The National Health Service (Pharmaceutical and Local Pharmaceutical Services) (Amendment) Regulations 2026
- Department: Department of Health and Social Care
- Made under: National Health Service Act 2006
Added meningitis, tetanus, diphtheria, and polio vaccines to the list of medicines subject to zero or nominal NHS reimbursement in England starting 20 July 2026.
These regulations amend the National Health Service (Pharmaceutical and Local Pharmaceutical Services) Regulations 2013 to include several additional vaccines in the list of medicines eligible for zero or nominal reimbursement.
They apply to NHS pharmaceutical service providers in England who administer centrally purchased vaccines for meningococcal disease (groups A, C, W, Y, and B), tetanus, diphtheria, and polio.
The instrument ensures that where the government has already paid for the supply of these vaccines, pharmacies do not receive a standard purchase price reimbursement for them.
Arguments For
The explanatory note states that the regulations enable alternatives to ordinary remuneration arrangements for centrally purchased vaccines, allowing the government to set a zero or nominal reimbursement price.
Proponents within the Department of Health and Social Care indicate that the scheme for pharmaceutical services is intended to be flexible, allowing for specific exceptions when items are provided to pharmacies through central procurement rather than private purchase.
The document asserts that no significant impact on the public sector is foreseen and that private sector impact remains below the threshold for a full impact assessment, suggesting administrative efficiency in these specific vaccine categories.
Arguments Against
Legal scholars may note that the regulations reduce the standard reimbursement ordinarily owed to service providers for prescription items under the National Health Service Act 2006.
Pharmacy trade bodies might argue that zero or nominal reimbursement increases the administrative burden on providers to track which vaccines are eligible for payment versus those centrally supplied.
Critics could question the lack of a full impact assessment, arguing that even limited impacts on the private sector pharmacy market aggregate over time as more vaccines are added to the list.
Citation, commencement, extent and application
- -(1) These Regulations may be cited as the National Health Service (Pharmaceutical and Local Pharmaceutical Services) (Amendment) Regulations 2026.
- (2) These Regulations come into force on 20th July 2026.
- (3) These Regulations extend to England and Wales and apply to England only( 2 ).
This section establishes the official name of the regulations and sets the start date as 20 July 2026.
Although the legal jurisdiction extends to both England and Wales, the actual application of these rules is limited to the National Health Service in England.
Amendment to regulation 91A of the National Health Service (Pharmaceutical and Local Pharmaceutical Services) Regulations 2013
- -(1) Regulation 91A of the National Health Service (Pharmaceutical and Local Pharmaceutical Services) Regulations 2013 (zero or nominal product reimbursement for vaccines and antivirals)( 3 ) is amended as follows.
(2) In paragraph (2)- (a) omit 'or' at the end of sub-paragraph (ae); and (b) after sub-paragraph (ae), insert-
'(af) a drug or medicine which is used for vaccinating or immunising people against meningococcal disease caused by-
(i) Neisseria meningitidis groups A, C, W and Y bacteria, or
(ii) Neisseria meningitidis group B bacteria,
if the conditions set out in paragraph (3) are satisfied;
- (ag) a drug or medicine which is used for vaccinating or immunising people against tetanus, diphtheria and polio, if the conditions set out in paragraph (3) are satisfied; or'.
- (3) In paragraph (3A), for 'to (ae)' substitute 'to (ag)'.
This section expands the list of medicines that the government may designate for zero or nominal reimbursement to include vaccines for various groups of meningitis, as well as combination vaccines for tetanus, diphtheria, and polio.
This legal mechanism prevents pharmacies from claiming reimbursement for the cost of the drug if the vaccine was provided to them at no cost through central government purchasing.
The change applies only if specific conditions regarding the procurement and supply of the vaccines are met.
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