Other · United Kingdom
NHS Penalty Charge Notice — a wrongly ticked exemption box, and 28 days to pay
An NHS Penalty Charge Notice says you received a free or reduced-cost NHS prescription or dental treatment while, per NHSBSA's records, you were not entitled to the exemption you ticked. It asks for the original charge plus a penalty, with 28 days before a surcharge is added.
How serious: routineAlso called: NHS PCN, Prescription penalty charge, Dental penalty charge, NHSBSA penalty
The notice is issued because NHSBSA's records show you were not entitled to the exemption ticked when you received a free or reduced-cost prescription or dental treatment. Common causes are an expired exemption certificate, a misunderstood benefit category, or a wrongly ticked box.
It asks for two things: the original NHS charge you should have paid, and a penalty. By law the penalty is the smaller of £100 and five times the unpaid charge (regulation 3, SI 1999/2794).
Foreign residents get caught out frequently because UK exemption categories are confusing. If you actually held a valid exemption at the date of treatment, the notice can be challenged with evidence.
Who sends it
The NHS Business Services Authority (NHSBSA) — the NHS body that checks claims for free prescriptions and dental treatment and issues penalty charges.
A letter headed 'Penalty Charge Notice' from the NHS Business Services Authority, referring to a named prescription or dental treatment date, showing the original charge, a penalty amount, and a 28-day payment deadline with a warning of a 50% surcharge.
The deadline
28 days to pay before the surcharge is added — regulation 2(1) of the National Health Service (Penalty Charge) Regulations 1999 requires payment 'within the period of 28 days beginning with the date on which the penalty notice was sent'
There are 28 days to pay before the surcharge is added. Regulation 2(1) of the National Health Service (Penalty Charge) Regulations 1999 requires payment 'within the period of 28 days beginning with the date on which the penalty notice was sent' — the clock starts on the sending date, not the day the letter arrives (reg 2(1), SI 1999/2794).
If you do nothing
A surcharge is added by law: 'The amount of the surcharge shall be 50% of the amount of the penalty charge' (reg 4(2), SI 1999/2794). The penalty itself is capped: 'The amount of the penalty charge shall be whichever is the smaller of - (a) £100, and (b) the amount... multiplied by 5' (reg 3) — that is, five times the unpaid NHS charge up to £100, on top of repaying the original charge. The debt then remains recoverable.
How it escalates
- 01After 28 days: a 50% surcharge is added to the penalty charge (a maximum surcharge of £50 on the £100 maximum penalty).
- 02The original charge, penalty and surcharge remain a recoverable debt.
Common questions
How much is the penalty?
The smaller of £100 and five times the unpaid NHS charge, on top of the original charge itself (reg 3, SI 1999/2794).
When does the 28 days start?
On the date the penalty notice was sent, not the date it arrived (reg 2(1), SI 1999/2794).
What if I was actually entitled to the exemption?
NHSBSA can be sent evidence, such as a certificate or benefit award valid at the date of treatment, to have the penalty withdrawn.
What is added after 28 days?
A surcharge of 50% of the penalty charge (reg 4(2)) — at most £50 on the £100 maximum penalty.
Sources
Facts verified against the sources below on 28 August 2026.