OBJECTIVES: In the UK, Patient Access Schemes (PAS) have become common in health technology submissions, and have been instrumental in enhancing the availability of otherwise non cost-effective treatments. Despite notable efforts towards recognising and reducing the administrative impact of PAS on frontline staff, evidence suggests that they still result in a significant burden. The study presented here attempted to assess the burden of PAS administration, and how this could change if and when the planned changes to the UK healthcare system are enacted. METHODS: A literature search was conducted and freedom-of-information requests were sent to the Patient Access Scheme Liaison Unit (PASLU) for data on PAS administration. A questionnaire developed from our previous pilot study on the administrative burden of PAS was distributed to hospital pharmacists across the UK, and a call for participants was hosted on the Royal Pharmaceutical Society website. RESULTS: Value Based Pricing (VBP) is expected to be introduced in the UK once the current Pharmaceutical Price Regulation Scheme comes to an end. PAS approved before this point will continue to be used, although additional PAS may not be introduced under VBP. It is unclear from the available literature how this will affect the role of PASLU and the administration of the remaining PAS. The return-rate for our questionnaire was low; however, responders voiced similar concerns to those recorded in our pilot study, namely the poor recognition of the burden of PAS and the resources required to manage them. Responders were also unclear about how administration of PAS would change with the move to VBP. CONCLUSIONS: The role of PAS in the changing NHS, and the burden such schemes could entail, is uncertain. Clear guidelines on the impact of healthcare reform are necessary, alongside additional support to facilitate effective PAS implementation even after VBP is introduced.