a public prescription".

"This would be viewed as fraud in the NHS," according to the board minutes.

As a result of the Royal College of Physicians' review, new Immunotherapy Lead Pharmacist – otherwise known as a ‘Biologic Pharmacist’ – was employed in the Hospital Pharmacy to support patients with the appropriate use of biologic drugs, including prescribing.

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Pictured: The review of Jersey's rheumatology department raised concerns about the lack of built-in challenge to prescribing, particularly biologics, by the pharmacy team.

But the FOI response revealed that the mix-up between private and public prescriptions is "not limited to prescribing of biologics or high-cost drugs".

So far, only two medications have been identified as being involved in the mix-up – Fremanezumab and Baricitinib.

Fremanezumab, sold under the brand name Ajovy, is a medication used to prevent migraines in adults. It is given by injection under the skin.

Baricitinib, sold under the brand name Olumiant among others, is a disease-modifying antirheumatic drug (DMARD) used primarily in the treatment of rheumatoid arthritis.

The FOI response concluded that "the full extent of prescriptions in-scope and the value of these is, as yet, unknown, and can only be identified moving forwards through extensive review and interrogation of records".

No further investigation

Responding to queries from Express this afternoon, Deputy Binet confirmed that there would not be any further investigation into the extent and cost of the mix-up between private and public prescriptions.

"We do not feel it would be a good use of taxpayer's money to investigate further," the Health Minister said.

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Pictured: The Health Minister said that further investigation would be "very time consuming and costly".

The full statement from Deputy Binet explained: “Establishing the full extent of the cost would require an interrogation of paper records.

This would be a very time consuming and costly exercise, and the resulting information would serve very little useful purpose. 

“It would not provide an accurate picture of cost to the State as there is no way of judging how many patients would have moved away from private healthcare (and back into State provision) as a result of having to pay for prescriptions.

With that in mind, we do not feel it would be a good use of taxpayer's money to investigate further.”

He added: “Fortunately, I am confident that the new Electronic Prescribing and Medicines Administration System (implemented in April 2024) is currently helping to ensure that mistakes of the past are not able to continue.”

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"State of confusion" saw private patients get "high-cost" prescriptions for free

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