Private patients' prescriptions (FOI)

​​​Request

A

How long were some private patients in Jersey getting prescriptions for free when they should have been paying for them? (in months or date range)

B

How many patients got their private prescriptions for free when they should have been paying for them? 

C

How much has this cost the health service/government?

D

What were the top 10 most expensive medications given out for free and how much did these cost? (It can be broken down in cost per prescription or supply per month)

E

How was this error made? (Was it a computer error/human error/ done on purpose)

F

When did the government first find out this was happening? When was their investigation into this completed?

G

When did the government find out it was illegal?

Response

A to D

During the period January to April 2024, the wider implementation of electronic prescribing through the Electronic Prescribing and Medicines Administration (EPMA) system for public patients enabled greater distinction and identification of private prescriptions, which continued as paper-based prescriptions. Previously, some private prescriptions were written on Health and Community Services (HCS) branded paper, so unless they were specifically marked as private by the prescriber, there was no obvious way for HCS Pharmacy to identify them as distinct from public prescriptions.

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. Identifying this information would require reconciliation of all prescriptions received against patient care records to establish whether treatment was delivered as a public or private patient for each instance. A Scheduled Public Authority is not required to create or manipulate data for the purpose of responding to Freedom of Information requests. Furthermore, the resource required to perform such analysis and reconciliation exceeds that prescribed in the Freedom of Information (Costs) (Jersey) Regulations 2014. Therefore, Article 16 of the Freedom of Information (Jersey) Law 2011 has been applied.

HCS has identified 25 patients who have been prescribed treatment while under a consultant acting in a private capacity which were not flagged as private prescriptions. These patients have collectively received medicines with a total cost of at least £200,000 at British National Formulary (BNF) prices, during the period since February 2021.

The information identified so far has come about through review of the use of biologic agents, though it is anticipated that such issues are not limited to prescribing of biologics or high cost drugs. Only two medications have been identified to date, these are Fremanezumab and Baricitinib.

E

In some cases, HCS Pharmacy was not informed by the prescribing doctors when a prescription was private, as described above. Patients may not have been aware that they should expect to pay for their medicines.

F and G

HCS became aware when a member of staff identified the issue and brought it to the attention of senior management. This was subsequently raised with the Executive team on 03 May 2024.

The investigation into the process culminated in a discussion with the Minister for Health and Social Services. Confirmation that such supply is inconsistent with allowable practice and agreements for medicines procurement and dispensing was provided to the Minister in Quarter 3 of 2024.

Article applied

​Article 16      A scheduled public authority may refuse to supply information if cost excessive

(1)     A scheduled public authority that has been requested to supply information may refuse to supply the information if it estimates that the cost of doing so would exceed an amount determined in the manner prescribed by Regulations.