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Gwyn
08-08-2006, 01:19 PM
I always feel registering patients from abroad is a tricky area and despite trying I have yet to find definitive guidelines. Can anyone offer advice, we want to allow access to all those entitled to NHS treatment but obviously want to prevent misuse.

IreneL
08-08-2006, 04:46 PM
We have guidance that states eligibility to receive free medical treatment is determined by whether a patient is ordinarily resident in the UK. It is not related to the person's nationality nor the payment of NI contributions or taxes. The only free treatment we would give such non-eligible patients would be 'emergency or immediately necessary' treatment.

magwilk
13-08-2006, 03:24 PM
This gives us a major headache.Our practice is 95% ethnic and relatives stay for long periods-mostly 6 months or more.If we register patients who are staying for 6 months they are given an NHS number which is not making our PCT happy,they have asked that we try to avoid registering patients with the practice who are only staying in the country for 6 months and see them as temporary as NHS numbers are being given out for fun.

laura
14-08-2006, 09:38 AM
I always feel registering patients from abroad is a tricky area and despite trying I have yet to find definitive guidelines. Can anyone offer advice, we want to allow access to all those entitled to NHS treatment but obviously want to prevent misuse.
I always have an absolute nightmare trying to find out who is entitled to NHS care i spent 25 minutes on Friday trying to find out if a couple from Lithuania were entitled I spoke the the health Authority who did not know I spoke to immigration who didnt know and I eventually gave up and allowed them to join the practice it is a very grey area with very little guidance I am afraid

B Wolski
15-08-2006, 12:26 PM
We have a very clear procedures for overseas patients. Obviously if they ar visiting here, they will not be signed to the NHS at all and we charge 25 to see a Doctor, plus private prescription unless the Doctor feels it was an emergency appointment. Then they are still not signed to the NHS but are not charged.
If patients come to register, having only just entered the country, I peruse passports to see what is the entry visa/stamp on the passport. If I am told that they are here as students, I will tell them that they cannot register here as they must be registered at the Student Health Centre of the University/College (Uni's etc. get paid a sum for this). If the passport is in order we do not register anyone for the first six months after entering the country. After six months we need a utility bill (not mobile phone). rent book etc to prove residency in this country and then we will register but not until then.
We have a very diverse ethnic population in our area and this is something that we have had to be scrupulous about over the last few years. It works well
Regards
Barbara

des.mccarthy
23-08-2006, 01:42 PM
Have attached guidance I lifted from the DOH website. Hope it helps.

Des

janeb
24-08-2006, 01:08 PM
I am confused regarding the first 6 months that a person from overseas is in the country. Where a person may be treated as ordinarily resident because he has set up a home and has a job, but has only been inthe country for a matter of weeks, can we refuse to register that person and his family before the 6 months is up? I see that B Wolsi says that their policy is that they do not until 6 months has elapsed.

des.mccarthy
25-08-2006, 08:55 AM
I take Jane's point as the guidance states that "Anybody who is in the UK for ‘a settled purpose’ will normally be considered to be ‘ordinarily resident’; in practice, following court cases, this means anyone who is in the UK for a period of six months or more." (see my earlier post)

However, it is my opinion that we just take a view and do not get too hung up on this. After all, they will be seen immediately on the NHS if they are classified as an emergency and the 'system' will not challenge that clinical judgement. The same applies to a managerial judgement, so for those who have been resident for less than 6 months, I would make a judgement based on what I know of their circumstances (eg have a permenant job; children in school?) and then run with it. You won't be put away for getting it wrong! ;-)

Des

Janeking
31-08-2006, 09:15 AM
we recently had a British girl who married a Hungarian and moved out to Hungary. She returned heavily pregnant so that she could deliver here, but the local hospital wanted to charge her as a private overseas patient. apparrently you have to be resident in the UK not just a UK passport holder to qualify for free NHS treatment.

MikeyM
01-09-2006, 12:31 PM
The six months is a guide to the minimum time they should be staying in the country to be considered ordinarily resident. It is not a minimum period they have to be here before they can register with a GP!!

There are quite separate rules concerning eligibility to primary and secondary care. Access to primary care is down to being ordinarily resident whilst secondary care is mainly governed by reciprocal health care agreements.

