Ratio of GPs to population falls by a tenth since 2009

Ratio of GPs to population falls by a tenth since 2009

July 13 2018 There were 62.0 GPs per 100,000 population in 2017, a decrease of 11.2% from the...

Dementia risk advice introduced into NHS Health Check

Dementia risk advice introduced into NHS Health Check

June 19 2018 Health professionals providing the NHS Health Check service will be expected to give...

Wales announces £100m to shake up NHS and social care services

Wales announces £100m to shake up NHS and social care services

June 14 2018 Wales is to undergo a significant overhaul of NHS and social care services, the...

Welsh pharmacies to supply flu vaccine for care home workers

Welsh pharmacies to supply flu vaccine for care home workers

June 11 2018 Care home workers in Wales will be eligible for free flu vaccination in the 2018-19...

Flu vaccination by GPs sees increase for 2017-18 season

Flu vaccination by GPs sees increase for 2017-18 season

May 30 2018 Flu vaccine uptake among people aged 65 years or over increased to 72.6% for the...

  • Ratio of GPs to population falls by a tenth since 2009

    Ratio of GPs to population falls by a tenth since 2009

    Friday, 13 July 2018 13:02
  • Dementia risk advice introduced into NHS Health Check

    Dementia risk advice introduced into NHS Health Check

    Tuesday, 19 June 2018 10:15
  • Wales announces £100m to shake up NHS and social care services

    Wales announces £100m to shake up NHS and social care services

    Thursday, 14 June 2018 14:24
  • Welsh pharmacies to supply flu vaccine for care home workers

    Welsh pharmacies to supply flu vaccine for care home workers

    Monday, 11 June 2018 14:07
  • Flu vaccination by GPs sees increase for 2017-18 season

    Flu vaccination by GPs sees increase for 2017-18 season

    Wednesday, 30 May 2018 11:07

a pound imageOctober 23 2017

New regulations requiring hospitals to charge people upfront if the patient cannot prove entitlement to free NHS treatment could put more pressure on general practice.

A BMJ editorial has warned that “with primary care remaining free to all in England, the increased workload on already overextended general practices is likely to be unmanageable.”

The NHS (Charges to Overseas Visitors) (Amendment) Regulations have come into force on Monday 23 October. NHS Trusts and community care providers now have a legal obligation “to establish whether a person is an overseas visitor to whom charges apply, or whether they are exempt from charges,” says the Department of Health. In addition: “NHS Providers and non-NHS Providers are legally required to recover charges that are not immediately necessary or urgent in full, in advance of providing them.”

Until now, the notion of charging patients not eligible for NHS care in advance had been a recommendation, not a legal obligation. The new regulations also require providers to record when a person is an overseas visitor on the Summary Care Record application.

Concerns about the impact of the new regulations are raised in the BMJ article by Lucinda Hiam, health adviser to Doctors of the World, and Martin McKee, Professor of European public health at the London School of Hygiene and Tropical Medicine.

They note: “The NHS’s founding principles—to meet the needs of everyone, to be free at the point of delivery, and to be based on clinical need, not ability to pay—were restated as recently as 2011, when a ‘wider social duty to promote equality’ was added.”

However, under the new system, “anyone, including children, attending healthcare facilities in England who is unable to establish their entitlement to free care will be charged upfront for the estimated cost of treatment. If they are unable to pay, treatment may be refused.” The authors question how people, such as the homeless or those with mental health problems, will be able to prove their entitlement to care.

Department of Health guidance is set out in a 34-page document intended “primarily for use of those individuals in NHS organisations, including Overseas Visitor Managers (OVM), patient facing administrative teams, administrative staff and finance managers, who have responsibilities associated with the identification and charging of those patients not eligible for free NHS services.”

Only clinicians will be able to make an assessment as to whether a patient’s need for treatment is immediately necessary, urgent or non-urgent, says the guidance. It defines ‘immediately necessary treatment’ as “that which a patient needs promptly:

  • to save their life; or
  • to prevent a condition from becoming immediately life-threatening; or
  • to prevent permanent serious damage from occurring.”

In addition; “Urgent treatment is that which clinicians do not consider immediately necessary, but which nevertheless cannot wait until the person can be reasonably expected to return home. However, urgent treatment should also always be provided to any person, even if a deposit has not been secured, and must never be delayed or withheld.”

Links:
Department of Health: 'Guidance on overseas visitors hospital charging regulations’          
‘Upfront charging operational framework’ document                  
L Hiam and M McKee. Upfront charging of overseas visitors using the NHS’. BMJ 2017; 359: j4713                 

Contract News

July 27 2018 Adolescent boys will be offered the human papilloma virus (HPV) vaccine to protect them from cancer, the Department of Health and Social Care has announced.
July 20 2018 Doctors are being reminded to ensure that any patient or other records which may be relevant to the UK Infected Blood Inquiry are not destroyed. Earlier this month, the Inquiry’s Chair, Sir...