Skip to main content Skip to footer

Help with Health Costs - England 2023/24

Published 20 June 2024. 


NHS Help with Health Costs 2023/24 statistical summary narrative (HTML)

This dashboard will allow you explore the data in more detail.


The NHSBSA administers a range of services to help people with their health costs. Help includes:

  • 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.

Six different certificate schemes are available, with different levels of help with health costs:

These statistics are Official Statistics in development, and we will be looking to develop and improve them following user feedback. They are also fully compliant with 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 552,000 maternity exemption certificates issued in 2023/24. 

The most deprived areas of the country have the highest number of births. However, the most deprived areas do not receive the highest number of maternity exemption certificates. 

Medical exemption certificates 

The number of certificates issued has risen following a drop between 2019/20 and 2021/22. There were 475,000 medical exemption certificates issued in 2023/24. 

The number of certificates issued typically rises with age. 

NHS tax credit exemption certificates 

The number of NHS tax credit exemption certificates has been declining for several years. As part of the Universal Credit rollout people are being migrated away from tax credits and onto new benefit schemes. In 2023/24, 1.2 million certificates were issued, compared to 3.7 million in 2018/19. 

The age profile of recipients has changed over the past few years. In 2018/19, 55% of certificates were issued to people aged under 40 years old but in 2023/24 this has dropped to 30% of issued certificates. 

NHS Low Income Scheme 

The number of applications and issued certificates in 2023/24 was a slight decrease from 2022/23 but higher than the 2 years prior. There were 161,000 HC2 certificates and 87,000 HC3 certificates issued in 2023/24. 

Certificates were most commonly issued to people from the younger (15-24) and older (65+) age groups, and to people from more deprived areas. 

NHS Prescription Prepayment Certificate (PPC) 

The number of PPCs purchased has increased in each of the past 5 years. In 2023/24 there were 2.1 million 12-month certificates issued and 936,000 3-month certificates issued. 

The number of certificates issued typically rises with age. 

The number of PPCs issued is slightly lower in the most and least deprived areas of England. 

NHS Hormone Replacement Therapy Prescription Prepayment Certificate (HRT PPC) 

The HRT PPC was launched in April 2023, with 131,000 certificates being issued in the first month. This represents 23% of the 566,000 certificates issued in 2023/24. 

The number of certificates issued was higher in less deprived areas. There was also a higher number of patients in the least deprived areas receiving HRT medicines. 

The South West region has some of the largest rates of HRT PPCs issued. 

Resource list 

Summary tables (Excel: 204KB)

Background information and methodology note (HTML)

Pre-release access list (HTML)

This publication has been produced using a reproducible analytical pipeline. You can view the code used in this RAP on our GitHub


We're collecting feedback about our publications. You can complete a short survey to help us make our statistical releases more useful and accessible.  

The survey takes about 5 minutes to complete. 

All responses will remain anonymous and you will not be identifiable in any report we produce. 

You can view our privacy policy to see how your data is used and stored. 

Contact us 

If you have any questions, comments, or would like more information you can email  

Responsible statistician: Steven Buckley