A hostile environment for care

A hostile environment for care

"There is now clear evidence that The National Health Service (Charges to Overseas Visitors) (Amendment) Regulations 2017 are deterring vulnerable groups from accessing NHS treatment, threatening public health, and taking vital clinical time away from patient care."

This opener to a new report from the BMA sets the scene for a strong challenge to government on its rules for charging ‘overseas visitors’ for accessing NHS services in England.

The rules, introduced in 2015, are seen as part of the government's "hostile environment" for immigration. They were updated in 2017, to expand charging to community services, introduce upfront charging for non-urgent care, and require NHS services to record patients’ eligibility for free treatment.

The Department for Health and Social Care (DHSC) announced a review in December 2017, less than two months after the updated rules came into force, and before some providers had had time to fully implement them, let alone assess their impact. DHSC says that the review found no evidence of the regulations deterring patients from accessing care - but it has said that the findings of the review will not be published.

The BMA's report is based on a survey of its members, and refers to patient experience as outlined in reports such as Maternity Action's What Price Safe Motherhood. It finds that patients are, in fact, deterred from seeking care, "including for treatments that are not chargeable". It states that "vulnerable groups are being, and will continue to be, negatively affected by the regulations".

The BMA is calling for publication of the findings of the DHSC review, and for "the introduction of safeguards to ensure that vulnerable populations are not deterred from seeking care, are able to access the care they are entitled to and that necessary treatment is not denied due to difficulty or delay in proving eligibility".

You can download the report via our website.

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- The Tower Hamlets GP Report, Satisfaction with booking appointments and waiting lists in GP Surgeries across the borough.
- Mental health, Understanding how integrated care systems are supporting people's mental health.
- Use of mobile applications in the management of overweight and obesity in primary and secondary care. Clinical Review.
- Comparing psychiatric care experiences shared online with validated questionnaires; do they include the same content?

Free resources

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Our quarterly Patient Experience magazine carries insightful comment from a range of contributors, as well as our top picks of recent reports on patient experience and patient/public involvement.

Patient Experience in England is our annual overview of the evidence base, drawing on surveys and research from government bodies, health charities and academic institutions.  The evidence is broken down into manageable chunks, and research findings are grouped under key themes for ease of understanding.

You can browse our Knowledge Maps to see how patient experience is being reported in your area.

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