The NHS is not Free to Everyone

Terms of Treatment - Important information about your visit to our hospital

The NHS is not Free to Everyone

We understand that your visit to our hospital may be very stressful and we would like to make it as easy as possible when it comes to your understanding of the information that may be required by our staff, and why it is necessary to establish entitlement to NHS services.

The National Health Service Act 2006 and the National Health Service (Charges to Overseas Visitors) Regulations 2015 as amended, sets which visitors are required to pay for NHS treatment, and which treatments are chargeable.

The Department of Health and Social Care charging regulations place a legal obligation on the Trust to recover the costs of NHS services where an individual is not entitled to free treatment. This income is invested back into NHS services.

The Trust may share non-clinical information with The Home Office and other agencies as part of its process to establish your entitlement to free NHS services. If you are worried about eligibility, charges levied, or have any questions, please do not hesitate to contact our team.

Further information is also available at: Visiting or moving to England - NHS

Please note: The Emergency Department services are free at the point of use for all patients. This includes all Emergency services provided at an NHS hospital e.g. those provided at an Emergency Department, walk-in centre or urgent treatment centre. This does not include those emergency services provided after the overseas visitor has been accepted as an inpatient or at a follow-up outpatient appointment, for which charges must be levied unless the overseas visitor is exempt from charge in their own right.

Introduction - ordinary residence

The UK's healthcare system is a residence-based one. Hospital treatment is free to people classed as ordinarily resident in the UK which means that 'you must be living lawfully and voluntarily in the UK for settled purposes, as part of the regular order of your life, for the time being'. In addition, all patients subject to immigration control must have 'indefinite leave to remain'.

Ordinary residence is not dependent on nationality (including UK citizens), European Union Settlement Scheme (EU SS) status, payment of UK taxes, National Insurance contributions, being registered with a GP, having an NHS number, or owning property in the UK.

Students

All students are required to provide a copy of their passport, visa, Biometric Residents Permit (BRP), or proof of travel insurance, to cover their entire stay in the UK. In addition, a letter from the school, college or university where you are studying, confirming that you are attending a course, and where it is full/part-time, the duration, and confirmation of your attendance rate. EU students (excluding students from Iceland, Lichtenstein, Norway or Switzerland), studying on courses less than 6 months, are required to have a European Health Insurance Card (EHIC) or valid medical/travel insurance.

EU/European Free Trade Association (EFTA)

All EU/EFTA visitors to the UK, including those who have been granted settlement/pre-settlement status, will be asked for their documentation to confirm their nationality and status. Our Overseas Visitors Team will advise you as to what documents they require (see below). Visitors from Iceland, Lichtenstein or Switzerland (EFTA) who entered the UK after 31 December 2020 may be chargeable for NHS treatment.

UK nationals who moved to the EU/EFTA after 31 December 2020 and hold, or become eligible for a UK S1 (including UK pensioners) will not be entitled to free NHS treatment unless another exemption applies.

Non EU/Non EFTA

All non-EU/non-EFTA visitors to the UK, including those who have been living or working here and have been granted "leave to remain"/paid the Immigration Health Surcharge will be asked for documentation to confirm their nationality and status. Our Overseas Visitors Team will advise you as to what documents they require (see below).

Documents

It is your responsibility to prove you are entitled to treatment without charge. You will be asked for various documents, depending on your specific circumstances; examples include:

  • EHIC Card - A copy of your EHIC card or Provisional Replacement Certificate (PRC). To find out to apply for a card from your country of residence, please go to www.ehic.europa.eu
  • Travel insurance - A copy of your travel insurance policy.
  • Proof of identity/immigration status - Your passport and visa, National ID Card, UK BRP, or EU settled/pre-settled status share code.
  • Proof of UK residency - A copy of a recent bank or building society statement, council tax bill, tenancy agreement, utility bill, recent payslips, P60, contract of employment, job offer letter, communication from HMRC or DWP.

Children born in the UK (to those here lawfully for more than 6 months)

If you give birth to a child in the UK, your child will be entitled to free NHS hospital treatment in England on the same basis as someone who is ordinarily resident and covered until 3 months of age, but only if they do not leave the UK during that period.

You will also need to have either: a valid visa of more than 6 months and have paid the Immigration Health Surcharge for that visa OR a valid visa of more than 6 months, but were exempt from pay the  Immigration Health Surcharge.

