Fraud. Together we can stamp it out.

Patient Exemptions

NHSScotland under the Family Health Services (FHS) banner provides Medical, Optical, Pharmacy and Dental services in Scotland. There is a charge for receiving treatment from three of these services unless the patient qualifies for an exemption for paying them.

Fraudulent claims for exemption from NHS charges are now being investigated and analysed by the CFS. The majority of these investigations are triggered by patients not providing evidence when obtaining services or treatment. In addition, a sample of claims where evidence has been provided is also being checked.

The CFS has a dedicated team charged with checking these claims. On a monthly basis thousands of 'exempt' claimants are checked with the relevant agency and, if entitlement to exemption cannot be confirmed, the patients will be contacted and requested to provide proof of their entitlement.

Where it is identified that patients have mistakenly or fraudulently claimed entitlement, the charge will be recovered and where this is not forthcoming, a Penalty Charge notice will be issued. In extreme cases, legal action will be taken to recover payments.

If you are genuinely entitled to exemption from charges you have nothing to worry about. We are here to ensure that patients entitled to receive exemption from charges continue to do so.

The computerised payment systems introduced for Dental, Optical and Pharmacy services allow the CFS to quickly and easily identify claims that may warrant investigation. The systems will also show, for example, if a patient is visiting more than one optician and claiming free sight tests and glasses.