UK NHS Eligibility for Returning Expats

[nigelforbes]

The subject of free NHS eligibility by Thai based UK expats who suddenly return to the UK for medical treatment, prompted me to dig out the UK Gov. Ordinary Resident tool which is linked below.

 

There is no question that a UK citizen who returns to the UK for settled purposes, is eligible for free NHS treatment from day one. Questions arise however when expats return to the UK, solely to use free NHS  services, without any intention of becoming ordinarily resident once again. When I looked into the issue a few years ago, I found that the NHS was paying far more attention to fraud and abuse of the system by non-residents and that specialist staff had been recruited to determine eligibility. One of the tools in use is the Ordinarily Resident test which is linked below. Looking at the questions that are asked, makes me wonder how some expats who think they are eligible to use the service free of charge, would fare. Some may find the questions interesting:

 

https://www.gov.uk/government/publications/help-for-nhs-to-recover-costs-of-care-from-visitors-and-migrants/settled-purpose-tool

[soi3eddie]

Nothing to worry about. Simply get to France. Paddle halfway across the English Channel and call the coastguard. They'll send border force to come collect you, house you and give you free NHS treatment as required. Oh. Only one problem, you're British so don't qualify. Even though you might have paid significant British taxes all your life and likely still are paying. 

 

[proton]

Pity they don't ask for ID, they would save millions. 

[Mac Mickmanus]

38 minutes ago, nigelforbes said:

There is no question that a UK citizen who returns to the UK for settled purposes, is eligible for free NHS treatment from day one.

You would need to register with  G.P before being eligible for NHS treatment and you will need proof of a home address to do that 

[BangkokReady]

25 minutes ago, Mac Mickmanus said:

You would need to register with  G.P before being eligible for NHS treatment and you will need proof of a home address to do that 

Presumably, once you return home you register.  Doctor, voter's register, and so on.

[nigelforbes]

26 minutes ago, Mac Mickmanus said:

You would need to register with  G.P before being eligible for NHS treatment and you will need proof of a home address to do that 

Not so, read the link, you might be homeless and still eligible.

[Chivas]

Why would anyone in modern times burn their bridges with their original GP anyway

 

All it takes is a "tactical enquiry" once a year via the online practice website to ensure you stay listed and active as a patient

 

Nothing any surgery likes more than that standard patient fee when the patient him/herself makes no demands on the service at all lol

 

 

[brianthainess]

1 hour ago, Mac Mickmanus said:

You would need to register with  G.P before being eligible for NHS treatment and you will need proof of a home address to do that 

I registered at a walk in surgery, and said I'm on holiday and staying with a friend on his sofa, I did have a NI number, no more questions asked, and was treated ; therefore i was now registered.  

[Kwasaki]

2 hours ago, nigelforbes said:

makes me wonder how some expats who think they are eligible to use the service free of charge,

Because if you go back UK you collapse when you get into Heathrow and be taken to A & E.

[RayC]

Touch wood I haven't needed to visit a UK hospital as a patient for 40-odd years, but do they really play '20 questions' before they treat you?

 

If you visit A&E and there is a need for a follow-up consultation isn't it just a case of name, address, email address and phone number and then, 'Right, we'll be in touch'?

 

As @Proton suggests, ID (cards) is the easiest way to safeguard against this type of fraud: No ID, no treatment (other than emergency care).

[nigelforbes]

8 hours ago, RayC said:

Touch wood I haven't needed to visit a UK hospital as a patient for 40-odd years, but do they really play '20 questions' before they treat you?

 

If you visit A&E and there is a need for a follow-up consultation isn't it just a case of name, address, email address and phone number and then, 'Right, we'll be in touch'?

 

As @Proton suggests, ID (cards) is the easiest way to safeguard against this type of fraud: No ID, no treatment (other than emergency care).

No I don't believe they do plus I don't think it's that difficult to become registered with a GP who will likely treat anyone regardless.

 

The problem comes when the medical complaint becomes serious and needs investigation or urgent treatment, almost certainly when hospitals become involved and other doctors and staff become involved. Hospital doctors start to examine patient history and look at the patients medical records, seeing the expats records are mostly blank for long periods will raise concern. "So you haven't been ill for a while, no symptoms, you haven't seen a GP in five years"? What is the person to do, lie and say no or try and help matters by explaining that they had been treated overseas for several years for this or that? That is likely a trigger point, surely the doctor will need to update the patients NHS record with this information, perhaps others involved in hospital backroom operations will take action, dunno.

