- All secondary care, including community health services, are now charged upfront for those who are not 'ordinarily resident' in the UK. There are some exceptions.
- To be considered 'ordinarily resident', a person must have indefinite leave to remain in the UK.
- Immediately necessary and urgent treatment must always be given.
Those who are not 'ordinarily resident' are charged for secondary care services, including community services. However, there are some exceptions (see 'Services remaining free' and 'Eligible for free secondary care'). If a patient cannot pay in advance, the service is withheld. Immediately necessary and urgent treatment, as defined by a clinician, must be given, regardless of someone's eligibility to receive care or their ability to pay. The attached form can be used and kept in a patient's notes for transparency of that decision.
Services remaining free
Some health services are currently free to all:
- STIs (including HIV)
- continuing courses of treatment
- sectioning under Mental Health Act 1983
- treatment for infectious disease e.g. TB
- family planning (does not include termination of pregnancy)
- diagnosis and treatment of specified infectious diseases and sexually transmitted infections
- services provided for the treatment of a condition caused by torture, female genital mutilation, domestic violence or sexual violence
- palliative care services provided by a charity or a community interest company
- school nursing and health visiting
Eligible for free secondary care
Some patients are eligible for free secondary care (even though they are not considered 'ordinarily resident'):
- Asylum seekers
- Refused asylum seekers receiving Home Office support
- EEA nationals (if exercising treaty rights)
- Dependency visa
- Work / Student Visa
- Those from countries with bilateral health agreements
- Survivors of human trafficking who have passed through the National Referral Mechanism (the formal process that identifies victims of trafficking)
- Children in care of a Local Authority