Accessing the NHS in England as an Overseas Visitor
In this post we will explore the extent to which an overseas visitor can access the National Health Service (NHS) in England. We will assess the relevant limits and risks to accessing the NHS in England as a visitor. Please note this post is restricted to the provisions for the NHS in England as each country in the UK has slightly different health systems.
What Is the Definition of a ‘Visitor’ and Who Is Considered to Be a Visitor?
A visitor is a person who is coming to the UK, usually for up to six months, for a temporary purpose, for example as a tourist on holiday, to visit family or friends, or to carry out a business activity.
A visitor must be a genuine visitor, meaning they must intend to leave the United Kingdom at the end of their visit, and will not make the United Kingdom their home through successive and frequent visits. Further, visitors must not undertake any prohibited activities, such as work (unless for business purposes permitted).
The following are examples of ‘visitors’:
- Non-visa nationals;
- Visa nationals, such as those holding Short-Term UK Visitor Visas (6 months);
- Tourism, leisure and family;
- Business;
- Creative;
- Sports;
- Marriage or Civil Partnership Visit Visas;
- Private Medical Treatment Visas (this can be up to 11 months);
- Permitted Paid Engagement Visit Visas (up to month);
- Science and Academia Visit Visas (this can be up to 12 months);
- Or Long-Term UK Visitor Visas (2, 5, or 10 years);
What is the NHS Service?
The National Health Service (NHS) is a government funded medical and healthcare system in the United Kingdom which was established in 1946. The NHS is responsible for providing comprehensive and free healthcare for people ordinarily resident in the United Kingdom. An ordinarily resident individual is defined as someone who lives in the UK on a lawful and properly settled basis for the time being. Those ordinarily resident in the United Kingdom are entitled to fully access the NHS for free with no restrictions.
What NHS Medical Services Can I Access in England as a Visitor?
As previously stated, the NHS in England is a residence-based system, unlike many other countries, which have insurance-based healthcare systems. This means that all visitors to England may have to pay for NHS healthcare, depending on their circumstances.
Primary Care
All visitors are entitled to primary care for free. Primary care is generally considered as being the first point of contact between patients and medical professionals. Some examples include:
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- General Practitioner visits (GPs). This relates to GP doctors and nurse consultations. Treatment provided by a GP and other primary care services are free of charge to all whether registering with a GP as an NHS patient, or accessing NHS services as a temporary patient;
- Accident and Emergency (A&E). This relates to visits to A&E departments, walk-in centres, minor injuries units or urgent care centres. [Please note this does not include emergency treatment if admitted to hospital as an impatient or for any follow-up outpatient appointments];
- Family planning services. [Please note this does not include abortions or infertility treatment];
- Treatment for most infectious diseases, including sexually transmitted infections (STIs)
- Treatment required for a physical or mental condition caused by torture, female genital mutilation (FGM), domestic violence or sexual violence. [Please note this does not apply if you have come to England to seek this treatment]
- Covid-19. This includes investigation, diagnosis, vaccination, and treatment.
- Palliative care services provided by a registered palliative care charity or a community interest company, for example, a hospice;
- Services that are provided as part of the NHS 111 telephone advice line;
Secondary Care
Secondary care is characterised as treatment that isn’t delivered as the first point of contact for that individual. Secondary care most commonly refers to when a primary care provider refers an individual to the hospital to see a specialist or a healthcare professional who has more specific expertise in the health issues they are facing. Secondary care includes treatment for illness, injury, or other health problems in hospital or in an outpatients’ clinic. Secondary care often involves diagnostic and therapeutic services that require specialised equipment and expertise.
Secondary care is residency based, meaning you must be ordinarily resident in the UK to access it for free. If you are visiting the UK and you need secondary care you will be required to pay for it. The government always advises that all visitors to the UK have comprehensive travel or health insurance in any event.
Exemptions to Secondary Care
However, there are certain categories of people who are exempt from such charges for secondary care. The exemption categories only apply to people who are not ordinarily resident in the UK.
Some examples of these include:
- Anyone who is ordinarily resident in Ukraine, but lawfully in the UK from 24 February 2022 (except assisted conception services);
- Refugees (people who have been granted asylum, humanitarian protection or temporary protection under the immigration rules) and their dependants;
- Asylum seekers (people applying for asylum, humanitarian protection or temporary protection whose claims, including appeals, have not yet been determined) and their dependants;
- People receiving support under section 95 of the Immigration and Asylum Act 1999 from the Home Office;
- A failed asylum seeker who receives support from the Home Office under section 4(2) of the Immigration and Asylum Act 1999 or from a local authority under section 21 of the National Assistance Act 1948 or Part 1 (care and support) of the Care Act 2014;
- Children looked after by a local council;
- Victims, and suspected victims, of modern slavery or human trafficking, as determined by the UK Human Trafficking Centre or the Home Office, plus their spouse or civil partner, and any children under 18 provided they are lawfully present in the UK;
- Prisoners and immigration detainees;
- Those receiving compulsory psychiatric treatment or treatment imposed by a court order (for example, under the Mental Health Act 1983 or the Mental Capacity Act 2005);
- NATO personnel where medical service cannot be provided by armed forces medical services – this includes spouses or civil partners and any children under 18 as long as they are lawfully present in the UK;
Other examples of those exempt from charges include UK government employees and war pensioners, who have been visiting the UK as a requirement of their employment, or have been ordinarily resident in the UK immediately prior to taking up their post or another of these posts in the past. In this case, you do not have to be in the UK with your family at the time of their treatment. Some examples include:
- Member of Her Majesty’s armed forces (including your spouse or civil partner and any children under 18, as long as they are lawfully present in the UK);
- Crown servants;
- British Council employees;
- Commonwealth War Graves Commission employees;
- Or working or volunteering in employment overseas that is financed in part by the UK government;
- War pensioners;
- Those receiving armed forces compensation scheme payments;
Please note if you were not previously ordinarily resident in the UK and are only exempt because you are visiting the UK as a requirement of your employment, your spouse or civil partner and any children under 18 will only be exempt when visiting the UK with you.
Visitors Who Hold EHIC Cards
Short-term visitors from the EU can continue to access medically necessary healthcare (including secondary care) through the European Health Insurance Card (EHIC) scheme, or planned healthcare through the S2 funding route.
You should also make sure you have adequate travel and health insurance for your visit as an EHIC does not cover all healthcare costs. If you cannot provide your EHIC card, Provisional Replacement Certificate (PRC), or S2 form you will be charged at 150% of the national NHS rates.
Norway
If you are visiting the UK from Norway, you will be entitled to medically necessary healthcare (including secondary care). You will need to show a valid Norwegian passport.
Contact our Immigration Barristers
In this post we have highlighted some of the key factors to accessing the NHS in England as a visitor, including exploring what primary and secondary care is, and whether there are any relevant exemptions.
For expert advice in relation to a UK visa application or immigration appeal, contact our immigration barristers on 0203 617 9173 or complete our enquiry form below.
