Malaine,
You cannot make an application for the visa until you have a pass certificate for English Language Test. That certificate is part of the documents needed to be submitted.
Without that your application will be refused. Period
You do not need IELTS exam at all.
There are quite a few different tests that are approved by UKBA.
IELTS is actually assessed at level B1 whereas UKBA only require level A1 so you can see already that IELTS is more difficult than others. This can make a difference if your skill level is not good or your confidence is a little low.
You must review the UKBA approved listing for tests and find a test centre that is convenient for you that offers a good test for you.
Follow this link - UKBA list of approved English Language Tests
The TB screening is also compulsory and MUST only be done at the UKBA approved clinic in Manila. There is currently no other approved clinic.
Please follow this link - Tuberculosis testing in the Philippines
May I suggest your first step is reading this forum thread and following all the included links to the UKBA site.
All New Guide - How to apply for a Fiance Visa
You should also make searches here in the forum for any areas/topic of concern
You'll have a much better understanding to ask questions about you own circumstances.
Your fiance should also read it