The Department engaged with 79 organisations as part of the process of reviewing of the National Health Service (Charges to Overseas Visitors) (Amendment) Regulations 2017 and received 57 formal responses. Of these, 22 case studies included instances where individuals were required to make advance payment for treatment that the Department has concluded was arguably, on proper analysis, immediately necessary and/or urgent.

The common issue in these cases is that clinicians have not fully taken into account the date at which those seeking treatment have been expected to leave the United Kingdom, something that national guidance is clear must be taken into consideration when making a decision as to whether or not treatment is considered urgent. To mitigate this risk and help ensure the regulations are applied as intended the Department has updated its guidance, published on 24 December 2018, and is planning further updates to relevant training material and case studies in early 2019 to ensure all relevant circumstances are considered when deciding if a treatment is to be considered immediately necessary, urgent or non-urgent.

The Department has no plans to produce and publish a formal review document or the evidence collected as part of it.

The current review was initiated as a response to concerns that have been raised by stakeholders regarding the introduction of the National Health Service (Charges to Overseas Visitors) (Amendment) Regulations 2017, the ‘amendment regulations 2017’, and in line with the continuing public sector equalities duty in relation to these regulations. A document outlining the scope of the review, to consider the impact of the amendment regulations 2017, was shared with stakeholders in November 2017. The questions which have been sent to stakeholders since the sharing of the scope document have intentionally focused on asking for evidence relating to the impact of the amendment regulations 2017. This is in accordance with the rationale for the review and the review scope, which had previously been communicated to stakeholders.

The Department is aware that, given that the amendment regulation, introduced as part of the amendment regulations 2017, requiring relevant bodies to withhold treatment from chargeable overseas visitors until the estimated full cost of the service has been paid, made a legal requirement of what was previously best practice, it may be relevant to refer to the effects of upfront charging prior to the amendment regulations 2017 coming into effect. This is acknowledged in the question documents which the Department has sent to stakeholders. For example, in the question document sent to vulnerable group’s representatives, the introduction asks for stakeholders to indicate whether the evidence they present relates to the period before or after the relevant provisions of the Amendment Regulations 2017 came into force. It is also the case that if, during the course of engaging with stakeholders as part of the review the Department were to receive evidence concerning the impact of upfront charging prior to the amendment regulations 2017 coming into force the Department would, of course, consider this evidence and take any resulting action which it judged to be necessary.

The Department has no plans to include a public consultation as part of the review of ‘The National Health Service (Charges to Overseas Visitors) (Amendment) Regulations 2017’ (the 2017 Amendments). The Department ran a consultation ‘Making a fair contribution: consultation on the extension of charging overseas visitors in and migrants for using the NHS in England’ in early 2016. This covered many of the areas included in the 2017 Amendments. The Government published its response in February 2017.

The Department initially sent a list of review questions on 22 December 2017 to several organisations with a deadline of 31 January 2018 for the submission of evidence to be returned.

The Department does fully recognise the need to ensure that sufficient time is provided for both evidence collection and analysis. The end of January deadline was chosen so that the Department could seek to identify the main impacts of the amendment regulations on vulnerable groups as early in the review process as possible. This will allow more time to further explore these impacts with stakeholders, within the timeframe of the review that has been set out.

The Department has responded to questions from stakeholders about the deadline by saying ‘we recognise that the end of January deadline may not be possible for all organisations due to the issues you have raised. As we previously stated, we are therefore willing to be flexible on this deadline, so while we would appreciate organisations submitting their responses as soon as possible, we will of course still consider the information in responses that are submitted after that.’ The Department has made it clear that evidence submitted within a timeframe that allows it to be taken into account as part of the review will be considered.

The Department has also committed to continue to work with stakeholders to monitor the effects of the charging regulations on vulnerable groups after the review process has concluded. Therefore, if new evidence concerning the impact of the impact of the 2017 Amendments is presented to the Department, after the time at which it can be considered as part of the review process, it will be considered in accordance with the Secretary of State’s ongoing duties.

The Department does not see any reason to change the position, outlined above, which has already been communicated to stakeholders.

The Department has undertaken a review of the 2017 Amendments in line with continuing public sector equalities duty, and also in response to concerns that have been raised by stakeholders. The National Health Service (Charges to Overseas Visitors) (Amendment) Regulations 2015 were minor amendments in respect of errors identified by the Joint Committee on Statutory Instruments. Given that there have not been recent concerns raised by stakeholders about these amendment regulations the Department does not feel it necessary to review them.

The Department has no plans to include a public consultation as part of the review of ‘The National Health Service (Charges to Overseas Visitors) (Amendment) Regulations 2017’ (the 2017 Amendments). The Department ran a consultation ‘Making a fair contribution: consultation on the extension of charging overseas visitors in and migrants for using the NHS in England’ in early 2016. This covered many of the areas included in the 2017 Amendments. The Government published its response in February 2017.

The Department initially sent a list of review questions on 22 December 2017 to several organisations with a deadline of 31 January 2018 for the submission of evidence to be returned.

The Department does fully recognise the need to ensure that sufficient time is provided for both evidence collection and analysis. The end of January deadline was chosen so that the Department could seek to identify the main impacts of the amendment regulations on vulnerable groups as early in the review process as possible. This will allow more time to further explore these impacts with stakeholders, within the timeframe of the review that has been set out.

