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Gold, incentives and meh

NHS trusts ask GP practices to identify overseas patients when referring

GPs have been asked by trusts to find out if patients are eligible for free NHS health care, according to an LMC.

The Cambridgeshire LMC newsletter this month revealed that NHS trust overseas visitor managers (OVMs), who are responsible for charging overseas patients in hospitals, have written to local GP practices requesting their help in identifying patients who need to pay for care.

The newsletter said: ‘GPC have been made aware that NHS trust OVMs have written to local GP practices requesting their help in identifying whether patients are eligible for free NHS care.

‘Specifically, the OVMs have asked GPs to note on referrals that patients are “overseas visitors” if they have been resident in the UK for less than six months.’

However, it added: ‘GPC want to reassure GPs that this is absolutely not their responsibility and that they are not required to do so.

‘Guidance from the Department of Health and Social Care is explicitly clear that the responsibility for determining a patient’s eligibility for NHS care lies with the trust and never with a GP or GP practice.’

Dr Richard Vautrey, GP Committee chair at the BMA, said: 'Anyone in England, be they visiting or living here, is automatically entitled to free NHS primary care when they need it - it is not a GP’s responsibility to question or decide who is eligible for treatment.'

It follows the news that EU citizens living in the UK may have to prove their immigration status in order to receive free NHS care in the event of a no-deal Brexit.

NHS Cambridgeshire and Peterborough Foundation Trust said they were investigating whether this was happening in their hospitals.

 

Readers' comments (13)

  • GPs are being asked to become unwilling and untrained border patrol agents by the government... Didn’t the government try to do the same years ago with the landlords?

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  • That will be a no.

    Surely you can only put something in a referral that is relevant and what the patient consents you to share. There is an implied consent that you will tell the hospital that the patient has chest pain, high blood pressure etc.

    But no implied consent to share residency status.

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  • I personally don’t have a problem this - one of the ethical principles is justice.

    We have had a couple of families who ask for their family members to be treated when they come on holiday - ask for referrals and I have pointed out on the letter that they are from abroad as they should have to pay to use the nhs - I don’t see why that is wrong

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  • Another job with all the risks and if you get it wrong, complaints and litigation and payouts.
    No pay=no work.
    These days even with pay I will not do any extra. Nobody wants to get hardly anything taking on so much risk or worse, pay to work.

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  • David Banner

    The article makes it clear that this is a voluntary request, not a compulsion. As Primary Care is free for all who attend, our only duty is to the patient in front of us. If a decision is made to refer, then it is Secondary Care’s responsibility to check if fees are required.

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  • Since 2ndry care is not free to people not normally resident in the UK whether British or not it would be reasonable to see if the patient wanted a private referral to the NHS or to a non NHS service and so it is a discussion that needs to be had with the patient so they are fully informed about their referral. I would have thought it reasonable to inform the service to whom you evenetual refer that this is a private referral.

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  • it would help if it was made clear the rules about eligibility, what a person can or cannot have and stick to them. the rules are too broad ands we are told as GPs not to check for eligibilty when registering patients. other countries dont have an issue. Dont live there - you pay, end of. tough, should have gotten insurance. if the government really wanted to sort the issue out they would but are too cowardly to do so as they know it would lose votes at an election so they dump the problem on GPs and hospitals. in that case it should be up to us what we will and will not accept. you can't have it both ways and this is why its all a complete mess. what we need is clear leadership from the RCGP, NHS england and the DoH to make clear rules on eligibility. It should be based on living in the UK permanently and contributing to the country coffers as was originally intended in 1948 NHS act. otherwise you pay. It was never intended as a freebie to the masses. perhaps its time to change the funding via a NHS tax - you pay tax, eligible for benefits or pension and live in the UK you can access the NHS as do any dependent children living in the UK permanently. money saved then can sponser charities to help those who may be eligible but not contributing, as they are better placed to help these people than the NHS. Any one else its a free market and you charge what you like. simples

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  • @Mark (and others)

    IF the patient says they want a referral to the NHS hospital, but do not want you to tell them that they have only been in the country for 3 months - what would you do? You would certainly warn the patient that they should be charged for their care (more than the cost of treatment if I remember correctly), but they still say they do not want you to share that data.

    I supposed you could add a comment - 'as far as I am aware this patient is entitled to free NHS secondary care' to all referrals, and leave it out of this referral. That would work very well with a tick box that you couldn't tick for this patient.

    But the opposite in that specifically pointing out how long they have lived in the country without their permission is probably not allowed. That would be sharing information that is not relevant to their medical problem, specifically for the reasons of billing the patient, specifically against their consent.

    It puts GPs in a complicated position. But when that happens you tend to be less likely to be blamed if you put the patient first, unless required to do so by law.
    - someone planning a terrorist attack, call the police.
    - someone who stole an apple from the grocers - ignore it.
    - Someone planning to stab their partner, call the police
    - Someone planning to fraudulently view sports online, ignore it.
    - Someone planning to fraudulently access free medical care - ??? - I would ignore it.

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  • DrRubbishBin

    I can't see this is a problem, it's not compulsory and it's quite clear the buck stops with secondary care. It's perfectly reasonable that people from overseas who aren't resident should pay for their medical care. The tax payers of the U.K. aren't funding a health care system that's free to access for the entirety of the 6 billion soles living on the plant., what's the problem in pointing this out if you get the chance, and not if you don't ?

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  • CDR - because you don't have permission to share that information.

    I really don't think it counts under the implied consent that you have to share information about the patient's medical problems. I don't think it counts as a serious arrestable offence or significant harm to a named/ specified individual.

    So if you share it you are breaking rules related to good medical practice and data handling.

    I do agree that it being optional is good - but I would want to specifically get permission (express consent) from the patient before ticking the box.

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