To register with a GP, a person must be able to show that they will be living in the UK for a specific purpose for a reasonable period of time. DH guidance suggests six months is the minimum that would be considered a reasonable time. This is only guidance though. A specific purpose could include working, studying, voluntary work etc. Simply visiting the UK for an extended period would not fulfil the specific purpose criteria for obtaining NHS care. Unfortunately the DH complicated matters. Someone visiting their partner who is working here would not qualify for care. However if that person came to live here with their partner for the duration of the work contract then the DH says they can be registered too, since eligibility should extend to family members who are ordinarily resident.

The ordinarily resident test takes no account of nationality, citizenship or payment of UK taxes. Unless you live here you don't qualify - even if you are British! There are exceptions who are eligible without having to pass the ordinarily resident test. Those seeking or granted asylum (including during any appeal process); members of the EU in possession of an E112 or E128 form (obtained from their home country prior to arrival).

Hope this helps!
Mikey

Nursie
04-09-2006, 04:17 PM
I think I've attached a policy on this. If I haven't mastered it and you'd like a copy of it please email me.

magwilk
04-09-2006, 06:31 PM
Nice one Nursie I'll definitely be pinching this one to use

trisha
05-09-2006, 03:17 PM
The six months is a guide to the minimum time they should be staying in the country to be considered ordinarily resident. It is not a minimum period they have to be here before they can register with a GP!!

There are quite separate rules concerning eligibility to primary and secondary care. Access to primary care is down to being ordinarily resident whilst secondary care is mainly governed by reciprocal health care agreements.

To register with a GP, a person must be able to show that they will be living in the UK for a specific purpose for a reasonable period of time. DH guidance suggests six months is the minimum that would be considered a reasonable time. This is only guidance though. A specific purpose could include working, studying, voluntary work etc. Simply visiting the UK for an extended period would not fulfil the specific purpose criteria for obtaining NHS care. Unfortunately the DH complicated matters. Someone visiting their partner who is working here would not qualify for care. However if that person came to live here with their partner for the duration of the work contract then the DH says they can be registered too, since eligibility should extend to family members who are ordinarily resident.

The ordinarily resident test takes no account of nationality, citizenship or payment of UK taxes. Unless you live here you don't qualify - even if you are British! There are exceptions who are eligible without having to pass the ordinarily resident test. Those seeking or granted asylum (including during any appeal process); members of the EU in possession of an E112 or E128 form (obtained from their home country prior to arrival).

Hope this helps!
Mikey
We are experiencing a lot of problems, (mainly slovakian patients) The 3 practices in our Health Centre received a letter today telling us " Any EU national (evidence being either a passport or National identiy card) should be registered.
The inability to procuce proof of residency is not justification to refuse registration"

This contradicts what we have previously been told.

hina
08-09-2006, 10:47 AM
NHS numbers are being given out for fun.

thats exactly what it seems like, but if its a rule then there's not much anyone can do against it.

but bear in mind, the health authority has allowed registering patients in the country with a valid 6 months (or more) visa on their passport "from the date of entry", which means that even if they have the 6 months visa, but have not entered the UK in time (and the visa runs out in less that 6 months time from the date they entered) then that becomes invalid and they are not allowed to be registered.

Harmander
25-09-2006, 01:24 PM
We Are Advised By Our Pct To View Their Passports, Anyone With A Visitor Visa , Except Eu Countries, Should Pay For Their Nhs Service. But This Really Depends What Code Has Been Writen On Their Visa. Our Pct Has A Service Available, We Photocopy The Passport Visa Section And Fax It To The Immigration Dept. Then We Are Told Whether We Can Register The Patient Or Charge Them Private Fees. Lot Of Elderly Patients Come To Visit Their Families For Six Months Etc So Have To Be Very Careful , They Should Really Pay For Their Service Unless The Visa Says To Join Family.

judigreen
27-10-2006, 02:21 PM
If not part of EU we insist on a copy of the work permit or visa. This needs to be for 3 months or more as that makes them resident in the UK and thus entitled to register. However we keep a note of the date of expiry and write to them 2 weeks before asking them to bring in their new visa etc. If they don't we deduct them on the day that the visa expires as we make an assumption that they have returned to country of origin. this prevents them from sitting on our lists and working against our targets by never attending for checks, imms etc

MikeyM
27-10-2006, 02:27 PM
Current Department of Health guidance on eligibility takes no account of nationality. Therefore if you register EU nationals but make checks on everyone else then you could be accused of discrimination on grounds of nationality which would be a breach of your GMS contract.