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Immediately Necessary Treatment
Everyone is entitled to Immediately Necessary Treatment including all Maternity Treatment regardless of their status in the UK. The Department of Health offers this guidance to service providers:
“immediately necessary treatment, including all maternity treatment, must never be withheld for any reason. It should be limited to that which is necessary to enable the patient to return to their own country, but trusts should consider the likelihood of the person returning home when deciding what limits to place on the treatment”
For more information click here.
To see a full introduction to the updated NHS Constitution on the Department of Health website click here.
“The NHS provides a comprehensive service, available to all irrespective of gender, race, disability, age, sexual orientation, religion or belief. It has a duty to each and every individual that it serves and must respect their human rights. At the same time, it has a wider social duty to promote equality through the services it provides and to pay particular attention to groups or sections of society where improvements in health and life expectancy are not keeping pace with the rest of the population.”
“The NHS works across organisational boundaries and in partnership with other organisations in the interest of patients, local communities and the wider population. The NHS is an integrated system of organisations and services bound together by the principles and values now reflected in the Constitution. The NHS is committed to working jointly with local authorities and a wide range of other private, public and third sector organisations at national and local level to provide and deliver improvements.”
The NHS also commits:
Access to Free Primary Care (GP) for Non-UK Nationals
Any person living in the UK may register with a GP Practice. However, in certain instances, GP practices have discretion about whether or not they register someone.
The principle is that as long as GPs have capacity for new patients, they cannot refuse to register anyone who is legally living in the UK and is living within their catchment area. This includes:
Your visa may include a statement that you have ‘no recourse to public funds’. This statement does not apply to primary healthcare and does not exclude you from registering with a GP.
GPs can show discretion about registering Non-UK residents who do not meet the above requirements, for example:
If a GP practice refuses to register you because you fall in one of the above categories, it is still worth trying to register with another GP Practice because you may very well be accepted.
Access to Free Secondary (Hospital) Care for Non-UK Nationals
Free NHS Secondary Care is available to anyone living legally and permanently (i.e. anyone who has settled) in the UK. Asylum Seekers, Refugees and Victims of Human Trafficking are entitled to free Secondary Care. Furthermore, visitors to the UK from countries who have signed a bilateral healthcare agreement are entitled to free secondary care, which is clinically required before they return home. For a full list of countries who have signed a bilateral healthcare agreement, click here.
Visitors to the UK (including Non-UK nationals who are in the UK on a Visitor visa and UK and EU nationals who live abroad) may access Secondary Care but they may be charged for this care. People who live in the EU are able to access free secondary care in the UK for treatment which is clinically required before they return home, if they have a European Health Insurance Card or a Provisional Replacement Certificate. They may be able to obtain a refund for any costs incurred from their home country’s healthcare system. For more information, click here.
Other groups who may access secondary care but who may be charged include failed asylum seekers, people who have overstayed their visa conditions and people with no documents.
Non-UK nationals who are living in the UK legally but who are on a work or study visa may access free Secondary Care but they may be asked to provide evidence that they have settled in the UK i.e. that that they are actually working or studying (enrolled on a full time course, lasting longer than 6 months).
People living in the UK who require immediately necessary treatment, urgent treatment or maternity treatment should always receive it regardless of whether they are eligible for free Secondary Care or whether they are able to pay for care.
The advice from the Department of Health is that:
“If a Trust decides that the need for treatment is urgent and it is to go ahead, it should use any intervening period ahead of treatment to secure payment, but if this is not possible, treatment should not be cancelled or delayed. In doing this, Trusts should take care not to discourage those in need of urgent treatment from receiving it. Whilst Trusts have a duty to recover charges, this will not be possible in all cases, and they should not go beyond what is reasonable in pursuing them. Trusts have the option to write off debts where it proves impossible to recover them or where it would be futile to begin to pursue them, for instance when the person is known to be without any funds.”
The Department of Health’s advice to Trusts regarding immediately necessary, urgent and non-urgent treatment is as follows:
“i) immediately necessary treatment, including all maternity treatment, must never be withheld for any reason. It should be limited to that which is necessary to enable the patient to return to their own country, but trusts should consider the likelihood of the person returning home when deciding what limits to place on the treatment.”
“ii) urgent treatment is that which clinicians do not consider immediately necessary, but which nevertheless cannot wait until the person can be reasonably expected to return home. This may be for conditions such as cancer. It will be necessary for an assessment to be made as to when the patient is likely to return home in order for the clinician to establish if the need is therefore urgent.”
“iii) non-urgent treatment is routine elective treatment which could, in fact, wait until the patient returned home. Once again, an assessment of how long the patient will likely remain in the UK will be necessary for the clinician to come to this conclusion. If the patient is unlikely to return for some time, but the need for treatment remains non-urgent, then it should not be initiated until the full estimated amount has been received. If the patient’s need for treatment becomes urgent, either because their condition unexpectedly increases in severity, or because their circumstances change and they are no longer able or likely to return home within a medically acceptable time, then they should be provided with the treatment even if payment cannot be secured in the meantime.”
In relation to paragraphs (i), (ii) and (iii), an assessment of when a patient is likely to return home needs to take account of their plans, intentions or ability to do so.
For further information see:
If you do not feel confident communicating in English with an NHS health professional (doctor, nurse, surgeon, therapist or anyone else involved in your clinical care) you have the right to have the support of a professional interpreter –either in person or on the phone. You should request an interpreter when making the appointment. There is no charge to the patient for this service.