The National Health Service (Help with Health Costs) (Miscellaneous Amendments) Regulations 2025
The Secretary of State for Health and Social Care enacts these Regulations under the National Health Service Act 2006 to amend existing NHS charging and remission rules, specifically granting eligibility for full NHS charge remission and travel expense reimbursement to individuals medically evacuated from conflict zones.
Furthermore, the Regulations introduce free prescription charges for drugs supplying treatment for tuberculosis and its effects, correct previous amendments concerning automatic prepayment certificate cancellations for cancer patients gaining exemptions, and update the monetary values for prescription prepayment certificate refunds to align with current pricing structures.
Arguments For
Introducing eligibility for full remission of NHS charges and travel expenses for individuals medically evacuated from conflict zones, ensuring essential healthcare access when they enter the UK.
Ensuring fairness and comprehensive coverage by correcting an omission in previous amendments, thereby granting automatic cancellation and refunds of prepayment certificates to individuals undergoing cancer treatment who gain medical exemptions.
Aligning the refund amounts for prescription prepayment certificates (PPCs) with their current costs, reflecting recent inflationary increases in purchase prices and ensuring repayment amounts are accurate.
Making prescription drugs for treating tuberculosis (and related effects/treatments) free of charge, improving public health outcomes related to this specific condition.
Arguments Against
The creation of a new discretionary category for medical evacuation patients may add administrative complexity to the NHS Low Income Scheme administration, requiring new determination processes by the Secretary of State.
Amendments to prescription charge refund values could face scrutiny if the public perceives the overall cost of PPCs is rising too quickly, even if the amendment merely aligns refunds with new statutory charges.
Introducing specific exemptions (like for TB treatment) can create complexity in billing and auditing, as prescribers must correctly use specific codes ('FS') or ensure treatments fall under a patient group direction.
The regulations apply only to England regarding health cost remission, potentially creating disparate treatment for reciprocal medical arrangements in devolved nations.
The Secretary of State for Health and Social Care makes the following Regulations in exercise of the powers conferred by sections 115(2)(e), 116(2), 172(1), 174(1) and (3), 178(1)(b) and (2)(a) and (b), 179(1), 180(1), (2)(d) and (5), 182, 183, 184(1) and 272(7) and (8) of the National Health Service Act 2006.
The Secretary of State for Health and Social Care issues these Regulations.
The power to make these rules comes from specific sections (listed by number) within the National Health Service Act 2006.
Citation, commencement, extent, application and interpretation 1. (1) These Regulations may be cited as the National Health Service (Help with Health Costs) (Miscellaneous Amendments) Regulations 2025 and come into force on 1st December 2025.
(2) These Regulations extend to England and Wales and apply only to England.
(3) In these Regulations, “the Prescription Charges Regulations” means the National Health Service (Charges for Drugs and Appliances) Regulations 2015.
These Regulations are officially named the National Health Service (Help with Health Costs) (Miscellaneous Amendments) Regulations 2025 and become legally effective on December 1st, 2025.
The legal application of these rules covers England and Wales, but their specific provisions regarding health costs only impact England.
The document defines 'the Prescription Charges Regulations' as the National Health Service (Charges for Drugs and Appliances) Regulations 2015 for reference purposes.
Amendments to regulation 5 of the National Health Service (Travel Expenses and Remission of Charges) Regulations 2003 2. (1) Regulation 5 of the National Health Service (Travel Expenses and Remission of Charges) Regulations 2003 (entitlement to full remission and payment) is amended as follows.
(2) In paragraph (1), after sub-paragraph (d) insert—
“(da) that person is part of medical evacuation arrangements from a conflict zone;”.
(3) After paragraph (1D) insert—
“(1E) For the purposes of paragraph(1)(da), a person is part of medical evacuation arrangements from a conflict zone if—
(a) the person is about to enter or has recently entered the United Kingdom, having been evacuated from an area where there is or has recently been an armed conflict;
(b) the sole or main purpose of the evacuation is or was for them to receive, or for a person they are or were accompanying to receive, medical treatment;
(c) as regards any charge that may be payable under article 3 of the Immigration (Health Charge) Order 2015 (requirement to pay an immigration health charge)—
(i) the person is exempt from paying such a charge by virtue of article 7 of, and any provision of Schedule 2 to, that Order (exemptions from the requirement to pay the immigration health charge), or
(ii) the Secretary of State has exercised their discretion, pursuant to article 8 of that Order (reduction, waiver or refund), to reduce, waive or refund all or part of a charge payable by the person;
(d) the Secretary of State has determined that the person is to benefit from membership of the NHS low income scheme for a specified period (which may be extended by the Secretary of State), regardless of what that person’s or any other person’s resources are; and
(e) the period specified under sub-paragraph (d) has not come to an end.”.
