Not everyone is entitled to free NHS treatment in England.
The NHS is a residency-based healthcare system, which means entitlement to healthcare in the UK is based on living lawfully in the UK. This contrasts with many other countries which have insurance-based healthcare systems. Eligibility for free NHS care (apart from primary medical, dental or ophthalmic treatment) is based on the concept of “ordinary residence”. A person who is "ordinarily resident" in the UK must not be charged for NHS services. Ordinary residence means, broadly, living in the UK on a lawful, voluntary and properly settled basis.
An "overseas visitor" is any person who is not “ordinarily resident” in the UK. A person is not ordinarily resident in the UK simply because they have British nationality; hold a British passport; are registered with a GP in the UK; have an NHS number; own property in the UK; or have paid (or are currently paying) National Insurance contributions and taxes in the UK.
If you are an overseas visitor to the UK you may be charged for some treatments; however there are exemptions where some NHS services are free to everyone regardless of their status and not every overseas visitor will automatically be subject to a charge.
- Accident and emergency (A&E) services
- Family planning services
- The diagnosis and treatment of the conditions specified in Schedule 1 to the Charging Regulations which is necessary to protect the wider public health.
- The diagnosis and treatment of sexually transmitted infections;
- Palliative care services provided by a registered palliative care charity or a community interest company;
- Services provided as part of the "NHS 111" telephone advice line commissioned by a Clinical Commissioning Group or the NHS England;
- Services provided for treatment of a condition caused by torture, female genital mutilation, domestic violence or sexual violence
Only A&E services that are provided prior to an overseas visitor being admitted as an inpatient are free to all. Emergency services provided after a patient has been admitted as an inpatient and at outpatient appointments are chargeable.
Since October 2017, NHS providers and non-NHS providers have been legally required to recover in full charges for services that are not immediately necessary or urgent, in advance of providing them. Only clinicians can make an assessment as to whether a patient’s need for treatment is immediately necessary, urgent or non-urgent.
Immediately necessary treatment is that which a patient needs promptly to:
- save their life
- prevent a condition from becoming immediately life-threatening
- prevent permanent serious damage from occurring
Urgent treatment is that which clinicians do not consider immediately necessary but which nevertheless cannot wait until the person can be reasonably expected to return home.