What is an NHS Penalty Charge Notice?
An NHS Penalty Charge Notice (PCN) is a letter from the NHS Business Services Authority saying you claimed free NHS prescriptions, dental treatment, or other help you may not have been entitled to. It asks for the original charge back plus a penalty of up to £100, and gives you 28 days to pay or challenge it. Plenty are issued by mistake, so it's worth checking carefully before you pay.
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An NHS Penalty Charge Notice (PCN) is a letter from the NHS Business Services Authority saying you claimed free NHS prescriptions, dental treatment, or other help you may not have been entitled to. It asks for the original charge back plus a penalty of up to £100, and gives you 28 days to pay or challenge it. Plenty are issued by mistake, so it's worth checking carefully before you pay.
Last reviewed: July 2026 · Written in plain English, checked against gov.uk · Information only, not legal advice
NHS Penalty Charge Notice: the essentials
- What it isA charge for wrongly claiming free NHS treatment
- Who sends itNHS Business Services Authority (NHSBSA)
- PenaltyUp to 5× the charge, capped at £100, plus the charge
- Late surchargeExtra 50% up to £50 if not paid in 28 days
- Time to respond28 days to pay or challenge
Why have I been sent an NHS penalty charge?
The NHSBSA checks claims for free prescriptions, dental treatment, sight tests, and similar help against records of who was actually entitled at the time. A PCN is issued when that check suggests you claimed free treatment you weren't eligible for. Often it's because an exemption, such as a benefit or a medical exemption certificate, had run out, hadn't started yet, or wasn't the right type. These checks are automated and entitlement dates get missed, so a penalty doesn't always mean you did anything wrong.
How much do I have to pay?
A PCN asks for the original charge you should have paid, plus a penalty of five times that charge up to a maximum of £100. Miss the 28-day deadline to pay or challenge, and a further surcharge of half the penalty, up to another £50, can be added. That brings the total to as much as £150 plus the original charge. Responding promptly avoids the surcharge, so don't leave it even if you plan to dispute it.
Can I challenge an NHS Penalty Charge Notice?
Yes. If you believe you were entitled to free treatment, you can challenge the notice and send evidence, for example proof of the benefit you were getting, a valid medical or maternity exemption certificate, or an HC2 certificate. You do this using the details on the notice. If you simply made an honest mistake, respond and explain, because the penalty can be cancelled where you can show you were exempt. Don't ignore it, as that just triggers the surcharge and further recovery action.
What happens if you ignore it?
If you ignore an NHS Penalty Charge Notice, the £50 surcharge is added after 28 days, and the NHSBSA can chase the full amount as a debt, including referring it for recovery and, in the end, court action. Ignoring a notice you could have successfully challenged is the worst outcome, because you lose the chance to prove your exemption. Whether you think it's right or wrong, respond within the 28 days, to pay, to challenge, or to explain.
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See what your letter means — freeFrequently asked questions
I thought my prescription was free — why am I being charged?
Free entitlement depends on the exact dates of your benefit or exemption certificate. If yours had lapsed or hadn't yet started when you claimed, the NHSBSA flags it. You can still challenge with proof.
What if I can prove I was entitled?
Send your evidence, such as a benefit award, exemption certificate, or HC2 certificate, using the notice. If you were genuinely exempt, the penalty should be cancelled.
Does an NHS penalty charge affect my credit file?
Not directly, but if left unpaid it can be pursued as a debt and end in court action. It's best to respond within 28 days.
Official sources & free help
For the full detail — and free, independent advice — see: