Caring and charging with compassion
The elderly patient in A&E held a British passport but had been living abroad and was visiting his family in the UK. Under NHS residency rules he was not eligible for free treatment, so his case was referred to our overseas visitors team.
His granddaughter expressed concern about the charging process, and she was reassured that treatment would continue without delay. In the ensuing discussions she also disclosed that the family wanted him to settle permanently in the UK because of his ongoing medical needs.
The team advised how he could meet the eligibility requirements from the date of residence, and helped the family provide evidence for this. Meanwhile the family settled an invoice for £14,000 to cover the costs of treatment in the meantime.
This example highlights how our overseas visitors team exercises compassionate and coordinated management of complex cases - balancing financial recovery with patient-centred care and clear communication.
It features in our annual report to the trust Board on overseas visitors, which also signals a potential income opportunity for our hospitals in these difficult financial times.
During 2024-25 we identified more than 1,600 overseas visitors who were eligible to pay for treatment that cost the NHS over £15m. Despite the best efforts of the overseas patient team so far, we are only recouping a fraction of the cost, and are writing off thousands of pounds in uncollected historic debt every year.
The team is being strengthened under new leadership while the trust considers what further steps we can take to improve our cash recovery rate while ensuring that vulnerable patients are appropriately safeguarded.
Ajit Abraham, group director for inclusion and equity, said:
“Our chief concern remains to address with insight and kindness the needs of the most vulnerable among our overseas visitors - such as refugees, asylum seekers, and pregnant women.
“However we are duty bound to follow the law of the land, and in the current NHS financial crisis we recognise that there are overseas visitors who can afford and should legitimately be contributing to the cost of NHS treatment.
“Our innovative and diverse team will continue to respond to overseas visitors with compassion and cultural sensitivity, and any additional funds we can recover from taking a more robust yet fair approach will be reinvested in NHS care.”
Read more