A woman has been left furious after receiving a £100 penalty charge notice from the NHS for an honest mistake involving her Hormone Replacement Therapy (HRT) pre-payment certificate.
The Unwelcome New Year's Letter
The individual, who shared her story on Mumsnet, explained she had been on HRT for around 18 months and had purchased an annual pre-payment certificate (PPC) to cover the costs. Each time she collected her prescriptions, she would show the certificate as proof of payment at the pharmacy.
However, in early January 2026, she received a letter from the NHS stating she had falsely claimed for a prescription and would be fined £100. Upon calling to query the charge, she discovered the issue. Six months prior, her GP had added a new medication to her HRT regimen which, unbeknownst to her, was not covered by the specific HRT PPC she held.
Pharmacy Acceptance No Defence
The woman stated the pharmacy had accepted her certificate without question when she collected the prescription, leading her to believe the payment was valid. She expressed her anger, arguing that if an item is not payable with the provided certificate, it should be flagged immediately at the point of sale.
Her frustration was compounded by the NHS letter's explicit statement that being misled by the pharmacy is not considered a valid excuse to have the fine waived. "If I've pre-paid my HRT then it should cover all HRT," she wrote online.
A Shared and Costly Confusion
Her post resonated with others who had faced similar penalties. One respondent confirmed they had been in the same situation, noting that the means of payment is ultimately the patient's responsibility, regardless of what the pharmacy says at the counter.
Another shared a nearly identical experience, where a fine—around £60 in their case—was issued after a prescription included testosterone gel as part of an HRT regime. This specific gel, they learned, was not covered by the HRT certificate. They also highlighted a lack of communication from the pharmacist at the time of collection.
While some emphasised the patient's duty to check, others expressed sympathy. One poster argued that an unreasonable burden is sometimes placed on service users, and in this instance, the onus should lie more with the healthcare provider to clarify coverage at the point of dispensing.
Official NHS Advice on HRT Certificates
The NHS clearly states that penalty charge notices are issued if someone incorrectly claims for free prescriptions or dental treatment. It specifies that an HRT PPC only covers certain HRT medicines, and GPs may prescribe other items not included.
Their official guidance stresses: "It's important to check that the medicine you need is covered before buying an HRT PPC." A list of covered medicines is available on the NHS website, placing the responsibility on patients to verify their specific medications are included under the certificate scheme.
