Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what guidance has been provided to NHS bodies on the criteria needed to exempt patients from NHS debt where they have been determined to not be ordinarily resident including (a) which criteria are used to determine if such a patient is destitute and (b) any other criteria.

Guidance to providers of National Health Service-funded secondary care states that where a person cannot support their entitlement to care free of charge, the provider may decide to charge for treatment. In making this decision, the provider should judge each case on its own merits and take any reasonable steps to ascertain a patient's claim that an exemption applies. If charged, the person can subsequently claim reimbursement where there is sufficient evidence to show an entitlement to free treatment at the time it was given.

The guidance also states that any treatment a clinician determines to be immediately necessary or urgent must never be delayed due to charging. Where a charge applies it cannot be waived for any reason. However, the guidance sets out circumstances when providers may write off the charge in the accounts and not pursue the debt, including if the patient is destitute or genuinely without access to funds. The Department works with NHS England to support NHS providers in implementing the Regulations appropriately. The Department and NHS England are producing additional guidance relating to debt and destitution to support relevant bodies dealing with financially vulnerable patients.