For patients
& visitors

Information for overseas visitors

You may not be aware but the law requires every NHS Trust to check all patients who are newly referred or attending for a new episode of treatment to determine whether they are entitled to free NHS hospital treatment.

This information is designed to help you understand this process. 

The NHS Charges to Overseas Visitors regulations 2011 (the "Charging Regulations") place a legal obligation on NHS Trusts in England to establish whether a person is an overseas visitor to whom charges apply or whether they are exempt from charges. 

Definition of an Overseas Visitor 

An overseas visitor means any person, of any nationality, not "ordinarily resident" in theUKand therefore potentially liable to charges for NHS hospital treatment.  Ordinarily resident means living lawfully and on a properly settled basis in theUK. 

Southend University Hospital NHS Foundation Trust will 

  • Ensure that patients who are not ordinarily resident in theUKare identified. Please Note: A person is not ordinarily resident in the UK simply by having British nationality, holding a British passport, being registered with a GP, having an NHS number, owning a property in the UK or currently paying or having paid National Insurance contributions and taxes in the UK
  • Assess liability for charges in accordance with the Charging Regulations
  • Charge those liable to pay in accordance with the Charging Regulations and recover charges from those liable to pay 

Treatment free of charge 

  • No charge will be made for Accident & Emergency treatment. Please note that once a medical decision has been determined and either an outpatient clinic appointment or admission is requested it is then necessary to determine liability to pay for treatment, including emergency treatment provided after admission.
  • Certain diseases where treatment is necessary to protect the wider public health.  For HIV this exemption only applies to the initial diagnostic test and connected counselling sessions (rules change October 2012 when HIV treatment will be in the exemption category).
  • Compulsory psychiatric treatment
  • Family planning services (not including termination of pregnancy)
  • With effect from 2012 overseas visitors are now entitled to free HIV treatment and care as defined in the HIV Outpatient Clinical Care Pathway and in line with the NHS HIV care and treatment commissioning arrangements.  Treatment, including prescribing of antiretroviral (ARV) therapy, is available only for the duration of a person's stay in the UK.

GP Referrals

If you are an overseas visitor and have been referred by a GP to an NHS hospital and you do not qualify for free hospital care you will be charged for the hospital treatment you receive. 

European Economic Area 

Overseas visitors who are resident in an EEA country or Switzerland must have a valid European Health Insurance Card ("EHIC") or be in possession of a valid Provisional Replacement Certificate ("PRC") to receive free necessary medical care during their visit.  Failure to provide this card may mean they are charged for their NHS hospital treatment. 

Patients with Travel Insurance 

If you have insurance cover, the amount of treatment will be charged to the individual who remains responsible for payment.  Unless the Trust is in possession of a letter of guarantee from your insurers authorising treatment at Southend Hospital, you will need to settle your account and reclaim this from your insurers at a later date.  A full breakdown of charges will be provided at the time of payment. 

Other Reciprocal Healthcare Agreements 

Several countries and territories outside the EEA also have reciprocal healthcare agreements with the UK covering their nationals, or sometimes all residents regardless of nationality.  Patients who can show they are lawfully resident in one of those countries (and a national of that country if applicable) are exempt from charges providing the need for treatment arose during their visit to the UK. 

You will be asked for documented proof to establish eligibility for free NHS hospital treatment. 

Please Note: Reciprocal and bilateral agreements do not apply if you are having elective (planned) treatment or treatment that can be carried out in your country of origin. 

Cost of Treatment 

The Overseas Visitors Manager ("OVM") will provide you with an estimated cost for the treatment which you receive.  These costs are calculated from the Standard National Tariff which is applied throughout the UK.  

The amount charged at this stage ("deposit") will be as close to the final figure as possible.  However the OVM will not be able to quote an exact price for your care until you have been discharged, whereupon all your treatment will have been updated on the hospital system.  We will then send you an invoice for the complete package of care.  Any deposit paid towards your treatment will be stated in your invoice and accounted for accordingly. 

No power has been given in the Charging Regulations or otherwise for any person, including a relevant NHS Trust's Chief Executive or Government Minister, to waive charges which are due. 

Urgent and Immediately Necessary Treatment 

No one will be refused urgent or immediately necessary treatment because they cannot pay, however treatment is not made free of charge by virtue of being provided on an immediately necessary or urgent basis.  Charges found to apply cannot be waived. 

Further Information 

If you need any further help or advice please contact the Overseas Patients office Monday to Friday 08.00 - 16.00 

This is a general guide and not a full statement of the current regulations.  Please click here to open the Department of Health website for more information.