UK Healthcare for Migrants 2026: Access & Rights

Foreign nationals coming to the UK will need to understand their rights to access healthcare services, but dealing with a new healthcare system can be challenging. UK immigration status can affect whether a person is treated as an “overseas visitor” for NHS charging purposes and employers and applicants should also be aware of the compliance framework overseen by UKVI and how it interacts with wider UK immigration law.

The National Health Service (NHS) is the UK’s public healthcare system. Established in 1948, the NHS is funded primarily through taxation and provides a wide range of healthcare services that are largely free at the point of use for people who are ordinarily resident in the UK. This includes general practitioner (GP) services, hospital care, dental treatment, and mental health services. The system is widely recognised for universal coverage and accessibility, supporting access to medically necessary care regardless of an individual’s ability to pay.

While some foreign nationals will be entitled to access NHS services by virtue of having paid the Immigration Health Surcharge (IHS) as part of a UK visa application, others may be chargeable for certain types of NHS care under the overseas visitor charging rules. Paying the IHS generally allows access to NHS services on a broadly similar basis to an ordinarily resident person, but it does not remove standard patient charges such as prescription charges in England, NHS dental charges and optical costs where these apply.

In this guide, we explain the rules for foreign nationals accessing health services in the United Kingdom, including how the IHS works, what services may still attract charges, what visitors can expect (including those in the Standard Visitor route and other UK Visitor visa categories), and the practical steps individuals can take to access care lawfully and safely.

Section A: Immigration Health Surcharge

The Immigration Health Surcharge (IHS) is a fee imposed on most foreign nationals applying for permission to stay in the UK for more than six months. It is paid as part of the UK visa application process and is designed to ensure that migrants contribute towards the cost of NHS services during their period of immigration permission.

In broad terms, paying the IHS means the person can access NHS services on a similar basis to someone who is ordinarily resident in the UK, for the period covered by their immigration permission. However, the IHS does not make all NHS healthcare “free”. Standard patient charges can still apply, including (for example) prescription charges in England, NHS dental charges and optical costs, unless the individual qualifies for an exemption within the relevant NHS regime. The IHS also does not remove the NHS’s separate charging framework for overseas visitors if a person falls outside the scope of IHS cover or becomes chargeable under the overseas visitor charging rules.

Employers and individuals should treat the IHS as one part of wider compliance planning under UK immigration law. Where immigration status changes, permission expires, or a person moves between categories, healthcare charging and entitlement can become fact-specific. For this reason, it is often sensible to keep a clear record of immigration permission dates and any IHS payment confirmation as part of the worker’s compliance file.

If you need fuller detail on how the surcharge works, when it applies, how it is calculated and how it interacts with specific visa routes, see our guide to the Immigration Health Surcharge.

1. How much is the Immigration Health Surcharge?

The IHS is paid upfront, usually at the same time as the visa application is submitted. The amount depends on the length of immigration permission being applied for and is calculated on a per-year basis, with part-years typically charged as a proportion of the annual rate in line with the Home Office calculation method.

As of 2024, the standard IHS rate is £1,035 per year, with a discounted rate of £776 per year for students, those on Youth Mobility Scheme visas, and children under 18. Because the IHS is paid in addition to the underlying application fee, it can materially affect overall budgeting for a move to the UK. For broader cost planning, applicants may also want to cross-check the relevant UK visa fees and, where timing is critical, expected visa processing times.

Where organisations are recruiting overseas nationals, it is also good practice to factor IHS costs into relocation discussions. Even where the employer agrees to reimburse a worker, the IHS is still paid by the applicant through the Home Office system at the point of application, and reimbursement should be documented carefully to avoid later disputes about deductions or repayment provisions.

2. Who pays the IHS?

Not everyone needs to pay the IHS. In many cases, the surcharge applies to most migrants seeking permission to stay in the UK for more than six months, including workers, students, and family members of visa holders. However, there are important exemptions and special rules.

Examples of people who may be exempt from paying the IHS include certain vulnerable groups and people in specific immigration situations, such as some asylum-related cohorts. Where an individual is claiming asylum or has protection-based status, entitlements and charging exemptions can depend on the person’s status and support arrangements. If your content is being read by individuals in or connected to protection routes, it may be helpful to signpost to our guidance on asylum in the UK and refugee status, noting that healthcare charging for asylum seekers and refugees operates under distinct rules from mainstream work and study routes.