You should apply for a visa for your child during the 3-month period after your child's birth. You may have to pay the Immigration Health Surcharge for your child. Failure to do so means you may be charged for NHS services provided for your child after the 3-month period. If a parent of the child is either a British Citizen or has Indefinite Leave to Remain (ILR) and an ordinary resident in the UK, then the child will take that parent's immigration status and your child will be automatically entitled to free NHS secondary care.

Patient registration form

On arrival at the hospital, you will be asked to fill in a Patient Registration Form. It is essential that you complete both sides of the form which will be used in conjunction with your documents to assess your entitlement to free NHS services.

Chargeable patients

If the Patient Registration Form and documents are insufficient to confirm entitlement to free NHS services, or you are a chargeable patients, you will be asked to make a payment for your treatment costs.

Payments will be based on your initial clinical diagnosis and is an estimate of the overall treatment costs. This will be taken as a deposit against the final invoice. All patients are charged at 150% of the NHS national tariff in line with National Health Service (Charges to Overseas Visitors) Regulations.

Immediately necessary or urgent services (including maternity services)

Clinically assessed immediate, urgent and maternity care will not be withheld on the basis of your ability to pay, but you will be asked to make a payment based on the anticipated treatment pathway at the earliest, most appropriate opportunity. If you're insured, please see below.

Non-urgent or elective treatment

We are required by law to withhold treatment from chargeable overseas visitors until the estimated full cost of the treatment has been paid. This decision will be based on clinical opinion. Whilst we will provide you with an estimation of your treatment costs, we will be unable to assess the actual cost until you are discharged from our care, as we use national codes which are generated once an episode of care is finished. We will issue a final invoice as soon as possible after this.

Please note: This may differ from the estimate provided as this will depend on your diagnosis and your treatment pathway. Any underpayment will need to be paid, any overpayment will be refunded, once the final invoice has been issued.

Insured patients

Should your medical expenses be covered by travel or health insurance, you may not need to pay at the time of your treatment, but we will need to assess this based on the information available to us at the time of your attendance and after communication with your insurance company.

Invoices

If you wish to settle an invoice, please see our contact details.

Reciprocal Healthcare Agreements

Reciprocal agreements on a tiered basis have been agreed with some countries. Within the reciprocal agreements, there are variations in the level of free treatment provided to visitors travelling to the UK. Generally, only immediate medical treatment* is to be provided free of charge, to allow the overseas visitor to return home for other needs i.e. follow-up treatment or outpatient appointments. Please ensure you check with the Overseas Visitors Team to ensure your financial responsibilities are clear.

*Immediate medical treatment is defined as to save the patient's life/prevent a condition from becoming immediately life-threatening or needed promptly to prevent permanent serious damage occurring.

Treatment considered immediately necessary or urgent (including all maternity treatment) will never be withheld pending payment.

Please contact us if you need further help or information

We are available over the phone or in person. We advise you to email your documentation to us, but if you wish to bring our documents in, we would encourage to to do so between 9.30am to 10.30am or 3pm to 4pm.

Settling your invoice

We accept all major debit and credit cards, with the exception of American Express (Amex). Card payments can be made over the phone, receipts are available upon request. Any invoices not paid within two months of the issued date may be referred to a debt collection agency for recovery, and outstanding debt (over £500) may be reported to The Home Office, which could affect future applications to enter or remain in the UK.

Data Protection Legislation - Privacy Notice

Information on how the Trust look after your personal information can be found on the Trust's website: Privacy Notice :: Portsmouth Hospitals University NHS Trust - alternatively, please speak to the ward manager who can access the information on your behalf.

How to comment on your treatment

We aim to provide the best possible service and if you have a question or a concern about your treatment, then the Patient Advice and Liaison Service (PALS) are always happy to try to help you get the answers you need.

You can contact PALS on telephone via 0800 917 6039 or on email via pho-tr.phtpals@nhs.net. They will contact the department concerned on your behalf.

NHS 111 is the free number to call when you have an urgent healthcare need. It directs you to the right local service first time; this could be a GP, dentist or pharmacist.

The service is available 24 hours a day, 365 days a year.

 

Telephone number: 02392 286288

Email: pho-tr.overseas@nhs.net