Overseas visitors

If you are visiting the United Kingdom and require treatment at St Georges University Hospitals NHS Foundation Trust, you may have to pay for your treatment.

This page gives you more details about treatment for overseas visitors.

Resident of the UK?

NHS hospital treatment is not free for everyone. Anyone of any nationality who is not ordinarily resident in the UK at the time of treatment is an ‘Overseas Visitor’. This means that you may be charged for the treatment you receive from us.

NHS hospitals have a legal obligation to establish whether a person is an overseas visitor, and whether charges apply, or they have an exemption. Where there is no exemption, we must charge the person liable and recover the costs from them. We will ask for a deposit or interim payment for elective care up front.

Entitlement to free NHS treatment

The NHS provides free hospital treatment to people who live in the UK permanently. You must live here lawfully and on a settled basis to receive free treatment. If you are not ordinarily resident in the UK, you may have to pay for your hospital treatment.

NHS trusts have a statutory obligation to identify patients who are not entitled to free NHS treatment and to charge them for the treatment they receive.

We will always provide treatment that is immediately necessary or urgent, but we reserve the right not to provide treatment that, in the opinion of a clinician, is not immediately necessary or urgent. In this event we will not provide care until the cost has been paid in full, in advance.

Emergency and maternity treatment is regarded as ‘immediately necessary or urgent’ and NHS care will always be provided. Treatment in our emergency department (A&E) is exempt from charges, but patients receiving any other emergency care, including maternity, will be charged if they are not eligible for free treatment. It is important to be aware that A&E is free to all. If admitted or have been given an outpatient appointment because of A&E attendance charges may apply.

To establish your eligibility, we may ask you questions about your residential status when you register for a clinical appointment. This can apply to any patient regardless of nationality or if you’ve paid National Insurance contributions or taxes in the past.

We always ask new maternity patients to provide 2 documents as evidence of their identity and address at their appointment for a 12-week scan.

What is the Trust guidance on overseas visitors?

The Department of Health overseas visitor charging regulations require all trusts in England to identify and charge overseas visitors for the treatment they receive.

Establishing residency

Upon arrival at the trust, you will be asked to confirm how long you have lived in the United Kingdom and may be asked to complete a form and provide documents to prove that you are ordinarily resident in the UK.

If you cannot provide documents you may have to pay a deposit equal to the estimated cost of your treatment before you have an appointment or treatment.
Maternity services, or treatment which the doctor or nurse think is immediately necessary or urgent, will not be withheld. However, charges will still apply, and you will receive an invoice after your treatment.

A person does not become ordinarily resident in the UK by:

  • Having British nationality
  • Holding a British passport
  • Being registered with a GP
  • Having an NHS number
  • Owning property in the UK
  • Having paid (or are currently paying) National Insurance contributions and taxes in this country.

Whether a person is ordinarily resident is a question of fact, for which several factors are considered.

What type of documents can I provide?

The following documents can be used as proof of identity; you must provide one photographic document and any other documents as proof of address:

  • Current signed passport / Visa if applicable
  • Biometric Residence Permit issued by the Home Office
  • EU or Swiss national identity photo-card
  • Application Registration Card (ARC)
  • Valid armed forces or police photographic identity card.

The following documents can be used as proof of address. They must contain your current address and be dated within the last six months:

  • Recent original utility bill, ie gas, electric, water, landline (mobile not acceptable)
  • Council Tax bill for the current year
  • Bank, Building Society or Credit Union statement
  • Current Council or Housing Association tenancy agreement or rent book

Patients living in European Economic Area (EEA) countries

If you access our services because the need arose during your visit to the UK, you will need to show your European Health Insurance Card (EHIC), Global Healthcare Insurance card (GHIC) or a Provisional Replacement Certificate (PRC). Proof of EU Pre settled and EU Settled status will also be required

If you do not have these documents with you and cannot demonstrate that you have an exemption to charges. You will be required to pay for your treatment and recover the costs from your ‘healthcare abroad team’ when you return home.

How can I obtain a Provisional Replacement Certificate (PRC)?

The onus is on the visitor to apply for a PRC and provide it to the Trust. Please go to the European Commission website and enter your search criteria, you must contact your institution and make the necessary arrangements in order to obtain your PRC. Alternatively, you can download the EHIC app to your smartphone and within the “I lost my card” section, select your country and your health insurance fund contact telephone, email and website address will be made available.

Important information

We may provide non-clinical information about you to external agencies for:

the purpose of confirming your entitlement to free NHS treatment, or

to recover debts owed to us for treatment provided

We always try to recover monies owed for treatment provided. We may use external debt collection agencies or take court action.

We always advise the Home Office about outstanding debts more than £500 for more than 2 months. The Home Office will prevent you from returning to the UK for as long as this debt remains unpaid.

If you fail to pay for NHS treatment for which charges are appropriate, your future application to enter, or remain in the UK may be denied.

Scotland, Wales, and Northern Ireland

The National Health Service (NHS) is the umbrella term for the four health systems of England, Scotland, Wales, and Northern Ireland these patients are UK residents but are not automatically eligible for free NHS treatment in England and require prior approval from their local health authority.