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Patients not eligible for free NHS care to be charged up-front for non-urgent treatment

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New regulations requiring all hospitals to check upfront whether patients are eligible for free NHS treatment will be in place within months under plans to recover the cost of health treatments provided to patients not ordinarily resident in the UK.

Legal changes will require all hospitals to establish whether patients are eligible for free treatment, and to charge upfront those who are not eligible, for any non-urgent, planned care.

The law will change from April this year and this will play a vital role in meeting the Government’s ambition to recover up to £500 million a year from overseas visitors who are not eligible for free care.

The new measures will also require hospitals and NHS bodies to identify and flag a patient’s chargeable status so that other parts of the NHS can more easily recoup costs from overseas visitors wherever charges apply.

Health Secretary Jeremy Hunt said:

We have no problem with overseas visitors using our NHS – as long as they make a fair contribution, just as the British taxpayer does.


So today we are announcing plans to change the law which means those who aren’t eligible for free care will be asked to pay upfront for non-urgent treatment.


We aim to recover up to £500 million a year by the middle of this Parliament – money that can then be reinvested in patient care.


Dr Kathy Mclean, Executive Medical Director at NHS Improvement said:

This new approach will enable NHS hospitals to devote more time and resource to treating patients rather than chasing money they are owed. It will mean that more money is available to the NHS to care for patients and to continue to provide world class facilities.


However, this won't change the fact that, in an emergency, everyone will still have access to the urgent care they need. We are working with providers to help them improve how they manage cost recovery so we can make sure the NHS gets paid for the work it does.


Stephen Graves is Chief Executive Officer at Peterborough and Stamford Hospitals NHS Foundation Trust, which has already piloted upfront charging for elective care. He said:

Since implementing our policy, we have seen an improvement in our hospitals. The funds recouped are invested back into the system to benefit patients and our approach has not been to the detriment of the high quality patient care and patient experience we are able to provide.

There has not been any impact on the number of non-UK residents coming through the system for treatment but we do now identify non-eligible patients sooner, and at a higher volume than previously.


The Government will continue to provide support and guidance to the NHS so it can effectively identify those not eligible for free care and address any challenges ahead of the implementation of new legal regulations.

NHS Improvement will also be working intensively over the coming months with trusts that have the most potential to recover costs.

Where someone is unable to provide information upfront, or does not have physical ID documents, the Trust will work with the patient to determine their eligibility. No one will be denied urgent or immediately necessary healthcare. In developing this policy, we are determined to ensure there is minimal burden on British citizens.

Read our consultation response here.


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