NHS Prescription Costs and Exemptions

In England, the standard NHS prescription charge is £9.90 per prescribed item from April 2024. This means if a prescription has three different medicines listed, you pay £9.90 for each one — a total of £29.70 — unless you are exempt.

Prescription charges do not apply in:

• Scotland — free for all since 2011
• Wales — free for all since 2007
• Northern Ireland — free for all

Charges apply at the point of dispensing, which means hospital outpatient prescriptions issued on an FP10 form are subject to the charge, but medicines administered during a hospital stay or during an outpatient appointment are provided free.

You are automatically entitled to free NHS prescriptions if you are:

• Under 16 years old
• 16–18 years old and in full-time education
• 60 years old or over
• Pregnant, or have had a baby in the last 12 months (you need a Maternity Exemption Certificate — FW8 form)
• Diagnosed with a qualifying medical condition (including diabetes, epilepsy, cancer, myasthenia gravis, hypoparathyroidism, and others) — you need a Medical Exemption Certificate
• Receiving Universal Credit, Income Support, income-based JSA, income-related ESA, or Pension Credit
• An NHS inpatient
• Holding a valid HC2 certificate for full help with health costs (awarded via the NHS Low Income Scheme)

You must sign the declaration on the prescription form if you are exempt. Claiming free prescriptions when you are not entitled is a criminal offence — the NHS checks and issues Penalty Charge Notices.

A Prescription Prepayment Certificate (PPC) caps your prescription costs for a set period, regardless of how many items you need. The 2025/26 prices are:

• 3-month PPC: £31.25 (saves money if you pay for 4 or more items in 3 months)
• 12-month PPC: £111.60 (saves money if you pay for 12 or more items per year)

You can buy a PPC online at the NHSBSA website, by phone on 0300 330 1341, or at some pharmacies. The certificate can be backdated to the date of your most recent paid prescription. You can also spread the cost of a 12-month PPC by direct debit.

A new Serious Illness Exemption was announced in 2023 for cancer patients, providing an exemption certificate rather than requiring a PPC — check the latest NHS guidance for current eligibility.

If you do not automatically qualify for free prescriptions but have a low income, you may be able to get help through the NHS Low Income Scheme:

1. Complete an HC1 form (available from GP surgeries, hospitals, and online at NHSBSA) — this is an application for help with health costs.
2. If awarded, you receive an HC2 certificate for full help (free prescriptions, dental treatment, sight tests, and glasses) or an HC3 certificate for partial help.

The assessment takes into account your income, savings, and housing costs. If you receive Universal Credit but do not qualify for free prescriptions on that basis alone (for example, because your earnings are too high), you may still qualify via the HC1 route.

Two important areas that often catch patients by surprise: the NHS penalty notice system for incorrect exemption claims, and your rights over how the NHS uses your prescription data.

NHS Prescription Penalty Charge Notices

The NHS Business Services Authority (NHSBSA) operates a Prescription Charge Enforcement scheme. It checks prescriptions against benefit and exemption records and issues Penalty Charge Notices (PCNs) to people who have declared an exemption they do not hold. A PCN costs £100 plus the prescription charge — a total of around £110 per item.

You have 28 days to pay the PCN or to appeal it. Valid grounds for appeal include: you genuinely did hold the exemption at the time (for example, you were pregnant but had not yet received your Maternity Exemption Certificate); the exemption was correct but the system had not been updated; or the notice was issued in error. You can appeal in writing to the NHSBSA Appeals Team. If unsuccessful, you can escalate to the independent Review Service for Penalty Charge Notices. Repeat offenders can face prosecution under the NHS Act 2006, though first-time honest mistakes are generally resolved on appeal without prosecution.

NHS Prescription Data and UK GDPR

Every NHS prescription generates personal health data. Under the UK General Data Protection Regulation (UK GDPR) and the Data Protection Act 2018, you have rights over this data:

• Right of access: You can request a copy of your prescription history from the NHSBSA via a Subject Access Request (SAR). The NHSBSA must respond within one calendar month.
• Right to object: You can object to your prescription data being used for purposes beyond your direct care — such as NHS planning, research, or commercial analytics. Register your objection through the NHS National Data Opt-Out at nhs.uk/your-nhs-data-matters.
• Right to rectification: If your exemption status is recorded incorrectly — for example, a Medical Exemption Certificate you applied for has not been processed — contact your GP practice and the NHSBSA to correct the record and prevent future penalty notices.

The NHSBSA is a separate data controller from your GP practice or hospital. Any SAR directed to it must be addressed to the NHSBSA directly, not to your GP surgery.