 

When someone does begin to investigate and ask questions, that's where the Ordinarily Resident test kicks in. Can you show daily banking transactions for the past six months or so? Where do you live? Do you pay Council Tax and if so where? Are you really homeless, you said you'd been treated overseas in Thailand for several years, did you have medical insurance, that can't have been cheap. Remember, at this juncture the scamming patient is under pressure and is also vulnerable because of health issues. Personally, I'd find it very hard to come up with a plausible set of circumstances under those circumstances. I suppose as a last resort you could always say, I became sick overseas and had no money so I came here and now I intend to remain, I am a genuine returning expat who as of today is ordinarily resident. If that bought that and threw up their hands, fine. If they didn't and you have assets in the UK, such as a home, watch out.

[proton]

10 hours ago, RayC said:

Touch wood I haven't needed to visit a UK hospital as a patient for 40-odd years, but do they really play '20 questions' before they treat you?

 

If you visit A&E and there is a need for a follow-up consultation isn't it just a case of name, address, email address and phone number and then, 'Right, we'll be in touch'?

 

As @Proton suggests, ID (cards) is the easiest way to safeguard against this type of fraud: No ID, no treatment (other than emergency care).

Had a GP surgery 25 years ago who had a sign saying NHS cards must be shown if asked for, never was. When I moved I asked the new surgery how to change the address on it, they said they had hardly ever seen one and not to bother!

[nigelforbes]

Just now, proton said:

Had a GP surgery 25 years ago who had a sign saying NHS cards must be shown if asked for, never was. When I moved I asked the new surgery how to change the address on it, they said they had hardly ever seen one and not to bother!

I was planning to move back to the UK back in 2015 or thereabouts and was over there scouting for a flat. Because I thought I'd found what I wanted and thought my offer was going to be accepted, I went to register with a GP. I explained my circumstances to the practise, their response was that they couldn't register me until I had a council tax bill etc, which of course was nonsense. But just goes to show how different places handle the same thing differently.....bit like Thailand really!

[BritManToo]

10 hours ago, RayC said:

Touch wood I haven't needed to visit a UK hospital as a patient for 40-odd years, but do they really play '20 questions' before they treat you?

One of my rellies was 'foreign business manager' for a mojor London NHS hospital. She was only ever called to question people with 'iffy' accents. 

[nigelforbes]

4 minutes ago, BritManToo said:

One of my rellies was 'foreign business manager' for a mojor London NHS hospital. She was only ever called to question people with 'iffy' accents. 

That's Welsh expats screwed then.

[brianthainess]

13 hours ago, nigelforbes said:

Looking at the questions that are asked, makes me wonder how some expats who think they are eligible to use the service free of charge

Maybe because they paid into the system for years before they retired. I started work at 15yr so by the time I was 45 i had already paid 30yrs. and by 66y 51yrs ! Free ? only if you never paid NI contributions. 

[stratocaster]

I am curious to know how  returnees trying to get free medical care are going to beat the waiting times. I am sure residents of the UK would love to know the secret. My good mate in the UK who paid all his taxes and NI was diagnosed with a brain aneurysm one year ago but sadly died before he could get his operation. He was only 63. The UK press are reporting that 300 to 500 people are dying unnecessary per week due to not getting rapid A&E treatment. The UK PM has promised to get waiting times down to one and a half years by spring 2024 in a speech yesterday. As an exercise google the wait times for operations in your home town. In my town a life threatening operation is 17 weeks to a hip replacement time of 102 weeks.

Of course there is always the urban myth of the guy living in Phuket who collapsed at the baggage carousel at LHR and was rushed of to Papworth hospital no less, and had 3 stents inserted that day.

[proton]

1 hour ago, BritManToo said:

One of my rellies was 'foreign business manager' for a mojor London NHS hospital. She was only ever called to question people with 'iffy' accents. 

Geordies, Scousers and Jocks? ????

[RayC]

1 hour ago, stratocaster said:

I am curious to know how  returnees trying to get free medical care are going to beat the waiting times. 

That is a very good question.

 

Emergency treatment will, no doubt, be available but by definition that isn't planned. Would known conditions e.g. cancer be treated quickly?

 

Sorry to hear about your mate; if his example is anything to go by then the answer is 'No'.

[RayC]

2 hours ago, proton said:

Had a GP surgery 25 years ago who had a sign saying NHS cards must be shown if asked for, never was. When I moved I asked the new surgery how to change the address on it, they said they had hardly ever seen one and not to bother!

I'd forgotten all about NHS cards until you mentioned them!

[nigelforbes]

A friend and neighbor in the UK had a six month wait for heart reconstruction surgery, they took the damned thing out and pretty much reconditioned it, new valves the works, (even gave it a wash and wax afterwards)! Pretty serious and major stuff but that was a six month wait and he could barely walk before going in. A returning expat is hardly going to find surgeons just sitting around to treat them. 

