Public Health England
What this guidance is for
Many migrants will come from countries with very different health care systems to the UK. This guide can help to:
- explain to new patients how the NHS operates
- explore with them how this compares to the healthcare system that theyve been used to
This guidance is about NHS entitlements in England.
There is more information about the entitlements of particular groups visiting or moving to England on the NHS website.
The Scottish Government has published separate guidance on overseas visitors liability to pay charges for NHS care and services.
Further information is also available about health services for overseas visitors in Wales.
Summary of changes after the Brexit transition period
Short-term visitors from the EU can continue to access medically necessary healthcare through the European Health Insurance Card (EHIC) scheme, or planned healthcare through the S2 funding route.
Short-term visitors from the EU who are not covered by the new UK-EU agreement on reciprocal healthcare (including former UK residents) may be charged for NHS treatment.
There are no changes to the healthcare entitlements of short-term visitors who are covered by bilateral healthcare agreements between the UK and countries outside the EU, including Norway, Iceland, Liechtenstein and Switzerland.
Citizens of the EU, Norway, Iceland, Liechtenstein and Switzerland who move to the UK from 1 January 2021 for more than 6 months will pay the immigration health surcharge as part of any visa application.
EU citizens who were living in the UK on or before 31 December 2020 must apply to the EU Settlement Scheme by 30 June 2021 to maintain their healthcare entitlements in the UK.
COVID-19 testing, treatment and vaccination
Information about COVID-19 testing, treatment and vaccination for migrants can be found on the COVID-19 guidance page.
GP and nurse consultations in primary care, treatment provided by a GP and other primary care services are free of charge to all whether registering with a GP as an NHS patient, or accessing NHS services as a temporary patient. A temporary patient is someone who is in the area for more than 24 hours and less than 3 months.
For secondary care services, the UKs healthcare system is residence-based. This means that you must be living lawfully in the UK on a properly settled basis to be entitled to free healthcare.
The measure of residence that the UK uses to determine whether someone is entitled to free NHS healthcare is known as ordinary residence. To be ordinarily resident in the UK, people from countries outside the European Economic Area (EEA) who are subject to immigration control need to also have the immigration status of indefinite leave to remain.
People who are not ordinarily resident in the UK may be required to pay for their care when they are in England. However, some services and some individuals are exempt from payment.
The National Health Service (Charges to Overseas Visitors) Regulations 2015 and government guidance on overseas visitors hospital charging regulations outline the NHS services that are currently free of charge irrespective of an overseas visitors country of normal residence (as long as they have not travelled to the UK for the purpose of seeking that treatment). These services are:
- accident and emergency services, such as those provided at an A&E department, walk-in centre, minor injuries unit or urgent care centre (not including emergency services provided after being admitted as an inpatient, or at a follow-up outpatient appointment, for which charges must be levied unless the overseas visitor is exempt)
- services provided for the diagnosis and treatment of some communicable diseases, including HIV, TB and Middle East Respiratory Syndrome (MERS) (see the regulations for a list of diseases for which there is no charge for treatment).
- NHS services provided for COVID-19 investigation, diagnosis and treatment
- services provided for diagnosing and treating sexually transmitted infections
- family planning services (does not include termination of pregnancy or infertility treatment)
- services for treating a physical or mental condition caused by torture, female genital mutilation, domestic violence or sexual violence
- palliative care services provided by a registered palliative care charity or a community interest company
- services that are provided as part of the NHS 111 telephone advice line
Groups that are exempt from charge include:
- refugees (people who have been granted asylum, humanitarian protection or temporary protection under the immigration rules) and their dependants
- asylum seekers (people applying for asylum, humanitarian protection or temporary protection whose claims, including appeals, have not yet been determined) and their dependants
- people receiving support under section 95 of the Immigration and Asylum Act 1999 from the Home Office
- children looked after by a local council
- victims, and suspected victims, of modern slavery or human trafficking, as determined by the UK Human Trafficking Centre or the Home Office, plus their spouse or civil partner, and any children under 18 provided they are lawfully present in the UK
- prisoners and immigration detainees
People whose application for asylum has been rejected may still be exempt from charge if they are supported:
- under section 4(2) of the Immigration and Asylum Act 1999 by the Home Office
- by a local council under section 21 of the National Assistance Act 1948
- under Part 1 (care and support) of the Care Act 2014
People receiving compulsory treatment under a court order, or who are liable to be detained in an NHS hospital or deprived of their liberty (for example, under the Mental Health Act 1983 or the Mental Capacity Act 2005) are exempt from charge for all treatment provided, in accordance with the court order, or for the duration of their detention.
There may also be exceptional humanitarian reasons where the secretary of state can determine that a person is exempt from charges for relevant services. This exemption also applies to their child or companion who is authorised to travel with them but is limited to treatment that cannot wait until their return home.
People who are covered by reciprocal healthcare agreements, who hold an EHIC or who have paid the immigration health surcharge may also be exempt from payment for certain services. For further exemptions and information, see the NHS website on accessing services if you are visiting from abroad and government guidance on overseas visitors hospital charging regulations.
Services in Scotland
Practitioners in Scotland can refer to the National Health Service (charges to overseas visitors) (Scotland) regulations 1989.
Anyone in England can register and consult with a GP without charge.
GPs are self-employed and have contracts with NHS England to provide services for the NHS.
An application to join a practice can only be refused if the practice has reasonable grounds for doing so. A practice cannot refuse an application on the grounds of medical condition or any