The Department has responded to questions from stakeholders about the deadline by saying ‘we recognise that the end of January deadline may not be possible for all organisations due to the issues you have raised. As we previously stated, we are therefore willing to be flexible on this deadline, so while we would appreciate organisations submitting their responses as soon as possible, we will of course still consider the information in responses that are submitted after that.’ The Department has made it clear that evidence submitted within a timeframe that allows it to be taken into account as part of the review will be considered.

The Department has also committed to continue to work with stakeholders to monitor the effects of the charging regulations on vulnerable groups after the review process has concluded. Therefore, if new evidence concerning the impact of the impact of the 2017 Amendments is presented to the Department, after the time at which it can be considered as part of the review process, it will be considered in accordance with the Secretary of State’s ongoing duties.

The Department does not see any reason to change the position, outlined above, which has already been communicated to stakeholders.

The Department has undertaken a review of the 2017 Amendments in line with continuing public sector equalities duty, and also in response to concerns that have been raised by stakeholders. The National Health Service (Charges to Overseas Visitors) (Amendment) Regulations 2015 were minor amendments in respect of errors identified by the Joint Committee on Statutory Instruments. Given that there have not been recent concerns raised by stakeholders about these amendment regulations the Department does not feel it necessary to review them.

The Department has no plans to include a public consultation as part of the review of ‘The National Health Service (Charges to Overseas Visitors) (Amendment) Regulations 2017’ (the 2017 Amendments). The Department ran a consultation ‘Making a fair contribution: consultation on the extension of charging overseas visitors in and migrants for using the NHS in England’ in early 2016. This covered many of the areas included in the 2017 Amendments. The Government published its response in February 2017.

The Department initially sent a list of review questions on 22 December 2017 to several organisations with a deadline of 31 January 2018 for the submission of evidence to be returned.

The Department does fully recognise the need to ensure that sufficient time is provided for both evidence collection and analysis. The end of January deadline was chosen so that the Department could seek to identify the main impacts of the amendment regulations on vulnerable groups as early in the review process as possible. This will allow more time to further explore these impacts with stakeholders, within the timeframe of the review that has been set out.

The Department has responded to questions from stakeholders about the deadline by saying ‘we recognise that the end of January deadline may not be possible for all organisations due to the issues you have raised. As we previously stated, we are therefore willing to be flexible on this deadline, so while we would appreciate organisations submitting their responses as soon as possible, we will of course still consider the information in responses that are submitted after that.’ The Department has made it clear that evidence submitted within a timeframe that allows it to be taken into account as part of the review will be considered.

The Department has also committed to continue to work with stakeholders to monitor the effects of the charging regulations on vulnerable groups after the review process has concluded. Therefore, if new evidence concerning the impact of the impact of the 2017 Amendments is presented to the Department, after the time at which it can be considered as part of the review process, it will be considered in accordance with the Secretary of State’s ongoing duties.

The Department does not see any reason to change the position, outlined above, which has already been communicated to stakeholders.

The Department has undertaken a review of the 2017 Amendments in line with continuing public sector equalities duty, and also in response to concerns that have been raised by stakeholders. The National Health Service (Charges to Overseas Visitors) (Amendment) Regulations 2015 were minor amendments in respect of errors identified by the Joint Committee on Statutory Instruments. Given that there have not been recent concerns raised by stakeholders about these amendment regulations the Department does not feel it necessary to review them.

The Department has no plans to include a public consultation as part of the review of ‘The National Health Service (Charges to Overseas Visitors) (Amendment) Regulations 2017’ (the 2017 Amendments). The Department ran a consultation ‘Making a fair contribution: consultation on the extension of charging overseas visitors in and migrants for using the NHS in England’ in early 2016. This covered many of the areas included in the 2017 Amendments. The Government published its response in February 2017.

The Department initially sent a list of review questions on 22 December 2017 to several organisations with a deadline of 31 January 2018 for the submission of evidence to be returned.

The Department does fully recognise the need to ensure that sufficient time is provided for both evidence collection and analysis. The end of January deadline was chosen so that the Department could seek to identify the main impacts of the amendment regulations on vulnerable groups as early in the review process as possible. This will allow more time to further explore these impacts with stakeholders, within the timeframe of the review that has been set out.

The Department has responded to questions from stakeholders about the deadline by saying ‘we recognise that the end of January deadline may not be possible for all organisations due to the issues you have raised. As we previously stated, we are therefore willing to be flexible on this deadline, so while we would appreciate organisations submitting their responses as soon as possible, we will of course still consider the information in responses that are submitted after that.’ The Department has made it clear that evidence submitted within a timeframe that allows it to be taken into account as part of the review will be considered.

The Department has also committed to continue to work with stakeholders to monitor the effects of the charging regulations on vulnerable groups after the review process has concluded. Therefore, if new evidence concerning the impact of the impact of the 2017 Amendments is presented to the Department, after the time at which it can be considered as part of the review process, it will be considered in accordance with the Secretary of State’s ongoing duties.

The Department does not see any reason to change the position, outlined above, which has already been communicated to stakeholders.

The Department has undertaken a review of the 2017 Amendments in line with continuing public sector equalities duty, and also in response to concerns that have been raised by stakeholders. The National Health Service (Charges to Overseas Visitors) (Amendment) Regulations 2015 were minor amendments in respect of errors identified by the Joint Committee on Statutory Instruments. Given that there have not been recent concerns raised by stakeholders about these amendment regulations the Department does not feel it necessary to review them.