The DH has updated its guidance for NHS bodies carrying out their duties under the NHS (Charges to Overseas Visitors) Regulations 2011 which enables them to make and recover charges for NHS hospital treatment from those overseas visitors not exempt from those charges. The amended regulations came into force on 1 August 2011. The guidance supersedes the 2004 guidance.

In summary, a person who is not “ordinarily resident” in the UK falls within the definition of an overseas visitor and may therefore incur a charge for treatment. The guidance stresses that a person does not become ordinarily resident in the UK simply by:  

  • having British nationality;
  • holding a British passport;
  • being registered with a GP;
  • having an NHS number;
  • owning property in the UK; or
  • having paid national insurance contributions and taxes in the UK.  

Rather, the test of whether a person is ordinarily resident is a question of fact, which requires a number of factors to be taken into account.

It should be borne in mind that the charging regulations place a legal obligation on NHS bodies, as opposed to a legal right to establish whether a person is an overseas visitor to whom charges apply or whether they are exempt from charges. The guidance also stresses that when the charges apply, the relevant NHS body must charge the person for the cost of the NHS services.

Many NHS bodies will already have a designated person to oversee the implementation of the charging regulations, but for those that do not, the DH strongly recommends that someone is appointed to fulfil that role. The guidance also stresses that this person needs to be of sufficient seniority to be able to resolve complex and sensitive issues.

The guidance also stresses the human rights obligations owed by NHS bodies which means that treatment considered to be immediately necessary should never be withheld from chargeable overseas visitors pending payment (although charges will still apply) unless the service is exempt from charges (such as treatment inside an accident and emergency department). The guidance also emphasises that NHS bodies need to notify the overseas healthcare team at the Department of Work and Pensions of the details of the European health insurance card held by visitors from any of our European Economic Area partners or Switzerland whenever they provide services to such a visitor. This enables the UK to recover the cost of treating these patients.

Please note that the guidance does not cover treatment provided by a general practitioner, dentist or optician.