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Published 25 June 2026.
Publication
The narrative report contains analysis and charts on certificates issued through the 5 main NHS Help with Health Cost schemes.
NHS Help with Health Costs statistical summary narrative 2025/26 (HTML)
The Help with Health Costs 2025/26 dashboard will allow you to explore the data in more detail.
The background information and methodology note contains information to help you understand and interpret the data and analysis in this release.
Background information and methodology note (HTML)
Summary
The NHSBSA administer a range of services to help people with health costs, including help with:
- NHS prescription costs
- NHS dental costs
- sight tests, glasses and contact lenses
- travel to receive NHS treatment
- NHS wigs and fabric supports
Full details of these schemes are available on the Help with Health Costs webpage.
Different certificate schemes are available, with different levels of help with health costs:
- NHS Prescription Prepayment certificate (PPC)
- NHS Low Income Scheme (LIS)
- NHS Hormone Replacement Therapy Prescription Prepayment Certificate (HRT PPC)
- Medical exemption certificate
- Maternity exemption certificate
Most of these schemes cover England only, but the NHS Low Income Scheme also provides support to some applicants across the United Kingdom.
The NHS Tax Credit exemption certificate scheme is no longer issuing certificates, so analysis of this scheme is not included in this release. Data on Tax Credit exemption certificates is available in the previous 2024/25 release.
The Help with Health Costs – England 2025/26 publication is an official statistic. It has been produced with full consideration of the standards set out in the Code of Practice for Statistics.
Key findings
Maternity exemption certificates
The number of certificates issued has risen each year since 2020/21. There were 584,000 maternity exemption certificates issued in 2025/26.
Generally, less deprived areas of the country received fewer maternity exemption certificates than more deprived areas. The number of certificates issued was highest in 30-34 year olds, accounting for 36% of all certificates issued.
Medical exemption certificates
In 2025/26 the number of medical exemption certificates issued decreased for the first time since 2020/21, down to 436,000 medical certificates. Medical exemption certificates are normally valid for 5 years, so the reduced number of certificates issued in 2020/21 may be contributing to fewer renewals 5 years later in 2025/26.
The number of certificates issued increases with age.
Low Income Scheme
The total number of certificates issued in 2025/26 increased to 259,000. The total number of HC2 certificates increased to 162,000, while HC3 certificates increased to 97,000.
Certificates were most commonly issued to people from the youngest age groups of 15-19 and 20-24, and the oldest age group of 65+. More certificates were issued to people from more deprived areas.
NHS Prescription Prepayment Certificate (PPC)
The total number of PPCs purchased has increased every year since 2020/21. There were 2.2 million 12-month certificates issued and 1 million 3-month certificates issued in 2025/26.
The number of PPCs issued increases in older age groups for both 12-month and 3-month certificate durations. There is no clear pattern by deprivation in England, with the number of 12-month certificates issued in the most and least deprived areas slightly lower than in other areas.
NHS Hormone Replacement Therapy Prescription Prepayment Certificate (HRT PPC)
The HRT PPC was introduced on 1 April 2023. There were 572,000 HRT PPCs issued in 2025/26, an increase from 2024/25. Increases were not consistent across the year, with April 2025 to July 2025 having fewer certificates in the same months in the previous year. From August 2025 to March 2026 the number of certificates issued each month was higher than in the same month in the previous year.
The number of certificates issued was higher in less deprived areas.
Integrated Care Boards (ICBs) in the South and South West regions of England generally have higher rates of HRT PPCs issued.
Resource list
These datasets provide annual summaries, by calendar year or financial year, of the number of applications and certificates issued across the 5 schemes. The HRT PPC began in April 2023, so data on total applications and total certificates issued is presented by month for this scheme.
Data on certificates issued for each scheme is also available by financial and calendar year broken down by Integrated Care Board (ICB), applicant age, or Index of Multiple Deprivation (IMD) quintile. The maternity exemption scheme, Low Income Scheme, and PPC scheme include totals of certificates issued by certificate duration.
Financial year summary tables 2018/19 to 2025/26 (Excel: 211KB)Calendar year summary tables 2018 to 2025 (Excel: 212KB)
Pre-release access list (HTML)
This publication has been produced using a reproducible analytical pipeline (RAP) as part of our commitment to transparency and open code. The code used to produce this release will be made available on our Help with Health Costs GitHub repository in due course.
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Responsible statistician: Grace Libby