Review into new NHS charging regulations

Friday, 12 January 2018 - 12:25pm

The Department of Health is currently carrying out a review of the new regulations on charging overseas visitors for NHS services

people in a counselling session

The changes introduced in 2017 significantly expanded the scope of services that were expected to charge and made it a legal requirement for them to do so. The review aims to understand the impact of the regulations and is particularly interested in whether they are having unintended consequences on access to healthcare for vulnerable groups and those with protected characteristics.

The changes brought the majority of community health services into charging regulations, including those delivered by the independent and voluntary sector. Certain services, such as GPs and A+E, are exempt from charging but many, including community mental health services, homeless health services and others, are in scope. A full list of exemptions is available in the updated guidance from the Department of Health. Since October, there has also been a legal requirement for all providers of NHS-funded secondary health services, including those delivered by charities, to recover costs before treatment is given unless it is urgent.

Some of Homeless Link’s members have raised concerns about access to health care for vulnerable groups being further limited by these new regulations. They have flagged that people eligible for NHS services could still struggle to access support as they might be missing the necessary identification to prove eligibility. There are concerns that as well as negatively affecting health outcomes for vulnerable groups, this could also have a knock-on impact on GP services and emergency departments if people are unable to access support from other services.

We are interested in any evidence members might have that could feed into the review. This can include data, case studies or anything else you are able to share to answer these key questions:

  • Do you have any evidence of how the extension of charging to a wider range of services and providers has had a particular impact on any vulnerable group?
  • Do you have any evidence that the extension of charging may have deterred individuals from seeking treatment?
  • Do you have any evidence of how the requirement to charge upfront for treatment that is not immediately necessary or urgent, has had a particular impact on any vulnerable group?
  • Do you know of any examples of good practice or steps that could be taken which might mitigate the issues that you have raised?

Please send any information to by Thursday 18 January.