Waiving Prescription Charges for Ciprofloxacin for Meningitis Outbreak

Summary of immediate actions

• General Practice prescribers must issue paper FP10 prescriptions and endorse the item for prophylactic Ciprofloxacin chemoprophylaxis as a ‘free supply’ by writing  ‘FS’ plus the prescriber’s initials or signature
• Community pharmacies must dispense FS-endorsed prescriptions without collecting a charge
• Provide refund advice only where FS was incorrectly omitted and a charge was paid 

Action for General Practice: Issuing a prescription

While free supply is permitted for STI and TB, there is currently no functionality in GP clinical systems to support free supply for this indication. Therefore, prescribers must issue paper FP10 prescriptions for oral ciprofloxacin chemoprophylaxis. When generating an FP10 paper prescription (printed or handwritten), the letters ‘FS’ and the prescriber’s initials or signature must be annotated alongside the item being prescribed.

Example of how the ‘FS’ endorsement countersigned by the prescriber should appear on FP10 forms

Those eligible for a free prescription (which is subject to change) covers all those currently offered prophylactic Ciprofloxacin as part of this outbreak, specifically:

1. All University of Kent students and staff living /working in Halls of residence on Canterbury Campus
2. All those who attended Club Chemistry between Thursday, 5 March 2026 to Sunday, 15 March 2026
3. Sixth forms at schools and colleges where there has been a probable or confirmed case
4. Others identified as close contacts for whom prophylaxis is appropriate.

Guidance on how prescribers should apply this endorsement

The prescription charge will be waived for the period March Thursday 5 March 2026 to Tuesday, 21 April 2026. This may change as the situation evolves.

Action for community pharmacy:

A prescription charge exemption using the ‘Free supply for specified use (FS)’ endorsement has been approved for all prescriptions presented for this purpose. Guidance on how prescribers should apply this endorsement and how pharmacy teams should correctly submit ‘FS’ endorsed prescriptions 

Refunds for patients who have already paid:

If a patient from the affected cohort has already paid a prescription charge and requests a refund, they can write to hc5refundquery@nhsbsa.nhs.uk to request a refund.

Patients should include a covering letter outlining their circumstances and their proof of payment, an FP57 or till receipt, where they retained this. Or they can telephone 0300 330 1343.

Worried students, parents, or members of the public may seek advice from their community pharmacy teams. If an individual believes they may have been exposed, please advise them to follow UKHSA instructions rather than seeking private antibiotics. Community Pharmacy teams are advised to remain vigilant for symptoms of meningococcal disease. Symptoms may include:

• Fever
• Severe headache
• Neck stiffness
• Photophobia
• Non‑blanching rash
• Vomiting
• Confusion, drowsiness, or altered consciousness
• Limb pain, cold extremities, or mottled skin (potential early sign)

Anyone presenting with symptoms suggestive of meningitis (this could include patients referred into Pharmacy First through the usual pathways) or rapidly deteriorating illness, should be directed to urgent care via 999 or A&E for immediate emergency assessment. Any concerns should be documented and escalated through local clinical governance routes if appropriate.

A patient helpline, run by UKHSA, is now available for general enquiries. Patients can phone 0344 225 3861, Monday to Friday from 9am to 5pm if they have no symptoms but are concerned, they have been in contact with a confirmed case.

General practice are supporting the NHS in delivering the MenB vaccination to a small cohort of people in response to the meningitis outbreak. The GP offer is only for students at the University of Kent who are unable to access the local clinics in Canterbury, for example they have already returned home. If an eligible patient presents, who is not registered with a General Practice, they can be advised to either: 

1. Contact a local GP and register as a permanent patient or  
2. Register as a temporary resident 

A GP letter was published by NHSE outlining the MenB vaccination offer for University of Kent students. 

Guidance on who is eligible for an NHS Meningitis B vaccine is available on the UKHSA website. 

Independent Prescribing:  Pharmacist prescribers are advised not to issue private prescriptions for chemoprophylaxis. This is essential to:

• Prevent individuals bypassing UKHSA’s clinical prioritisation process
• Ensure UKHSA are aware of all potential exposure cases to support with contact tracing
• Ensure prophylaxis is limited to the appropriate cohorts
• Preserve supplies of antibiotics
• Avoid inappropriate use outside national guidance
• Support antimicrobial stewardship.