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7. Overseas visitors



In general, all overseas visitors are entitled to receive emergency or immediately necessary medical treatment free of charge on the NHS. For visitors requiring any other medical treatment, there is no obligation by the practitioner to provide it. If however, a practitioner wishes to offer treatment, consideration should be given as to whether this should be given on the NHS or privately.

 

Click link for BMA Guidance for GPs - Registration of Overseas Visitors

 

 

Key points for overseas visitors accessing primary medical services in the UK

  • You have a duty of care
    Practices have a contractual duty to provide emergency treatment and immediate necessary treatment free of charge for up to 14 days to any person within their practice area.
  • Pre-existing conditions are included
    There is no definition of immediate necessary treatment in primary medical services contract regulations but it should be viewed as including treatment not only of new conditions but also pre-existing conditions that have become exacerbated during the period of a person's stay in the UK.
  • Procedures for overseas visitors should be in place
    Practices should have appropriate procedures in place to ensure that patients in need of this treatment can be identified and assessed by a health care professional.
  • Registration should be discretionary
    When a person does not require emergency or immediately necessary treatment, practices have some degree of discretion under the contract regulations about whether to register the person.
  • Temporary resident is an option for registration 
    Practices, if their list of patients is open, may accept overseas visitors as temporary residents, if they will be in the area for 24 hours to three months, or may accept an overseas visitor's application for inclusion in their patient list.
  • Discrimination rules apply
    Persons applying for registration cannot be turned down for reasons relating to the applicant's race, gender, social class, age, religion, sexual orientation, appearance, disability or medical condition.
  • Requesting formal identification
    Overseas visitors have no formal obligation to prove their identity or immigration status to register with a practice. However, asylum seekers may be able to show an Immigration Service issued 'Application Registration Card' (ARC) or official documents that confirm their status. Where practices have a policy of asking applicants for identification then it should be for all patients and not just overseas visitors 

    Please note: We advise practices to use their discretion and consider the individual circumstances of an overseas visitor who cannot provide documents that they would normally require for patient registration.
  • Care on a private basis
    Any person who does not require emergency or immediately necessary treatment and has not been accepted onto a patient list or accepted as a temporary resident can still be treated by a GP on a private basis, for which they may be charged. Alternatively those persons can be directed to contact the appropriate local body, who can advise on what services are available locally.

 

 

Key points for referring overseas visitors to secondary care treatment in the UK

  • It is not the duty of a GP to establish a patient's entitlement for free NHS secondary care treatment. This is the responsibility of the NHS secondary care provider.
  • Trusts will ask patients questions on admission to determine whether they should be charged for the hospital treatment and the process will be handled by an overseas visitor manager.
  • GPs should avoid making any judgments about the likelihood of an individual patient being charged for secondary care and should refer whenever clinically appropriate.
  • GPs should consider warning overseas visitors that that their eligibility will be assessed by the trust and that not all patients are eligible for free NHS secondary care services.

 

 

Pharmaceutical Services:

A pharmacist or doctor providing pharmaceutical servcies may dispense an NHS prescription presented regardless of whether the patient is ordinarily resident or not. NHS charges will be payable in the normal way (e.g. patients aged 60 and over do not have to pay). A pharmacist or doctor providing pharmaceutical services may refuse to dispense an NHS prescription if a patient who is required to pay a charge does not do so. If a patient's chargeable status is not clear, the charge should be paid and the patient given an NHS receipt (form FP57). Their entitlement to exemption or remission may then be established retrospectively.

 

 

Hospital Treatment:

The National Health Service (Charges to Overseas Visitors) Regulations 2011

 

   

Summary of changes made to the way the NHS charges overseas visitors for NHS hospital care  (Updated 8 December 2017)

 



All treatment given by staff at a hospital or by staff employed by a hospital may be subject to a charge with the following exemptions:

  • Treatment given in an accident and emergency department, or walk-in centre providing similar services to an accident and emergency department
  • Treatment for communicable diseases (excluding HIV/AIDS where it is only the first diagnosis and connected counselling sessions that are free)
  • Family planning sevices
  • Compulsory psychiatric treatment.

The hospital will make the final decision on whether treatment is free.

People entitled to full NHS hospital treatment: (The spouses and children of these people are also entitled)

  • A person who is regarded as ordinarily resident in the UK
  • Asylum seekers and refugees
  • Anyone who is employed overseas who has lived in the UK for ten continuous years.....and
  1. has not been out of the UK for more than five years
  2. if more than five years, has been taking home leave in the UK at least once every two years, or has the contractual right to do so
  3. has the contractual right to their passage home to the UK at the end of their employment.
  • Anyone employed in an EEA member state and contributing compulsory UK national insurance contributions
  • Anyone from an EEA member state or from a country that has a reciprocal agreement, who is referred to the UK for specified treatment
  • Anyone who is detained in prison or by the Immigration Authorities
  • Anyone who is serving NATO personnel, posted in the UK, who is not using their own or UK armed forces hospitals.

 

Bilateral healthcare agreement countries:

 

European Economic Area countries (EEA):
Austria France Latvia   Poland 
Belgium Germany Liechtenstein Portugal 
Cyprus Greece  Lithuania  Slovakia 
Czech Republic Hungary Luxenbourg Slovenia 
Denmark Iceland Malta Spain 
Estonia Ireland Netherlands Sweden 
Finland Italy Norway UK

 

Nationals of the following countries:
Armenia Croatia Macedonia Tajikistan
Azerbaijan Georgia  Moldova Ukraine
Belarus Gibraltar  New Zealand Uzbekistan
Bosnia Kazakhstan Romania Yugoslavia i.e. Serbia & Montenegro
Bulgaria Kirgizstan Russia

 

Residents irrespective of nationality of the following countries:
Anguilla British Virgin Islands   Iceland  St Helena
Australia Channel Islands Isle of Man  Turks & Caicos Islands 
Barbados Falkland Islands Montserrat

Last updated by: Dupe Fagbenro on 25-04-2018 12:42