In addition, applicants under certain visa routes are exempt from the IHS. A key example is the Health and Care Worker visa. Applicants under this route are generally exempt from paying the IHS, but this does not automatically extend to all connected family members. In practice, dependants may still need to pay the IHS unless they qualify for their own exemption. For employers budgeting for healthcare-related recruitment and sponsorship, it can therefore be important to understand both route eligibility and the associated cost position, including the broader fee landscape addressed in our guide to Health and Care visa fees.

Because eligibility for exemption can be fact-specific, individuals should avoid assuming that vulnerability alone removes IHS liability. Where a person is unsure, the safest approach is to confirm the position before submission, particularly where the visa route or length of permission is close to the six-month threshold or where there are multiple applicants in one family unit.

3. Benefits of paying the IHS

Once the IHS is paid (where applicable), the migrant can generally access NHS services during their period of permission on broadly the same basis as a person who is ordinarily resident. This typically includes access to GP services, hospital treatment and maternity care within the NHS system, subject to the normal NHS operational rules, clinical commissioning decisions and eligibility parameters that can apply to all patients.

However, it is important to be clear about what the IHS does and does not cover. Paying the IHS does not remove standard NHS patient charges where these apply, such as prescription charges in England, NHS dental charges and optical costs. Nor does it guarantee immediate access to particular treatments where waiting lists, local referral pathways, or commissioning restrictions apply. The key benefit is that the individual is not generally treated as an overseas visitor for most NHS services during the covered period, meaning they are less likely to face chargeable secondary care costs that can apply to short-term visitors or those without IHS coverage.

From a practical perspective, access to NHS healthcare can reduce reliance on private medical insurance for core care needs, although some migrants still choose private cover for faster access, broader choice, or specific services not readily available through NHS pathways. The overall risk reduction point is that IHS payment can help avoid unexpected, high-value hospital invoices where treatment would otherwise be chargeable under the overseas visitor charging framework.

In some circumstances, an applicant may be entitled to a refund of the IHS, depending on their immigration outcome and the Home Office rules on refund eligibility. Where refunds may be relevant, see our guidance on IHS refund.

Section B: Eligibility to Access NHS Services

Eligibility to access NHS services is not determined solely by whether a person has paid the Immigration Health Surcharge. The legal framework is set out in the National Health Service (Charges to Overseas Visitors) Regulations 2015 (as amended), which distinguish between individuals who are “ordinarily resident” in the UK and those who are treated as “overseas visitors” for charging purposes.

A person is ordinarily resident if they are lawfully living in the UK, for settled purposes, as part of the regular order of their life, for the time being. Many migrants with valid leave to remain and who have paid the IHS will fall within this framework for the duration of their permission. By contrast, short-term visitors, including those in the Standard Visitor route or travelling under a business visitor visa, are generally treated as overseas visitors and may be chargeable for certain types of secondary care.

It is also important to distinguish between primary care and secondary care. GP services are generally free of charge to all patients, regardless of immigration status, whereas hospital treatment is subject to the overseas visitor charging rules unless an exemption applies. Employers sponsoring overseas workers and individuals relocating to the UK should therefore understand both their immigration category and how NHS charging rules interact with that status.

1. NHS services and what is generally covered

For those who are ordinarily resident or covered by IHS, the NHS provides a wide range of services. These typically include:

• General Practitioner (GP) services: Primary care, routine consultations, management of chronic conditions, and referrals to specialist services where clinically appropriate.
• Hospital care: Inpatient and outpatient services, including surgery, investigations, and specialist consultations.
• Emergency services: Access to Accident & Emergency (A&E) departments for urgent and life-threatening conditions.
• Maternity services: Antenatal, intrapartum and postnatal care delivered within NHS pathways.
• Mental health services: Access to primary and secondary mental health services, including talking therapies and specialist support.
• Dental and optical services: NHS dental and eye care services, subject to standard NHS charging rules.

It is important to note that A&E services are free to all patients up to the point of admission, even for those who are otherwise chargeable as overseas visitors. However, if a patient is admitted to hospital or requires follow-up treatment, charging rules may then apply unless an exemption exists.

