Not everyone is entitled to free NHS treatment in England. This page details our overseas visitor management and what can happen when you arrive at any of our sites. The How to access NHS Services in England website provides more details.
Who is an overseas visitor?
An 'overseas visitor' is any person who is not an 'ordinarily resident' in the UK. A person is not ordinarily resident in the UK simply because:
- they have British nationality
- hold a British passport
- are registered with a GP in the UK
- have an NHS number
- own property in the UK
- or have paid (or are currently paying) National Insurance contributions and taxes in the UK.
Since April 2015, non-EEA nationals who are subject to immigration control must also have Indefinite Leave to Remain (ILR) in the UK in order to be ordinarily resident in the UK.
What that means is that if you are visiting the UK as a tourist, on business, to stay with family, living in the UK without proper permissions, or if you are a British citizen but not settled in the UK, you may have to pay for the hospital treatment you receive. Depending on how urgent the treatment you require is, you may be asked to pay in advance.
What is BEH’s legal obligation?
The National Health Service (Charges to Overseas Visitors) Regulations 2015 (the Charging Regulations) amended recently by the NHS (Charges to Overseas Visitors) (Amendment) Regulations ("the 2017 Amendment Regulations") place a legal obligation on our Trust as a provider of 'relevant services' to establish whether a person is an overseas visitor to whom charges apply, or whether they are exempt from charges and when charges apply, we must make and recover charges in full in advance of providing them, unless doing so would prevent or delay the provision of immediately necessary or urgent services. Charges will still apply for these treatments if exemptions do not apply and patients will be charged and will be expected to pay. Not paying this charge may have an effect on any future immigration application you may make and you risk your visa application being denied.
What will happen when I arrive at the hospital?
All patients will be asked to provide acceptable supporting evidence to prove their entitlement to free NHS care – one evidence to prove identity and another to prove UK residence. The Overseas Visitors Team will advise you of the type of evidence that may be required depending on your circumstances.
What are exemptions that may apply?
There are some treatments which are free irrespective of your overseas visitor’s status. These services include appointments at your GP, treatments in the A&E departments, under Court Order, Mental Health Act etc. The Overseas Visitors Team will advise on the specific exemptions that apply to you.
What do I need to do?
If you are visiting the UK from the European Union (EU) and European Economic Area (EEA) member states, you are strongly advised to bring a valid European Health Insurance Card (EHIC) with you from your home country and present it to the staff at your appointment as this proves your entitlement to receive emergency, urgent and immediately treatments. Your EHIC card does not cover treatments for pre-existing conditions and routine treatments that can wait till you are reasonably expected to return home except when delaying the treatment will make your condition progressively worse. But you can present your S1/S2 Forms which will allow you access planned treatments. Read more information for Visitors from EEA or Switzerland.
If you hold a passport from the countries that UK has reciprocal health agreements with, you will be entitled to receive any treatment that cannot wait until you can return home and provided you did not come to the UK for the purpose of seeking treatment.
If you are from a non EEA country and have paid the Immigration Health Surcharge as part of your visa application or are exempt from paying, you will be entitled to receive free NHS care.
It remains your responsibility to satisfy the Trust of the validity of your claim to free treatment but sometimes, when there is uncertainty, the Trust may contact the Home Office to determine this.
If we confirm that you are not entitled to free NHS care, you will be asked to sign an 'Undertaking to Pay' form and pay the estimated cost of your treatment and when your treatment is deemed to be planned or elective, we will expect to receive the full cost for your treatment before it commences and if payment is not received, your appointment might be cancelled.
Where can I get more information?
If you have any questions please contact our Overseas Visitors Team:
Vivien Obiagwu, Overseas Visitors Income Manager
Tel: 020 8702 3710
You can also visit the Department of Health & Social Care Overseas Visitors pages: NHS Visitor and Migrant Cost Recovery Programme