England: TB drugs free on NHS from 1 December 2025

From 1 December 2025, three practical changes arrive in England to make it easier to get essential care without surprise bills. Tuberculosis medicines will be free on the NHS, people medically evacuated from conflict zones can be placed on the NHS Low Income Scheme for a set period, and refunds for prescription prepayment certificates will better match what people actually paid.

Here’s the timeline and scope so you can teach it clearly. The regulations were made on 5 November 2025, laid before Parliament on 6 November 2025, and apply in England. They extend to England and Wales but only apply in relation to England. The instrument is signed by Health Minister Karin Smyth, reflecting her current ministerial role at the Department of Health and Social Care.

If you or someone you support has been evacuated from a conflict zone for medical treatment, the Secretary of State can put them on the NHS Low Income Scheme for a specified period, regardless of income. During that period, they will not pay NHS prescription or dental charges, can claim help with travel for NHS treatment, and can get help with eye care costs. This mirrors what the scheme already covers for low‑income households.

To be eligible under this route, the person must have entered (or be about to enter) the UK from an area with armed conflict, with the main purpose of evacuation being medical treatment for them or for someone they are accompanying. They must also be exempt from, or have had reduced, waived or refunded, the Immigration Health Surcharge. Community groups, schools and colleges can help by signposting to the online Low Income Scheme application and helpline so people know how to evidence their status when asked at appointments.

The same regulations link this temporary Low Income Scheme membership to free NHS sight tests and optical vouchers during the specified period. In practice, that means evacuees granted this status can have a free NHS sight test and receive a voucher towards glasses or contact lenses while the certificate lasts. If you’re explaining this in class, the HC2 certificate is the document that shows full help.

On TB, the rules now make NHS prescription charges zero for drugs used to treat tuberculosis, its effects, or the effects of TB treatment. This can happen in two ways: the medicine is supplied under a patient group direction, or it’s issued on a standard NHS prescription with the prescriber’s “FS” endorsement, which flags a free supply. That endorsement must be added by the prescriber, not the pharmacy or patient.

For pharmacy teams and student pharmacists, one processing point matters for your coursework and placements. Paper prescriptions with a proper “FS” endorsement go in the red separator for exempt items at month‑end, and mixed scripts should ideally be split so free‑of‑charge and chargeable items sit on different forms. This helps prevent incorrect charging and delays.

Prepayment certificates (PPCs) are also tidied up. Earlier in 2025, regulations created an automatic cancellation and refund when someone becomes entitled to a maternity or medical exemption, but people in cancer treatment were unintentionally left out. That gap is now closed. Refund values will mirror the current PPC prices: £32.05 for three months and £114.50 for 12 months, in line with the most recent pricing statements.

Let’s ground this with classroom scenarios you can use. A family member evacuated for surgery arrives in England with confirmation of their status; they can be granted Low Income Scheme membership for a set period and won’t pay for prescriptions or NHS dental charges during that time. A student is diagnosed with TB; their medicines are free when supplied under a PGD or when the prescriber marks the item “FS”, so no counter payment is due. A worker with a 12‑month PPC starts cancer treatment and becomes exempt; their PPC can be cancelled with a refund matching the certificate’s price, rather than paying twice.

For learners and support staff, the safest first step is to check entitlement before claiming. If someone is unsure, paying the charge and using the FP57 refund route protects them from penalty notices while status is confirmed. You can point people to the NHSBSA eligibility checker and Low Income Scheme pages for plain‑English guidance and application routes.