The number of fines issued to patients in England mistakenly or fraudulently claiming free prescriptions has doubled in a year, new figures show. Almost one million fines were handed out in the last year to patients who claimed prescriptions while ineligible - but there are fears that people with long-term conditions and on low incomes are among the worst affected.

According to figures obtained by the BBC following a request under the Freedom of Information Act, 979,210 fines were issued in 2016-17, compared with 494,129 in 2015-16. Fines are issued by the NHS Business Services Authority (NHSBSA) and apply in England, which remains the only UK nation to charge prescription fees. Patients can be fined a maximum of £100 for obtaining free medication after an exemption certificate has expired, with fines in the last year generating £13.3m.

The NHSBSA says it is the responsibility of the patient to make sure they’re entitled to claim, and that fraudulent claims cost NHS England millions of pounds each year - which could be spent on frontline services. But the British Medical Association (BMA) said that those who most need help are among the hardest hit, with fines often being issued to patients with multiple conditions who may need ongoing treatment and prescriptions. According to the Royal Pharmaceutical Society, many of those fined don’t know the rules or forget to renew their paperwork.

Eligible patients need to present their exemption certificate and sign the back of the prescription form. The NHSBSA makes random checks when it thinks a free prescription claim has been made incorrectly and, unless the patient can prove they were entitled to claim at the time, they are liable to pay the original prescription charge plus a fine of five times that amount, up to £100.

In England, prescription charges rose in April from £8.40 to £8.60. Among those exempt are patients over 60 and under 16, as well as young people aged 16-18 who are in full-time education. Also excluded from paying are pregnant women and new mothers who have a valid maternity exemption certificate, patients with a specified medical condition, those with a continuing physical disability, NHS inpatients and certain holders of a valid war pension exemption certificate, as well as recipients of income support.