
Despite it being easier than ever to order your NHS prescription from an online pharmacy, the cost of living crisis is making it increasingly difficult for people to pay for them.
With the total amount of fines across the UK for unpaid prescriptions in 2022 totalling £24,193,372, we wanted to find out which areas of the UK haven’t been paying for their prescriptions. To do this, we submitted an FOI request to find out which integrated care boards (ICB) issued the most fines for unpaid prescriptions, as well as the total cost of these fines.
The NHS issued Greater Manchester residents with 617 fines for unpaid prescriptions per 100,000 people, more than any other area
We submitted a Freedom of Information request to find out which integrated care boards issued the most fines for unpaid prescriptions in 2022. We then found out the population of each ICB to reveal which areas of the UK had the most fines issued per 100,000.

1. NHS Greater Manchester – 617 fines issued per 100,000 people
The guiltiest area was Greater Manchester, where 617 fines for unpaid prescriptions were issued per 100,000 people. Greater Manchester was issued a total of 20,612 fines for unpaid prescriptions, which was the highest total in England.
2. NHS Cornwall and The Isles of Scilly – 594 fines issued per 100,000 people
In second place is Cornwall and the Isles of Scilly, with 594 fines for unpaid prescriptions per 100,000 people. Just under 4,000 fines were issued in total during 2022, which cost the residents a total of £380,000.
3. NHS Lancashire and South Cumbria – 577 fines issued per 100,000 people
Lancashire and South Cumbria is the ICB that completes our top three, with 577 fines issued for unpaid prescriptions per 100,000. There were 11,579 fines issued in total, which was the fifth highest in the UK during 2022, costing over £1 million.

Greater Manchester residents were fined almost £2 million due to unpaid prescriptions, more than in any other area
In our FOI request, we also wanted to find out how much each ICB paid in unpaid prescription fines in 2022.

1. NHS Greater Manchester – £1,894,412 issued in fines
Greater Manchester takes the top spot once again, paying just under £1.9 million in fines for unpaid prescriptions. The total amount that Greater Manchester was fined was £150,000 more than any other NHS ICB in 2022.
2. NHS North East and North Cumbria – £1,755,836 issued in fines
In second place is the North East and North Cumbria with just over £1.75 million issued in fines for unpaid prescriptions. North East and North Cumbria’s huge sum was spread over 18,400 cases, which was the second highest in the UK.
3. NHS Cheshire and Merseyside – £1,324,631 issued in fines
Completing an all-northern top three is Cheshire and Merseyside, whose unpaid prescriptions cost them over £1.3 million altogether. Cheshire and Merseyside’s total was spread over 14,000 cases, which was the third highest in the UK.

The most expensive average cost for an unpaid prescription was in Northamptonshire, at just over £100
An unpaid prescription fine will cost you five times the amount owed, which is capped at £100. However, if the fine is not paid within 28 days, then a surcharge could be added. That’s why we wanted to find out which ICBs had the highest average cost of unpaid prescription fines.

1. NHS Northamptonshire – £103.69 average cost per fine
The highest average cost per fine was in NHS Northamptonshire, at just under £104. There were almost 4,000 fines issued for unpaid prescriptions in Northamptonshire, with a total cost of just over £4,000. Not only were Northamptonshire residents not paying for their prescriptions, but they were also often late paying the penalty, with the average cost exceeding the £100 cap on initial fines.
2. NHS Norfolk and Waveney – £100.04 average cost per fine
In second place was NHS Norfolk and Waveney, with an average cost per fine of £100.04. Just like Northamptonshire, NHS Norfolk and Waveney were often late to pay their fines, which is why the average cost exceeds the £100 cap on initial fines. Almost 4,900 fines were issued to residents here, with a total value of almost £490,000.
3. NHS Lincolnshire – £99.71 average cost per fine
NHS Lincolnshire completes our top three, with an average cost of £99.71 per fine. There were almost 4,500 fines issued for unpaid fines in Lincolnshire, with a total value of just under £450,000. Despite the average cost per fine sitting underneath the £100 cap, there must have been a large number of residents in Lincolnshire who didn’t pay their fines on time to bring the average to just 39p off the cap.

Methodology
We submitted an FOI request to the NHS Business Services Authority, asking for the number of fines issued for unpaid prescriptions and the total cost of these fines in 2022.
We then took the overall ICB-weighted populations from NHS England to work out the number of fines per 100,000 people.
We then divided the total cost of fines by the number of cases to work out the average cost of fines per ICB.
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