BMA guidance directs GPs to provide routine care to tourists

The BMA was prompted to announce new guidance after there was confusion among GPs about which patients should be registered and which should be privately charged. Approaches to the dilemma varied across the country, causing the BMA to issue new and clearer guidance regarding patient care.

The General Practice Committee (GPC) has assured that the new guidance will be endorsed by NHS England and will clarify that all patients should be provided with routine care, including tourists who are temporarily residing in the area and should not be charged for either emergency or routine care.

The guidance has arisen as the Department of Health (DoH) is preparing to launch a consultation on extending charging for NHS services from overseas patients in general, which could include being charged for accessing GP services.

The new BMA guidance says: “There is no contractual duty to seek evidence of identity or immigration status or proof of address. Therefore practices should not refuse registration on the grounds that a patient is unable to produce such evidence.

“Anyone who is in England is entitled to receive NHS primary medical services at a GP practice and applications for registration for any patient in England must be considered in exactly the same way, regardless of country of residence.”

GPC deputy chair Dr Richard Vautrey said that the guidance means GP practices 'do have to treat tourists seeking general practice care if they are in their area and they have an open list'.

When asked whether this included routine care, he added: “Yes, they’d just need to show that they were in the practice area.”

He said: “It does not matter what you live in, or with whom, as long as the patient says they live within the practice boundary then the practice should see them under the current registration arrangements: immediately necessary care for those in the area that day; temporary residents if staying for up to three months; or full registration if beyond that.”

But he asserted this would not amount to practices working for free, as they 'will receive full global sum fees for fully registered patients'.

He added: “What we’ve been expecting for some time is guidance from NHS England on registration arrangements. We expect that this will make it absolutely clear that all people in the country, including tourists, can access free GP services.”
An NHS England spokesperson said: “We are currently working on guidance that reiterates the current regulations around patient eligibility and registration and will publish it in due course.”

Under the Immigration Act 2014, only UK residents with ‘indefinite leave to remain’ are entitled to free healthcare. The method of charging for care has only been implemented for elective secondary care, so far, however The Times has reported that the government is looking at also charging for emergency care.

A spokesperson for DoH said: “International visitors are welcome to use the NHS, provided they pay for it — just as families living in the UK do through their taxes. This government was the first to introduce tough measures to clamp down on migrants accessing NHS care and have always been clear we want to look at extending charges for non-EEA migrants. No-one will be denied urgent treatment and vulnerable groups will continue to be exempt from charging.”

A BMA spokesperson said it has updated advice because ‘this has long been an area of confusion for GPs, largely due to the absence of clear guidance from the DoH and NHS England’.

They added: “Therefore while the BMA’s existing guidance remains the same, we have made it clearer for doctors to understand. We are expecting NHS England to clarify its own guidance shortly to avoid any confusion on this issue in the future.”

Read more