[Mike Teavee]

14 hours ago, Chivas said:

Why would anyone in modern times burn their bridges with their original GP anyway

29 years  ago, my GP burnt my bridges for me whilst I was still living in the UK as he had only seen me 3 times in 27 years, the last one of those >5 years prior, & they were removing patients off of their list who hadn't been in to see them for a long time...

 

I never bothered getting a new one which is something I may well come to regret in later years but at that age you just don't think about it (Especially when you're paying additional, "Benefits in Kind" tax to have Private Health Insurance). 

 

 

 

[Chivas]

52 minutes ago, Mike Teavee said:

29 years  ago, my GP burnt my bridges for me whilst I was still living in the UK as he had only seen me 3 times in 27 years, the last one of those >5 years prior, & they were removing patients off of their list who hadn't been in to see them for a long time...

 

 

 

Indeed and there you go

By doing my suggestion of keeping in contact once a year for any spurious enquiry via website or even on the trumpet it just keeps you "active"

 

Someone further up the thread mentioned what happens with suspected cancer.  Last year I reported potential skin cancer via online website. Seen by own GP the following day and specialist 11 days later. No further action required

 

Second time last year ongoing problem I have with bladder cancer. Reported blood in urine (again).....No need to see own GP as they know the situation but again 10 days later was having the Scope up the japs eye the day England played Iran.......follow up MRI coming on 17th Jan as nothing obvious via the Scope

 

The initial cancer referral times are 2 weeks and it still appears the NHS hit the target

 

[Kwasaki]

4 hours ago, nigelforbes said:

I was planning to move back to the UK back in 2015 or thereabouts and was over there scouting for a flat. Because I thought I'd found what I wanted and thought my offer was going to be accepted, I went to register with a GP. I explained my circumstances to the practise, their response was that they couldn't register me until I had a council tax bill etc, which of course was nonsense. But just goes to show how different places handle the same thing differently.....bit like Thailand really!

In UK you can still be seen by a GP. 

Emergency treatment is also available.

Why don't you just have regular check ups and look after yourself if your so dam worried about UK hospital care.

[Chivas]

1 hour ago, Kwasaki said:

 

Why don't you just have regular check ups and look after yourself if your so dam worried about UK hospital care.

Not quite as simple as that and using my example above of blood in urine its not something you can legislate for in advance no matter how well you look after yourself

 

[Kwasaki]

3 hours ago, Chivas said:

Not quite as simple as that and using my example above of blood in urine its not something you can legislate for in advance no matter how well you look after yourself

 

Got no idea what you're on about, apart from when your God calls your boat number up you have to sail back to the harbor.

[Mac Mickmanus]

5 hours ago, Chivas said:

Indeed and there you go

By doing my suggestion of keeping in contact once a year for any spurious enquiry via website or even on the trumpet it just keeps you "active"

 

 

You don't even need to contact your G.P every year or any time at all , you will still remain enrolled on the members list.

  Some enlisted people don't visit their GP for years on end 

[nigelforbes]

4 minutes ago, Mac Mickmanus said:

You don't even need to contact your G.P every year or any time at all , you will still remain enrolled on the members list.

  Some enlisted people don't visit their GP for years on end 

Yes, that will work for some but not all. Technically, under NHS rules, GP's are meant to remove from their active lists, any patient they have not had contact with in the past twelve months. This is because GP's are paid by the NHS, based on how many patients are registered at a practise. My old GP practise in the UK transferred me to a subs system after 12 months, when I went back some years later I was recalled and put back on the main system, for 12 more months.

[theoldgit]

On 1/4/2023 at 6:49 PM, nigelforbes said:

The subject of free NHS eligibility by Thai based UK expats who suddenly return to the UK for medical treatment, prompted me to dig out the UK Gov. Ordinary Resident tool which is linked below.

 

It's also useful to read the guidance issued to Overseas visitor managers and their teams, Frontline staff providing relevant services and Providers and commissioners of relevant services
Overseas NHS visitors charging regulations - guidance December 2022

 

The advice for visitors, including expats, might be of interest: Visiting or moving-to-england/how-to-access-nhs-services-in-england-if-you-are-visiting-from-abroad/

 

It's worth noting that a referral from a GP is only required for non urgent hospital treatment, and is chargeable at 150% of cost for visitors, including non returning expats.

[thaibeachlovers]

On 1/5/2023 at 1:23 AM, proton said:

Pity they don't ask for ID, they would save millions. 

I used to work in a London hospital doing outpatient operations first decade of the century. While it was known that people that were not even British ( had children living in the UK ) would fly in and get a GP to refer them for NHS treatment, we were forbidden to ask them if they were actually entitled to be operated on.

 

I did hear that that was stopped, and a good thing if it was.