Maternity & Midwifery Forum
Midwifery Feature Articles

Midwives encouraged to join digital maternity exemption service

Saving NHS funds and getting patients quicker access to free prescriptions through a digital online alternative to the FW8 form.

The NHS Business Services Authority (NHSBSA) is responsible for administering the maternity exemption certificate, which entitles pregnant women and new mothers to free NHS prescriptions until their baby’s first birthday.

As part of a wider programme to digitise a number of our administrative processes, we’ve re-designed our service based on user needs.

The existing process

  1. A healthcare professional (usually a community midwife) completes part of the FW8 application form to confirm a patient’s pregnancy.
  2. The patient completes the rest of the form and submits it to the NHSBSA by post.
  3. The application form is scanned and a record is created for the patient using intelligent character recognition. Most are created automatically, but we have a team of processors who intervene where required.
  4. A data file is sent daily to a card production company. A plastic card is created for each record, attached to a letter and posted to the patient.
  5. The patient is asked to show her plastic card whenever she claims free NHS prescriptions.

Project objectives

  • To improve the application process for patients and healthcare professionals
  • To help eligible patients access the care they’re entitled to more efficiently
  • To create savings for the NHS through operational efficiencies
Digital maternity exemption service infographic
Digital maternity exemption service infographic


As the NHSBSA is an Arm’s Length Body of the Department of Health, our project team was required to adhere to the Government Digital Service’s agile framework for developing new digital platforms. This involved having our work assessed at each stage of the project to ensure that our solution meets the Digital Service Standard.
The first stage of the project involved engaging with patients, midwives, GPs and pharmacy staff. We carried out in-depth face to face interviews, focus groups and telephone interviews.
Everyone on the multi-disciplinary project team spent time with research participants to help us fully understand who our users are and what they need from our service. This includes users who avoid using digital services, so that the team could determine what ‘assisted digital’ support would be needed.
Based on what we learnt from our research, we built a prototype system. We continually tested the prototype with real users, used their feedback to build improved iterations, then tested with users again. This approach enabled us to quickly identify and address any problems with the system.
In January 2017, we launched a live version of the new system to a pilot group of 32 midwives based in Newcastle upon Tyne and Hexham, Northumberland. Our project team has maintained close relationships with this group and their patients to ensure that the system is continuing to meet their needs.


We have developed a secure online alternative to the FW8 application form and a digital version of the maternity exemption certificate that patients can receive by email. It can be shown to pharmacy staff on a mobile device to prove entitlement to free prescriptions. Assisted digital users (patients who don’t provide an email address) continue to receive plastic cards, although these patients currently account for just 8% of the applications processed since the system went live for the pilot group.
‘It’s so simple, it’s impossible to get it wrong’
– Charlie Pinkney, Community Midwife
‘I wouldn’t go back to paper’
– Kathryn Moreton, Community Midwife

Kathryn Moreton, Midwife

Are you interested in becoming an early adopter?

As the pilot group have now been successfully using the digital system for six months, we are looking to increase the number of users. If you’d like to find out more, call Mark Dobson or Anna Caine on 0191 203 5695 or email
Find out more by visiting the NHS Business Services Authority website here.