In the Statement of Changes to the Immigration Rules (HC1780), published on 07 September 2023, the Home Office introduced Appendix Tuberculosis (TB); the change was implemented on 05 October 2023. Paragraph 7.24 of the Explanatory Memorandum to The Statement of Changes to the Immigration Rules (HC1780) outlines the reasons for the change:

"7.24 We are replacing rules A39, B39 and C39, and Appendix T with a new Appendix Tuberculosis, which provides greater clarity and consistency on the TB requirement, and are making associated consequential changes to individual routes where the new Appendix Tuberculosis will apply in place of the current rules."

Paragraphs 36-39 of the Immigration Rules still contain references to medical examinations.

Do I Need To Be Tested for TB Before Coming to the UK?

A tuberculosis (TB) test is required if a UK visa applicant is coming to the UK for more than 6 months and they have been continuously present in a relevant country or countries for 6 months or more, which includes a period (of any length) within the 6 months before the date of application. The relevant countries are listed in TB6. of the Appendix.

Appendix Tuberculosis (TB) reads as follows:

  • "TB1. A person must provide a valid TB certificate with their application if paragraph TB2 applies, and they are applying for entry clearance to come to the UK:
  • (a) for more than 6 months, except for applications made under Appendix Ukraine Scheme; or
  • (b) as a fiancé(e) or proposed civil partner under Appendix FM: family members; or
  • (c) as a returning resident in accordance with Appendix Returning Residents."

When Might a TB Test Certificate Not Be Required?

A TB test certificate is not required if an applicant is a diplomat accredited to the UK or the Applicant is a returning resident, they have not been away for more than 2 years and their leave has not therefore lapsed.

How Long Is a TB Test Certificate Valid For?

A UK visa applicant will need to show they have undergone screening for active pulmonary tuberculosis and that this tuberculosis is not present in them. The applicant will be provided with a certificate which should be submitted with the visa application documents.

An applicant applying for a UK visa must show the certificate was issued within the 6-month period immediately before the date of application and has not expired. The date of application is the date the UK visa application form is submitted online and any relevant fees are paid. It is important to note that a TB test certificate is only valid for 6 months from the date it is issued. An applicant will therefore need to consider the timing of their clinic appointment and factor in the practicalities of arranging it and travelling to the approved clinic.

What Happens During a TB Test at an Approved Clinic?

A UK visa applicant will usually undergo a chest x-ray to test for TB. If this is not clear or there are concerns, the applicant may be asked to provide a sputum sample.

There are special arrangements for children and pregnant women. All children will need to see a physician who will decide if they need a chest x-ray. Children under 11 will not usually have a chest x-ray. A health questionnaire will be completed and if a clinician makes a decision meaning the child does not have TB, they will issue a certificate.

Pregnant women can choose either an x-ray with extra shield in the 2nd and 3rd trimesters, a sputum test, or to wait until they have delivered to be tested. If opting for the sputum test there may be an extra fee and it can take up to 8 weeks to receive a result.

If there is a positive test for TB the Applicant will be referred for treatment; once the treatment is complete they can be re-screened for an additional fee.

Where Will I Need to Go to Be Tested for TB?

The list of relevant countries an applicant for a UK visa will need to consider can be found in TB6. of the Appendix. Each country has a list of approved clinics that can be accessed here. The Appendix requires that the valid medical certificate must be issued by a medical practitioner approved by the Secretary of State and appearing on the Gov.uk website. Clinic fees and appointment arrangements will depend country to country and clinic fees are payable in addition to any UKVI application fees. Where no clinic is available in the country they reside in – applicants may need to take a test in a neighbouring country. This is a practical consideration for many in planning their visa application. Other countries do have approved TB test clinics.

Discretion To Waive the UK Visa TB Test Requirement

The Appendix allows for the TB test requirement to be waived:

"TB5. The decision maker may waive the requirement to provide a valid TB certificate if they are satisfied that the applicant is unable to obtain a certificate and it is reasonable to waive the requirement on the specific facts of the case."

You may wish to seek legal advice regarding any application involving arguments to waive the TB test requirements. The merits will depend on the individual facts and circumstances.

What Happens if I Apply for a Visa and Do Not Supply a TB Test Certificate?

Not providing a TB certificate with an application may lead to refusal. It is possible an applicant may be required to provide a new valid TB certificate before the application for entry clearance is granted, if the TB certificate provided with their application expired more than 6 months before the date on which the application is considered and all other requirements are met.

Do I Require a TB Certificate for an Application for Leave To Remain?

An applicant will only usually need to provide a TB certificate if making an application for entry clearance from outside the UK. Those applying for or extending a Hong Kong BN(O) visa from within the UK may need to consider obtaining a TB certificate. Approved UK clinics can be accessed here.

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.