England NHS: TB drugs free; evacuees covered from 1 Dec
From 1 December 2025 in England, the way you get help with NHS costs changes. The headline points for you are simple: TB medicines will be free; people evacuated from conflict zones for medical care can be brought into the NHS Low Income Scheme for a set period; and refunds for prescription prepayment certificates are corrected to match current prices.
These changes sit in the National Health Service (Help with Health Costs) (Miscellaneous Amendments) Regulations 2025 (S.I. 2025/1165). The instrument was made on 5 November 2025 and laid before Parliament on 6 November 2025. It extends to England and Wales, but it only applies in England.
It also cleans up past paperwork. Officials state this instrument corrects errors in S.I. 2024/456 and S.I. 2025/636 and is being issued free of charge to everyone who received those earlier regulations. That matters because a mistake last time left out people in cancer treatment from new automatic refund rules.
From 1 December, TB medicines are exempt from prescription charges. If you are being treated for tuberculosis, for the effects of TB, or for side effects of TB treatment, you will not pay a prescription charge for those medicines. Prescribers can issue a prescription marked with the reference “FS”, or your clinic may supply under a patient group direction.
What this means at the pharmacy is straightforward. From 1 December, staff should not charge you if the TB prescription shows “FS” or if your clinic supplies treatment under a patient group direction. This exemption sits in the Prescription Charges Regulations as new regulation 13C, so it becomes part of the standing rules rather than a temporary scheme.
People arriving in, or about to arrive in, the UK as part of medical evacuation arrangements from a conflict zone can now be granted membership of the NHS Low Income Scheme for a set period, regardless of income or savings. The Secretary of State will specify the period and may extend it if needed.
To qualify as part of those evacuation arrangements, you must have been evacuated from an area where there is, or has recently been, armed conflict; the sole or main purpose must be medical treatment for you or someone you accompany; and you must be exempt from the Immigration Health Surcharge or have had it reduced, waived or refunded. You are covered while the specified membership period is in force.
That membership brings practical help: full remission of NHS prescription and dental charges and reimbursement of necessary travel costs to receive NHS care. The sight test and optical voucher rules are updated too, so evacuees are eligible for free NHS sight tests and optical vouchers during the membership period.
Prepayment certificates (PPCs) help you cap prescription costs. Earlier in 2025, new rules allowed automatic cancellation and refunds when someone becomes entitled to a maternity or medical exemption certificate. People undergoing treatment for, or related to, cancer were left out by mistake. This instrument fixes that, so cancer patients are included in the automatic cancellation and refund process.
Refund amounts are also brought into line with the PPC prices. If you qualify for a refund, the figures are £32.05 for a three‑month PPC and £114.50 for a 12‑month PPC, matching the price changes made by S.I. 2024/456. This tidies up the numbers so the refund reflects what you actually paid.
A quick glossary if you are revising for class or planning your care. A prescription prepayment certificate (PPC) is a pass you buy to cover all NHS prescriptions for a set period. A patient group direction (PGD) is a legal instruction used by services to supply or administer medicines without individual prescriptions. “FS” is the reference prescribers include so TB treatment is supplied free under the new rule.
What should you do next? If you are on TB treatment, ask your GP, TB nurse or pharmacist how your prescriptions will be handled from 1 December. If you have a PPC and become entitled to a maternity or medical exemption certificate, including for cancer treatment, keep your confirmation letters and receipts while the system processes any refund. If you are part of a medical evacuation, your NHS trust will explain whether you have been granted Low Income Scheme membership, for how long, and how to claim help with travel and charges. For more detail, the NHS Business Services Authority has guidance at Link