No Recourse To Public Funds (NRPF) - Health
Services delivered by a GP, treatment for certain contagious diseases, and emergency department treatment at a hospital are free of charge to everyone regardless of their immigration status.
The main groups of people who will be charged for other NHS treatment are:
- Visa overstayers
- Illegal entrants
- Refused asylum seekers (who are not receiving Home Office asylum support or accommodation under the Care Act 2014)
These particular services must be paid for up front, unless the treatment is deemed to be ‘urgent’ or ‘immediately necessary’ by a clinician.
Maternity care, including antenatal appointments, will always be treated as ‘immediately necessary’. Anyone who is required to pay but is provided with treatment on this basis will still accrue an NHS debt. Failure to pay an NHS debt of £500 or more could lead to an immigration application being refused.
Prescriptions may be obtained free of charge if a person is on a low income. A person receiving accommodation and/or financial support from social services are able to receive free prescriptions. They must complete an HC2 form in order to obtain an HC1 certificate to allow them to do so.
Types of healthcare
- Primary healthcare
- Secondary healthcare
- Community healthcare and
- Other providers of medical care or information
- Urgent and emergency health care
Find out more about health services available and when there may be a charge by clicking on the links on this page or visit:
Primary healthcare is delivered through GP practices, NHS walk-in centres, dentists, pharmacists and optometrists. These services can be accessed by everybody in England, regardless of immigration status and are mostly provided free of charge, although some, such as prescriptions and dental treatment, must be paid for by certain people, depending on their age, income or medical condition rather than their immigration status.
(i) GP services
NHS England confirms that there is no requirement to prove identity, address or immigration status, so inability to provide identity or residence documentation would not be reasonable grounds to refuse to register a patient.
GPs have the discretion to accept any person to be fully registered as an NHS patient in order to receive free treatment. GPs may also register a person as a temporary resident for free treatment if the person is present in the practice’s area between 24 hours and three months. There is no minimum time period that a person needs to be in the UK before they can register with a GP.
GPs have a duty to provide emergency or immediately necessary treatment free of charge, and 14 days of cover after such treatment is provided, even if the patient is not registered.
NHS England provides further guidance on GP registration to find out more click here.
(ii) NHS walk-in centres & minor injuries units
Some minor illnesses and injuries can be treated free of charge and without the need for prior GP registration at:
- NHS walk-in centres
- Minor injuries units
Some types of secondary healthcare services must be provided free of charge to everyone because they are exempt from charging:
- Emergency Department (ED) services up until the point that the person is accepted as an in-patient
- Services provided as part of the "NHS 111" telephone advice line
- Family planning services (not including pregnancy termination)
- Diagnosis and treatment of some specific contagious diseases
- Diagnosis and treatment of sexually transmitted infections
- Treatment of a physical or mental condition caused by torture, female genital mutilation, domestic violence or sexual violence when the patient has not travelled to the UK seeking such treatment
- Palliative care services provided by a registered palliative care charity or a community interest company, for example, a hospice
- Services provided by school nurses and health visitors remain free of charge for all
People requiring such treatment may still be required to provide documents to confirm their nationality/immigration status as the NHS is still required to record whether they would otherwise be required to pay for treatment on their patient record
Community healthcare services which can be charged for include maternity care provided in the community, district nursing services, drug and alcohol treatment services and mental health services.
People who are not ordinarily resident in the UK (overseas visitors) and who are not exempt from charging must pay for most types of secondary and community healthcare.
a) Other providers of medical care or information
Some charitable and voluntary organisations provide medical services for migrants, although these are limited and tend to be specific to a particular region.
- Doctors of the World (Clinics in Bethnal Green and Hackney, London)
- Freedom from Torture (For survivors of torture. Clinics in London, North West, North East, West Midlands & Scotland)
- Maternity Action (Website and a telephone advice line)
What do I do in an emergency when my GP is closed?
If you phone your GP surgery outside normal surgery hours, a recorded message will tell you who to contact.
Alternatively, you can call NHS 111 if you urgently need medical help or advice but it's not a life-threatening situation.
You can also call NHS 111 if you're not sure which NHS service you need.
Immediately necessary treatment
Treatment to save a person’s life, to prevent a condition from becoming immediately life-threatening or to prevent permanent serious damage from occurring is deemed to be immediately necessary.
All maternity treatment, including routine antenatal treatment will be ‘immediately necessary’ and must be provided regardless of whether payment has been received.
Treatment which is not immediately necessary, but which cannot wait until the person can be reasonably expected to leave the UK is classed as urgent.
Routine elective treatment that could wait until the patient leaves the UK is non-urgent.
How do I register with a GP?
How do I book an appointment with my GP?
Many GPs now offer online booking service, which allow you to book or cancel your appointment or order a repeat prescription.
What if a person cannot afford to pay for treatment?
Department of Health guidance confirms that a payment plan can be set up to enable a person to pay the charge in instalments for urgent or immediately necessary treatment, as this can be provided before full payment has been received. Non-urgent treatment cannot be paid for in instalments as full payment must be made in advance.
What can a person do if they are refused treatment?
If a person believes that they should receive free secondary or community healthcare but is told they must pay or is refused what they believe to be immediately necessary or urgent treatment, then they can seek legal advice from a solicitor specialising in community care law. Even if a person does not fall under one of the exemptions, there may be scope for challenge if they are refused treatment but believe that the exemptions are discriminatory and do not comply with the Equality Act 2010 or Human Rights Act 1998.
For more information, see Home Office guidance: Pay for UK healthcare as part of your immigration application
- See the Home Office Modernised Guidance: General grounds for refusal.