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Are you engaging in employment in United Kingdom (UK)?

Rules, procedures and documentation on access to hospital and primary health care, NHS charges and exemptions.

What if I should need hospital treatment?

Under the current Regulations, anyone who is engaging in employment with an employer who has his principle place of business in the UK, or who is a self-employed person whose principle place of business is in the UK is fully exempt from National Health Service (NHS) hospital charges in England. This exemption applies to your spouse, civil partner and children (under the age of 16 or 19 if in further education) if they are living with you in the UK on a permanent basis.

Please note that to be exempt from NHS hospital charges on this basis you must be in employment at the time you receive treatment.  If you are here on a work visa but currently unemployed you will be charged for your treatment, unless you are otherwise exempt from charges.

Also under the current Regulations, anyone employed on a ship or vessel registered in the UK or anyone working offshore on the UK sector of the Continental shelf would be fully exempt from NHS hospital charges in England.

In common with those ordinarily resident in the UK, anyone who meets the criteria of ordinary residence or is exempt from charges for hospital treatment will have to pay statutory NHS charges, eg prescription charges, unless they also qualify for exemption from these, and will have to go onto waiting lists for treatment where appropriate.

If I should need hospital treatment what documents will I need?

The Regulations place a responsibility on individual hospitals to determine whether, in accordance with the Regulations, a patient is liable to be charged for treatment or not.  In order to establish entitlement, hospitals can ask you to provide documentation that supports your claim that you intend to engage in employment in the UK.  It is for you to decide what to supply, however examples of evidence could include:

  • if not an EEA* national or Swiss national then must have a valid work permit or;
    if EEA national or Switzerland proof of nationality;
  • proof that employment is based in UK, e.g confirmation from employer, or for self employed invoices or receipts;
  • proof of employment – e.g. recent letter from employer or contract of employment or current wage slip, for self employed invoices or receipts.
    * Nationals from Bulgaria and Romania need authorisation from the UK Border Agency.

Can I access Primary Care Services?

GPs have a measure of discretion in accepting applications to join their patient lists. It is advisable to approach a GP practice and apply to register onto its list of NHS patients. The practice may choose to accept or decline your application.  An application may be refused if the practice has reasonable grounds for doing so.  A practice would not be able to refuse your application on the grounds of race, gender, social class, age, religion, sexual orientation, appearance, disability or medical condition.  If you have difficulty in registering with a GP, you should get in touch with your local primary care trust (PCT). 

Do I have to pay for emergency treatment if I have an accident?

Regardless of residential status or nationality, emergency treatment given at Primary Care Practices (a GP) or in Accident and Emergency departments or a Walk-in Centre providing services similar to those of a hospital Accident and Emergency department is free of charge. 

In the case of treatment given in an Accident and Emergency department or Walk-in Centre the exemption from charges will cease to apply once the patient is formally admitted as an in-patient (this will include emergency operations and admittance to High Dependency Units) or registered at an outpatient clinic.

Am I entitled to help with the costs of non-emergency NHS treatment?

Information about help with health costs is detailed in leaflet HC11 ‘Are you entitled to help with health costs?’ which is available on the Internet at:

What if I do not meet one of these exemptions from charges?

If you are not ordinarily resident or exempt under the regulations, charges will apply for any hospital treatment you receive and cannot be waived. If this is the case you are strongly advised to take out private healthcare insurance that would cover you for the length of time you are in the UK.  There is no facility to purchase healthcare insurance from the NHS therefore any necessary insurance must be organised privately.

Please note the above information gives general guidance only and should not be treated as a complete and authoritative statement of law. In all cases the Regulations place the responsibility of deciding who is entitled to receive free hospital treatment with the hospital providing treatment.

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