In addition, certain categories of treatment are exempt from charging regardless of immigration status, including the diagnosis and treatment of specified infectious diseases and treatment required for certain public health reasons. The application of these exemptions can be fact-specific and should not be assumed without checking the relevant regulations or seeking advice.

2. Additional health costs and patient charges

Even where a migrant is not treated as an overseas visitor for charging purposes, standard NHS patient charges may still apply. These charges operate separately from immigration status and are part of the general NHS funding model.

Examples include:

• Prescriptions: In England, prescription charges usually apply unless the patient qualifies for an exemption based on age, income, pregnancy status, or specific medical conditions. Prescription charges differ in Scotland, Wales and Northern Ireland, where prescriptions are currently free.
• Dental treatment: NHS dental care in England is subject to banded charges. Different charging systems apply in other parts of the UK.
• Optical services: Eye tests may be free for certain groups, but glasses and contact lenses are usually paid for by the patient, with vouchers available for eligible individuals.

These charges apply equally to UK citizens and migrants who are ordinarily resident or covered by IHS. Paying the IHS does not remove these standard charges.

By contrast, individuals who are treated as overseas visitors and who are not exempt may be charged at 150% of the NHS tariff for most secondary care services. This can result in substantial hospital bills. Visitors coming to the UK under short-term routes, including the UK Visitor visa, should therefore consider adequate travel or medical insurance, as routine or elective treatment is not generally covered without charge.

Where there is uncertainty about charging status, NHS trusts are required to make reasonable enquiries before issuing invoices, but the onus is often on the patient to provide evidence of immigration status and entitlement. Maintaining clear documentation of visa status and IHS payment can therefore reduce the risk of later disputes about liability for healthcare charges.

3. Special categories and exemptions

Some individuals are exempt from NHS charges even if they have not paid the IHS. This includes certain asylum seekers, recognised refugees and other protection-based categories. The detailed rules can depend on the individual’s current status, whether their claim is ongoing, and whether they are receiving support under relevant statutory schemes.

Recognised refugees are generally treated as ordinarily resident in the UK. Asylum seekers with ongoing claims may also be exempt from charges for secondary care. However, the position can change if an asylum claim is refused and support arrangements alter. For individuals in these categories, understanding the intersection between immigration status and healthcare access is critical, and reference to specialist guidance on asylum in the UK and refugee status may be appropriate.

Other exemptions apply for specific types of treatment, such as care required as a result of torture, female genital mutilation, domestic violence or sexual violence, provided the person has not travelled to the UK for the purpose of seeking that treatment. These exemptions exist to ensure access to essential and safeguarding-related care.

Because healthcare charging operates under its own regulatory framework, separate from immigration enforcement, the assessment of chargeability is made by NHS bodies under the relevant Regulations. Nonetheless, immigration status remains central to that assessment, and any change in status can affect entitlement going forward.

Section C: Registering with a GP

Registering with a General Practitioner (GP) is one of the most important steps for foreign nationals living in the UK. GP services form the foundation of primary care within the NHS and are generally free of charge to all patients, regardless of immigration status. Unlike secondary care, GP registration is not dependent on having paid the Immigration Health Surcharge or being treated as ordinarily resident for charging purposes.

For migrants who have relocated to the UK under a work, study or family route, early GP registration helps ensure continuity of care, access to prescriptions, and appropriate referrals where specialist treatment is required. Even individuals in short-term categories may register with a GP on a temporary basis if they are present in the area and require primary care.

1. How to register with a GP

To register with a GP practice, the usual steps are as follows:

• Identify a GP practice: Use the NHS website to find a practice near your home or place of residence.
• Check whether the practice is accepting new patients: Some practices operate list limits depending on local capacity.
• Complete a registration form: Most practices will ask you to complete a GMS1 registration form, either in person or online.
• Submit the form: Return the completed form to the practice. Some surgeries offer digital registration options.
• Attend a new patient health check (if offered): Many practices invite newly registered patients for a routine health review to record medical history and baseline information.

Importantly, NHS guidance makes clear that lack of documentation should not in itself prevent a person from registering with a GP. Practices may ask for identification or proof of address, but they cannot refuse registration solely because a patient does not have these documents or because of immigration status. GP services are not chargeable in the same way as hospital care under the overseas visitor charging regulations.

2. Documents and evidence

Although documentation is not legally required as a condition of registration, GP practices commonly request certain forms of evidence for administrative purposes. These may include:

• Proof of identity: Such as a passport, national identity card or driving licence.
• Proof of address: For example, a tenancy agreement, recent utility bill or bank statement.
• Immigration documentation: In some cases, practices may ask to see confirmation of visa status, although this is not a mandatory requirement for registration.

Where a person has paid the Immigration Health Surcharge, it is not normally necessary to provide proof of IHS payment to a GP practice. Charging assessments for secondary care are carried out separately by NHS trusts where hospital treatment is required.

If a practice refuses registration and the refusal appears to be linked to documentation issues or immigration status, individuals may raise the matter with NHS England (or the relevant NHS body in Scotland, Wales or Northern Ireland) for clarification.

3. Temporary registration and moving areas

If you are in the UK temporarily but staying in one area for more than 24 hours and less than three months, you may be able to register as a temporary patient with a GP practice. This can be particularly relevant for visitors or short-term workers who develop a health issue while in the UK.

If you move home within the UK, you will usually need to register with a new GP practice in your new area. Your medical records will then be transferred between practices through NHS systems. Keeping your contact details up to date with your GP helps ensure you receive appointment notifications, screening invitations and other routine healthcare communications.

From an immigration compliance perspective, while GP registration itself is not tied to immigration enforcement, individuals should ensure that their immigration permission remains valid throughout their stay. A lapse in permission can affect entitlement to free secondary care under the overseas visitor charging framework, even though primary care access may continue.

Section D: Accessing Specialist Healthcare Services

Accessing specialist services within the UK healthcare system is an important aspect of ensuring comprehensive medical care for migrants. While GP services are generally free and accessible to all, most specialist and hospital-based services fall within secondary care and may be subject to the overseas visitor charging rules unless the individual is ordinarily resident or covered by the Immigration Health Surcharge.

Understanding the referral system, waiting time framework and charging position is essential, particularly for individuals in short-term immigration categories or those whose immigration status is close to expiry.

1. Referral process for specialist care

In most cases, access to NHS specialist care begins with a referral from a General Practitioner (GP). The typical process is as follows:

• Initial GP consultation: You attend a GP appointment to discuss your symptoms or health concern. The GP will assess whether specialist input is clinically necessary.
• Referral: If appropriate, the GP will refer you to a hospital consultant or specialist clinic. This is often done electronically through NHS referral systems.
• Choice of provider: In England, patients are usually entitled to choose from a range of NHS providers for their first outpatient appointment, subject to availability and service type.
• Appointment booking: You will receive confirmation of your appointment by letter, email or through NHS digital systems.
• Specialist consultation: The consultant or specialist team will assess your condition and determine next steps, which may include further tests, treatment or ongoing monitoring.

For individuals who are chargeable under the overseas visitor regulations, NHS trusts are required to assess chargeability before providing non-urgent treatment. In some cases, payment may be required in advance of treatment unless the care is classified as urgent or immediately necessary.

Emergency care and urgent treatment must not be refused on the basis of inability to pay, but charges may still be raised afterwards if the person is not exempt.

2. Types of specialist services available

The NHS offers a broad range of specialist services, including but not limited to:

• Cardiology: Diagnosis and management of heart conditions.
• Dermatology: Treatment of skin disorders.
• Endocrinology: Hormonal and metabolic conditions, including diabetes and thyroid disorders.
• Gastroenterology: Digestive system conditions.
• Neurology: Disorders of the nervous system.
• Oncology: Cancer diagnosis and treatment.
• Orthopaedics: Musculoskeletal and joint conditions.
• Ophthalmology: Specialist eye care.
• Psychiatry: Specialist mental health services.
• Rheumatology: Autoimmune and inflammatory joint disorders.

Eligibility for these services without charge depends on the individual’s charging status at the time treatment is provided. For migrants covered by the IHS, secondary care is generally accessible without separate payment beyond standard NHS charges. For short-term visitors, most elective or routine secondary care will be chargeable.

3. Waiting times and prioritisation

Waiting times for specialist services can vary depending on clinical urgency, local demand and workforce capacity. The NHS operates referral-to-treatment (RTT) standards which aim, in many cases, for patients to begin consultant-led treatment within 18 weeks of GP referral. However, performance against targets can fluctuate depending on service pressures.

