On 16 November 2017, the Parliamentary Under Secretary of State for Health announced to the House that my Department would be conducting a review into the impact of amendments made to the NHS charging regulations in 2017, with particular regard to any impact on vulnerable groups and those with protected characteristics.
The review is now complete, and the evidence received demonstrated that there is no significant evidence that the 2017 Amendment Regulations have led to overseas visitors being deterred from treatment or that the changes have had an impact on public health.
I am pleased that the review has shown that the 2017 Amendment Regulations are largely working in the way they were intended. These changes were, amongst other things, made to enshrine in law that overseas visitors not eligible for free care must pay for any non-urgent treatment upfront, to help reduce the need to chase up charges, and to remove the anomaly whereby the healthcare setting or provider type could determine whether services would be charged for or not.
Some case studies presented did reveal that there is more to do to ensure some groups of vulnerable overseas visitors understand their entitlements and treatment options, and that providers of NHS care consider fully when a patient can be reasonably expected to leave the UK before deciding if treatment should be safely withheld if payment is not provided.
We will continue to work to ensure that these issues are addressed, so that the Charging Regulations are implemented in as fair a way as possible. We will improve information and support for NHS staff and patients and work with stakeholders and interest groups to ensure that key messages and safeguards are understood by all.
To ensure clinicians, NHS and community care staff fully understand our guidance and how it should be implemented in practice, we will revise and relaunch our focused e-learning training programme, and work with NHS Improvement’s support teams to promote it. This will ensure that all relevant aspects of overseas visitors’ personal circumstances are taken into consideration when clinicians decide whether treatment is immediately necessary.
To combat any misconceptions around how the cost recovery regulations affect access to care, the Department and NHS Improvement will continue the close partnership with community groups and stakeholders representing vulnerable individuals to develop user-friendly, culturally-appropriate guidance, and ensure this reaches those who may be impacted by this policy.
Finally, we will continue to work closely with NHS Improvement and frontline staff to keep the impact of the regulations and these further actions under very close review, and to provide additional support and guidance to organisations implementing the regulations in different settings in the best interests of patients.
This statement has also been made in the House of Lords: