NHS: Fines

From November 2024 to October 2025, the NHS Business Service Authority issued 47,058 penalty charge notices (PCNs) to people who claimed a medical exemption but were found to have no exemption in place when checked. Of these, 21,328 were eased, for various reasons including the patient subsequently applying for an exemption successfully. The number of easements in this category cannot be confirmed. Of the 47,058 PCNs issued 3,583 people received multiple PCNs.

Although the Department has made no formal assessment of the effectiveness of issuing PCNs as a deterrent against improper claims, the fact that the vast majority who receive one PCN do not go on to receive another would, in my opinion, suggest a potential deterrent effect.