Urgent referrals, including suspected cancer pathways, are prioritised and typically follow accelerated timelines. In England, the two-week wait pathway applies to many suspected cancer referrals.

Patients are prioritised based on clinical need. If a person’s condition deteriorates while waiting, they should contact their GP to reassess urgency. Immigration status does not alter clinical prioritisation, but charging status may affect whether elective treatment proceeds where advance payment is required.

For migrants approaching the expiry of their immigration permission, it is important to consider how changes in status may affect ongoing treatment. If leave to remain expires and no extension application is pending, the individual may become chargeable for further non-urgent secondary care under the overseas visitor charging framework.

Section E: Emergency and Urgent Care

Understanding how to access emergency and urgent care in the UK is essential for migrants and short-term visitors alike. The NHS operates a tiered system of emergency, urgent and routine care, and the charging position can vary depending on the type of service provided and the patient’s immigration status.

Crucially, Accident & Emergency (A&E) services are free to all patients up to the point of admission, regardless of immigration status. This means that initial assessment and treatment in A&E will not attract a charge. However, if a patient is admitted to hospital or requires follow-up treatment, the overseas visitor charging rules may apply unless an exemption exists or the individual is covered by the Immigration Health Surcharge.

1. When and how to use emergency services

Emergency services should be used for life-threatening conditions or serious injuries requiring immediate medical attention. Examples include:

• Severe chest pain or suspected heart attack
• Breathing difficulties or severe asthma attack
• Severe bleeding that cannot be stopped
• Head injuries involving loss of consciousness
• Severe allergic reactions (anaphylaxis)
• Suspected stroke
• Severe burns or scalds
• Acute mental health crisis

In these circumstances, individuals should call 999 for an ambulance or attend the nearest A&E department if safe to do so. Emergency treatment must not be refused on the basis of inability to pay. Even where a patient is chargeable as an overseas visitor, care that is classed as urgent or immediately necessary must still be provided.

2. Urgent care centres and NHS 111

Not all health issues require A&E attendance. Urgent care centres, minor injury units and walk-in centres are designed to treat non-life-threatening conditions that still require prompt attention. These may include minor fractures, cuts requiring stitches, infections and moderate illness.

The NHS 111 service provides 24/7 non-emergency medical advice. By calling 111 or using the online service, patients can be directed to the most appropriate local service. NHS 111 can arrange out-of-hours GP appointments, direct patients to urgent treatment centres or provide self-care advice.

Pharmacies also play a significant role in urgent and minor care. Community pharmacists can provide advice, supply over-the-counter medication and, in some cases, provide treatment under locally commissioned NHS services.

3. Charging and exemptions in emergency care

While A&E attendance itself is free, subsequent admission to hospital is not automatically free for overseas visitors. NHS trusts are required to assess whether a patient is chargeable for secondary care under the NHS (Charges to Overseas Visitors) Regulations 2015.

Certain treatments are exempt from charge regardless of immigration status. These include, among others:

• Diagnosis and treatment of specified infectious diseases
• Treatment required as a result of torture, female genital mutilation, domestic violence or sexual violence, where the person has not travelled to the UK for the purpose of seeking that treatment
• Compulsory psychiatric treatment under mental health legislation

In addition, maternity services are classed as immediately necessary treatment and must not be withheld, even where the patient is chargeable. However, charges may still be raised for those not covered by the IHS or another exemption.

For individuals visiting the UK under short-term routes, including the Standard Visitor visa, comprehensive travel or medical insurance is strongly advisable. Secondary care costs can be significant if treatment extends beyond initial A&E assessment.

Section F: Dental and Optical Care

Dental and optical care form an important part of overall health, but they operate under distinct charging structures within the NHS. Migrants who are ordinarily resident or covered by the Immigration Health Surcharge can access NHS dental and optical services on the same basis as UK residents, subject to standard NHS charges and exemptions.

Individuals who are treated as overseas visitors for secondary care purposes should note that routine NHS dental treatment may still be available, but hospital-based dental treatment may fall within the charging framework depending on the circumstances.

1. NHS dental services

Unlike GP services, patients do not formally “register” with an NHS dentist in the same way. Instead, they contact a dental practice that offers NHS treatment and book appointments as required.