Regulation 5 of the 2003 Travel Expenses and Remission of Charges Regulations is being updated to include a new condition for receiving full remission and payment relief.
A person now qualifies if they are part of medical evacuation arrangements from a conflict zone.
Clause (1E) defines this status, requiring the individual to have recently entered the UK from an area of armed conflict primarily for medical treatment.
This eligibility requires the individual to either be exempt from the Immigration Health Charge or have that charge reduced or waived by the Secretary of State.
Crucially, the Secretary of State must grant this person membership in the NHS Low Income Scheme for a specified, potentially extendable period irrespective of personal financial resources.
Amendment to regulation 3 of the Primary Ophthalmic Services Regulations 2008 3. In regulation 3 of the Primary Ophthalmic Services Regulations 2008 (sight tests – eligibility), in paragraph (1), after sub-paragraph (d) insert—
“(da) who is, for the purposes of regulation 5(1)(da) of the National Health Service (Travel Expenses and Remission of Charges) Regulations 2003 (entitlement to full remission and payment), part of medical evacuation arrangements from a conflict zone;”.
This amends the 2008 regulations concerning eligibility for free NHS sight tests.
A person now qualifies for a free sight test if they satisfy the new criterion (da) added in Regulation 2, meaning they are recognized as being part of medical evacuation arrangements from a conflict zone.
Amendment to regulation 8 of the National Health Service (Optical Charges and Payments) Regulations 2013 4. In regulation 8 of the National Health Service (Optical Charges and Payments) Regulations 2013 (eligibility for a voucher – supply of optical appliances), in paragraph (2), after sub-paragraph (d) insert—
“(da) a person who is, for the purposes of regulation 5(1)(da) of the Remission Regulations (entitlement to full remission and payment), part of medical evacuation arrangements from a conflict zone;”.
The 2013 Optical Charges and Payments Regulations are updated regarding eligibility for optical appliance vouchers.
Eligibility is now extended to include individuals defined under the new sub-paragraph (da), which refers back to the status of being part of medical evacuation arrangements from a conflict zone.
New regulation 13C of the Prescription Charges Regulations 5. After regulation 13B of the Prescription Charges Regulations (coronavirus and influenza vaccinations and immunisations) insert—
“Treatments for tuberculosis 13C. (1) No charge is payable under these Regulations in respect of the supply or administration of any drug for the treatment of—
(a) tuberculosis;
(b) the effects of tuberculosis; or
(c) the effects of tuberculosis treatment.
(2) Paragraph (1) applies if the supply—
(a) is made in accordance with a patient group direction; or
(b) has been ordered on a prescription form, and the prescriber has included in the form the reference “FS”.”.
A new regulation, 13C, is inserted into the Prescription Charges Regulations removing fees for tuberculosis treatment.
This exemption covers drugs used to treat active tuberculosis, the lingering effects of the disease, or the side effects resulting from its treatment.
This removal of charge applies only if the drug is supplied under a patient group direction, or if the prescriber marks the prescription form with the reference 'FS'.
Amendments to regulation 17 of the Prescription Charges Regulations 6. In regulation 17 of the Prescription Charges Regulations (pre-payment certificates: repayment)—
(a) in paragraph (3A) for “or 10(1)(e)” substitute “to 10(1)(f)”;
(b) in paragraph (3B), for “or 10(1)(e)” substitute “to 10(1)(f)”;
(c) in paragraph (4)—
(i) in sub-paragraph (a), for “£31.25” substitute “£32.05”, and
(ii) in sub-paragraph (b) and (c)(i) and (ii), for “£111.60”, at each place that it occurs, substitute “£114.50”; and
(d) in paragraph (5), for “£31.25” substitute “£32.05”.
Regulation 17 of the Prescription Charges Regulations, which covers repayments for prepayment certificates (PPCs), receives several amendments.
Sub-paragraphs (a) and (b) make minor cross-referencing changes.
Paragraph (4) updates the refund amounts: the figure for a 3-month PPC refund becomes £32.05 (up from £31.25), and the figure for a 12-month PPC refund becomes £114.50 (up from £111.60).
Sub-paragraph (d) confirms the 3-month PPC refund amount change in a separate context.
Signed by authority of the Secretary of State for Health and Social Care Karin Smyth Minister of State Department of Health and Social Care 5th November 2025
This section identifies the official who signed the document on behalf of the Secretary of State for Health and Social Care.
Karin Smyth, as Minister of State for the Department of Health and Social Care, authorized these Regulations on November 5, 2025.