DHSC has made a correcting instrument that also widens access to help with NHS costs. The National Health Service (Help with Health Costs) (Miscellaneous Amendments) Regulations 2025 (S.I. 2025/1165) were made on 5 November, laid on 6 November, and commence on 1 December 2025. The instrument extends to England and Wales but applies only to England and is being issued free of charge to recipients of S.I. 2024/456 and S.I. 2025/636. It was signed on 5 November by Karin Smyth, Minister of State at DHSC.
A new route is created for people evacuated from conflict zones to receive temporary membership of the NHS Low Income Scheme at the Secretary of State’s discretion. Eligibility requires recent entry to the UK as part of medical evacuation from an area of armed conflict, with the main purpose being to receive treatment or to accompany someone for treatment. Individuals must be exempt from, or have had reduced or waived, the immigration health charge; membership is granted for a specified period and may be extended, and during that period it is not dependent on means.
To give operational effect to this, the 2003 Travel Expenses and Remission of Charges Regulations are amended so that a person who is part of medical evacuation arrangements from a conflict zone is entitled to full remission of NHS charges and to reimbursement of eligible travel costs. The entitlement applies for as long as the Secretary of State’s specified period of Low Income Scheme membership remains in force.
The same evacuee group is added to the Primary Ophthalmic Services Regulations 2008, making them eligible for a free NHS sight test. Parallel amendments to the 2013 Optical Charges and Payments Regulations allow optical vouchers for the supply, replacement or repair of optical appliances for those evacuees who meet the criteria and remain within the Secretary of State’s specified period.
Separately, the Prescription Charges Regulations 2015 gain a new regulation 13C. From 1 December, no prescription charge is payable for drugs used to treat tuberculosis, the effects of tuberculosis, or the effects of tuberculosis treatment. The exemption applies when supply is made under a patient group direction or when prescribed on a form carrying the reference “FS”, which the prescriber must include.
The Regulations also correct refund rules for prescription prepayment certificates (PPCs) so that repayment values mirror current PPC prices. Refund thresholds are aligned with the 2024 uprating: £32.05 for a three‑month PPC and £114.50 for a 12‑month PPC, replacing £31.25 and £111.60. These figures correspond to the PPC price changes made in S.I. 2024/456.
A drafting omission in S.I. 2025/636 is addressed. Automatic cancellation and appropriate refunds of PPCs, triggered when a person becomes entitled to an exemption certificate, will also apply to people undergoing treatment for, or related to, cancer. This restores consistency with the arrangements already set for maternity and medical exemptions in that 2025 instrument.
For NHS pharmacy contractors and dispensing doctors, items supplied for TB treatment under a patient group direction or on prescriptions marked “FS” should be processed as charge‑free from 1 December. Pharmacy system suppliers will need to ensure the “FS” reference can be recorded without generating a charge, and local patient group directions for TB treatment must be current where those are used.
Provider finance teams and the NHS Business Services Authority should update processes to reflect the revised PPC refund values and the clarified auto‑cancellation rules. Ophthalmic contractors should apply sight‑test eligibility and voucher support to evacuees who meet the new definition and can evidence the Secretary of State’s Low Income Scheme determination within the relevant period.
The Secretary of State’s discretion to grant Low Income Scheme membership to evacuees operates regardless of the individual’s resources for a specified period, which may be extended. Integrated Care Boards and providers will require a DHSC determination or equivalent confirmation to apply remission and travel reimbursement under the amended 2003 Regulations.
DHSC notes no, or no significant, impact on the private or voluntary sectors and only a limited impact on the public sector, so no full impact assessment is produced. In practice, the instrument corrects earlier charging regulations while adding time‑limited support for evacuees and formalising a TB treatment charge exemption without changing the wider NHS charging framework.