The National Health Service (Charges for Drugs and Appliances) Regulations 2015

Exemptions: general E+W

10.—(1) Subject to paragraph (4), no charge is payable under regulations 3, 4, 5, 7 or 8 by a person who—

(a) is under 16 years of age;

(b) is under 19 years of age and is receiving qualifying full-time education within the meaning of section 173(2) and (3) of the 2006 Act (exemptions from general charging);

(c) is 60 years of age or older;

(d) has a valid exemption certificate on the grounds that they—

(i) are expecting a child, or

(ii) have within the last twelve months given birth to a child (including a child whose death was registrable under the special provisions as to the registration of still-births in the Births and Deaths Registration Act 1953 M1 ),

or has a valid exemption certificate issued under equivalent arrangements (to regulation 15) having effect in Scotland, Wales or Northern Ireland;

(e) has a valid exemption certificate on the grounds that they are suffering from one or more of the following conditions—

(i) permanent fistula (including caecostomy, colostomy, laryngostomy or ileostomy) requiring continuous surgical dressing or an appliance,

(ii) the following disorders—

• forms of hypoadrenalism (including Addison's disease) for which specific substitution therapy is essential,

• diabetes insipidus and other forms of hypopituitarism,

• diabetes mellitus – except where treatment is by diet alone,

• hypoparathyroidism,

• myasthenia gravis, or

• myxoedema,

(iii) epilepsy requiring continuous anti-convulsive therapy, or

(iv) a continuing physical disability which prevents the person from leaving the person's residence without the help of another person;

(f) has a valid exemption certificate on the grounds that the person is undergoing treatment for—

(i) cancer,

(ii) the effects of cancer, or

(iii) the effects of cancer treatment;

(g) has a valid exemption certificate issued on any of the grounds in sub-paragraph (e) or (f) under equivalent arrangements which have effect in Scotland, Wales or Northern Ireland;

(h) has a valid exemption certificate in respect of the supply of drugs and appliances for the treatment of accepted disablement, but in either case only in respect of those supplies to which the certificate relates; or

(i) has a valid pre-payment certificate granted under regulation 16 or a valid pre-payment certificate granted under equivalent arrangements (to regulation 16) having effect in Scotland, Wales or Northern Ireland.

(2) No charge is payable under these Regulations in respect of the supply of any drug for the treatment of a sexually transmitted disease within the meaning of section 173(1)(b) of the 2006 Act M2 .

(3) Subject to paragraph (4), no charge is payable under regulation 6 or 9—

(a) by a person of a description specified in paragraph (1)(h) in respect of the supply of an item specified in column (1) of Schedule 1; or

(b) by a person of any description specified in paragraph (1) in respect of the supply of an appliance not specified in column (1) of Schedule 1, or of tights or of drugs.

(4) Subject to paragraph (5), a person who wishes to claim entitlement to exemption by virtue of paragraph (1) or (3) must provide any declaration of entitlement required under regulation 3(5) [F1 to (5E) or 4(3) to (3B),] or any declaration and evidence of entitlement required under regulation 5(3), 6(4), 7(4), 8(3) or 9(3).

(5) A person of a description specified in paragraph (1)(a) or (c) is not required to provide any declaration of entitlement required under regulations 3(5) [F2 to (5E) and 4(3) to (3B)] where—

(a) an electronic prescription form or an electronic repeatable prescription is created and the person's date of birth is recorded on the person's PDS patient details and is set out on the electronic prescription form or electronic repeatable prescription; or

(b) a non-electronic prescription form or a non-electronic repeatable prescription is issued and the person's date of birth is printed by means of a computer on the non-electronic prescription form or non-electronic repeatable prescription.

(6) A charge referred to in column (2) of Schedule (1) must, in the case of a person referred to in regulation 6 of the Travel Expenses and Remission of Charges Regulations M3 (entitlement to partial remission and payment), be remitted to the extent specified in that regulation.

(7) Where a charge is remitted in part under paragraph (6), the person making the part payment must, on doing so, sign a declaration in writing that the relevant part of the charge has been paid, complete a declaration of entitlement and provide such other evidence of entitlement to partial remission as may be required by the person supplying the drug or appliance.

(8) An exemption by reference to age or the validity of an exemption certificate must be determined by reference to the age or validity on the day on which—

(a) in the case of pharmaceutical services or local pharmaceutical services provided by a chemist, the order for drugs or appliances is presented for dispensing; and

(b) in any other case, the drugs or appliances are supplied.

(9) Where a claim to an exemption has been made but is not substantiated, and in consequence of the claim a charge has not been recovered, if—

(a) the drugs or appliances were supplied by a chemist as mentioned in regulation 3 or by a doctor as mentioned in regulation 4, then the Board must recover that charge from the person concerned;

(b) the drugs or appliances were supplied by an NHS trust or an NHS foundation trust as mentioned in regulation 6, then that NHS trust or NHS foundation trust must recover that charge from the person concerned; or

(c) the drugs or appliances were supplied as mentioned in regulations 5, 7, 8 or 9, then the body which made the arrangements for the provision of NHS services with the person or body that supplied the drugs or appliances must recover that charge from the person concerned.

Textual Amendments

F1 Words in reg. 10(4) substituted (26.11.2018) by The National Health Service (Pharmaceutical Services, Charges and Prescribing) (Amendment) Regulations 2018 (S.I. 2018/1114), regs. 1(1), 14(2)

F2 Words in reg. 10(5) substituted (26.11.2018) by The National Health Service (Pharmaceutical Services, Charges and Prescribing) (Amendment) Regulations 2018 (S.I. 2018/1114), regs. 1(1), 14(3)

Marginal Citations

M1 1953 c. 20. See in particular section 11 of that Act.

M2 Subsection (1) was amended by the Health Act 2009 (c. 21), Schedule 1, paragraphs 6 and 7(c).

M3 Regulation 6 has been amended by S.I. 2006/562 and 675.