Emergencies are the clearest case for discretion. Some schemes also have specific hospital exemptions or reimbursement schemes that people miss.
Hospital schemes that already exist
- Bristol: patients and visitors to the Bristol Royal Infirmary complex may be exempt; apply through University Hospitals Bristol.
- Birmingham: one-day vouchers for families attending Birmingham Children's Hospital, from the front desk.
- TfL: NHS patients assessed as too ill to use public transport can claim back some driving charges through their hospital.
Asking for discretion
Outside London, ask for cancellation for compelling reasons (SI 2013/1783 reg 8(1)(b)). In London, ask TfL to use its discretion; the tribunal cannot. In Scotland, extenuating circumstances is a legal ground (SSI 2021/177 reg 8(4)(f)). In each case, send evidence: an A&E discharge note, appointment letter or GP letter, with dates matching the journey.
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Questions people ask
Do I have to give medical details?
Only what supports the request: the date, that it was an emergency or appointment, and a document confirming it. You can redact unrelated information.
Sources
Last checked: 13 November 2026. Every fact on this page was checked against these official pages. How we check