£1 million to help NHS reclaim debts from overseas visitors

Plans to expand the team of cost-recovery experts will help recover millions of pounds in costs for treating overseas visitors in the NHS

Doctor examining patient

Health and Social Care Secretary Matt Hancock has announced plans to expand the NHS’s existing team of cost-recovery experts, backed by £1 million.

Since 2018, a dedicated team of cost-recovery experts has been established to work with trusts. The expansion of this team will help the NHS to reclaim outstanding debts from overseas visitors who are required to pay for their care. These experts will work with existing cost-recovery managers in NHS trusts to:

• provide additional time and human resource to help identify patients who should be charged, easing the administrative burden and speeding up the process

• ensure the rules and exemptions are universally understood and consistently implemented in hospitals across the country, including making clear that urgent treatment should never be withheld

• help improve the reporting of income and debt collection, ensuring chargeable tourists pay debts in full

The team will also help the NHS understand and implement the charging rules and processes for EEA visitors and migrants as part of preparations for leaving the EU. After Brexit, EEA nationals living lawfully in the UK can continue to use the NHS as they do now.

The NHS has already made progress in ensuring patients not ordinarily resident in the UK are identified and charged appropriately for access to NHS services, recovering more than £1.3 billion since 2015. However, there is still a significant amount of unpaid debt.

Only people who are ordinarily resident in the UK are eligible for free care, with non-EEA visitors required to pay a health surcharge when they apply for a visa to live temporarily in the UK. 

The government remains committed to protecting the most vulnerable people in our society, including refugees, asylum seekers, victims of modern slavery and children cared for by local authorities.

NHS rules state that trusts must never withhold treatment from patients who require urgent healthcare while they are in the UK, even if they cannot afford to pay. This means any care clinicians say should not wait until a visitor’s departure from the UK, and recovery of charges can take place after the care has been provided. Where treatment is non-urgent and it can wait until they leave the UK, it must not be provided unless fully paid for in advance.

Health Secretary Matt Hancock said:

"Our beloved NHS is renowned around the world for providing high quality health care and it is able to do so thanks to the valuable contributions made by hardworking taxpayers - so it is only fair we ask overseas visitors to pay their way as well.

"Today, we’re backing the NHS and giving them the support and the tools they need to ensure the rules are applied fairly and consistently.

"This new drive will help recoup millions in unclaimed funds for our NHS which can go back into frontline patient care, so the NHS can be there for all of us when we need it most."

Jason Dorsett, Chief Finance Officer, Oxford University Hospital Foundation Trust said:

"We have had huge support from NHSI’s overseas visitors improvement team. Being part of the programme, we have learnt alternative ways to identify chargeable overseas patients.

"The implementation of digital tools has reduced the administrative burden on previous methods resulting in a rise of income and cash recovery. We would recommend other Trusts if given the opportunity to be a part of the programme."