Health bosses have insisted that waiting lists won’t be affected by changes to the prescription system resulting from a £200,000 blunder that saw taxpayers foot the bill for a “small group” of private patients’ high-cost prescriptions.
The mix-up, which emerged last September, gave rise to a serious legal matter.
Described as the result of a “state of confusion” in the Hospital Pharmacy, the mix-up saw private patients mistakenly dispensed specialist drugs at the taxpayer’s expense before tighter controls were introduced the following month.
The Health Minister explained that the error came to light after a new electronic prescribing system was introduced in the Hospital Pharmacy earlier that year.
At the time, the number of impacted patients was not confirmed – but it later emerged that 25 patients had been identified who were prescribed treatment while under a consultant acting in a private capacity which were not flagged as private prescriptions.
These patients collectively received medicines with a total cost of at least £200,000 from February 2021 to October 2024, according to a response to a request made under the Freedom of Information Law.
Prescription confusion
The error came about as, prior to the introduction of the the Electronic Prescribing and Medicines Administration, some private prescriptions were written on Health Department-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.
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.
No further investigation
Responding to queries from Express, the Health Minister 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.
The full statement from Deputy Tom 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.”
A “robust policy” in place
The new prescription process was discussed at the most recent meeting of the Health Advisory Board.
It was explained that all patients transferring to the public waiting lists do so according to clinical priority and then chronologically.
Interim Health Chief Officer Tom Walker said that there was a “robust policy” in place, but explained there may be cases where patients are seen privately and their clinical priority changes.
At the meeting, a member of the public asked what measures were in place to stop a consultant in their private clinic prescribing medication to their patients on hospital prescriptions at the expense of the tax payer.
Medical Director Simon West explained that public and private prescribing processes are distinct.
He explained: “The electronic prescribing system is used only for public patients. There is a separate paper-based system for all private prescriptions.
“This clear demarcation separates the systems to ensure there is no confusion regarding how to prescribe for each pathway.
“The majority of private scripts are directed to community pharmacies, but some are dispensed by the hospital pharmacy where the drug is only available to order by Health and Care Jersey.”
“No evidence” of system abuse
Mr West admitted that “occasionally” a prescriber might make an error and prescribe a private script on the public system – but said that “on the rare occasions when this might occur, the prescriber would be reminded of process”.
“Should it become a matter of persistent error, then this would become a matter for professional standards,” he added.
The Medical Director confirmed that “there is no evidence to suggest that clinicians are abusing the system”.
Following queries from Express, Mr West also confirmed that the prescription system changes will have impact waiting lists
“There is no evidence that patients who previously received private healthcare are now choosing to return to public-funded treatment,” he explained.
No impact on waiting lists
The Medical Director’s full statement said: “We understand that when a patient is unwell or injured, they want to be seen as soon as possible so that they can manage their condition.
“All patients referred into Health and Care Jersey are clinically triaged dependent on their presentation and complexity and are categorised as either ‘urgent’, ‘soon’ or ‘routine’.
“Patients within the same category are seen in chronological order, meaning those who have been waiting longest, and therefore have the greatest clinical need, will be treated first.
“There is nothing to suggest that the improvements we have made to our prescription governance system will have a significant impact on waiting lists as there is no evidence that patients who previously received private healthcare are now choosing to return to public-funded treatment.
“To ensure transparency, we publish our waiting times online. If there is an impact, this will be evident as part of this reporting, and we would endeavour to address this accordingly.”