Overseas patients
The Barts Health group of hospitals serves one of the most diverse communities in the country with a catchment of around 2.5 million people living in east London. We take pride in providing quality care for all our patients, and do not wish to deter anyone from seeking treatment.
National regulations by the Department of Health stipulate that patients must be “ordinarily resident” in the United Kingdom to qualify for free NHS-funded hospital care. This means living here lawfully, with a settled purpose, for the time being. Nationals of countries outside the European Economic Area who have indefinite leave to remain in the UK are eligible for free care, but many British nationals who now live overseas may not be.
The Trust has a legal duty to recover costs from patients who are not entitled to free NHS hospital treatment. Any patient not entitled to free hospital care must be charged for treatment they receive unless a medical or service exemption applies. The regulations were tightened in 2017 to require full payment in advance of non-urgent treatment.
However, those who need care that is clinically deemed urgent or immediately necessary – such as maternity care - will always be treated promptly even if a patient indicates that they cannot afford to pay. We do not turn any patients away.
Nevertheless, the treatment is not free just because it is provided on this basis. Any patient booking into an emergency department or maternity unit is asked where they have lived in the last 12 months. If there is any question about residency status, the case is referred to the Overseas Visitors Team.
These staff do their best to help and support patients to understand our mutual obligations around payment. In some cases, they may check an individual’s immigration status with the Home Office in order to assess their entitlement to free NHS care. This gives prompt reassurance and clarity to the patient. Many team members have second language skills, and others can call on our Advocacy Service to support patients whose first language is not English.
We currently treat an average of 200 overseas patients every month and the income from this source is worth about £5m a year, less than 0.5% of our annual turnover. In recent years the Trust has taken a number of steps to ensure that our hospitals are consistent, clear and equitable in applying the eligibility rules.