In England, NHS dental treatment is subject to three standard charge bands. As of 2024/25, these are:

• Band 1 (£26.80): Examination, diagnosis, advice, X-rays, scale and polish and preventive care.
• Band 2 (£73.50): Includes Band 1 treatment plus additional procedures such as fillings, root canal treatment and extractions.
• Band 3 (£319.10): Covers Bands 1 and 2 treatments plus more complex procedures such as crowns, dentures and bridges.

Charging structures differ in Scotland, Wales and Northern Ireland, so patients should check the position in the relevant jurisdiction.

Certain groups are exempt from NHS dental charges, including children under 18 (or under 19 if in full-time education), pregnant women and those who have had a baby in the last 12 months, and individuals receiving qualifying benefits. These exemptions apply regardless of nationality, provided the person meets the eligibility criteria.

Availability of NHS dental appointments can be limited in some areas. Where NHS provision is unavailable or waiting times are significant, patients may choose to seek private treatment, which is not subject to NHS pricing controls.

2. Optical services and eye care

Regular eye examinations are important for detecting vision problems and wider health conditions such as glaucoma or diabetic retinopathy. NHS-funded eye tests are available free of charge to certain groups, including:

• Children under 16 (or under 19 if in full-time education)
• People aged 60 or over
• Individuals with specific medical conditions, such as diabetes or glaucoma
• Those receiving qualifying benefits

Where a patient qualifies for an NHS-funded eye test, they may also be entitled to an optical voucher to help towards the cost of glasses or contact lenses. The value of the voucher depends on the strength of the prescription.

Most opticians provide both NHS and private services. Patients can choose between NHS-funded care, where eligible, and private options offering a broader range of frames, lenses or additional services.

3. NHS versus private provision

The choice between NHS and private dental or optical care often depends on availability, clinical need and personal preference. NHS services are generally more affordable and operate within nationally set charging bands, focusing on clinically necessary treatment.

Private care may offer shorter waiting times, greater flexibility in appointment scheduling and access to cosmetic or specialist treatments not routinely available under NHS funding. However, costs can vary significantly between providers.

For migrants budgeting for life in the UK, it is important to understand that paying the Immigration Health Surcharge does not eliminate dental or optical charges. These operate under separate NHS charging rules and apply to UK citizens and migrants alike, subject to exemptions.

Section G: Mental Health Services

Mental health support is a core component of NHS provision across the UK. Migrants who are ordinarily resident or covered by the Immigration Health Surcharge can access NHS mental health services on broadly the same basis as UK residents, subject to clinical assessment and local service capacity.

Mental health services span primary care, community-based services and specialist inpatient treatment. As with other secondary care services, overseas visitor charging rules may apply to hospital-based treatment unless the individual is exempt or covered by the IHS. However, urgent and immediately necessary mental health treatment must not be withheld because of charging status.

1. Types of mental health services available

The NHS provides a range of mental health services, including:

• Primary care support: GPs can assess symptoms, prescribe medication and refer patients to specialist services.
• Talking therapies: In England, the Improving Access to Psychological Therapies (IAPT) programme, now known as NHS Talking Therapies, provides structured psychological therapies such as cognitive behavioural therapy (CBT). In many cases, patients can self-refer.
• Community Mental Health Teams (CMHTs): Multidisciplinary teams providing ongoing support for individuals with more complex or severe conditions.
• Crisis services: Crisis resolution and home treatment teams offering urgent support to help prevent hospital admission.
• Inpatient services: Hospital-based care for individuals requiring intensive support.
• Specialist services: Including Child and Adolescent Mental Health Services (CAMHS), perinatal mental health services and substance misuse support.

Access pathways and service structures differ slightly between England, Scotland, Wales and Northern Ireland, but the overall framework of GP referral and tiered specialist care is consistent.

2. Access routes and referrals

In most cases, the first step in accessing mental health support is through a GP appointment. The GP will assess the patient’s needs and determine whether referral to specialist services is required. For certain services, particularly talking therapies in England, self-referral is possible without first seeing a GP.

In a mental health emergency, individuals should attend A&E, contact emergency services via 999, or seek immediate support through NHS crisis lines. Crisis care is treated as urgent or immediately necessary treatment and must not be refused on charging grounds.

Charitable organisations such as Mind and other voluntary sector providers also offer helplines and support services. These operate independently of immigration status and can provide guidance, advocacy and signposting.

3. Confidentiality, data protection and patient rights

Confidentiality is a fundamental principle of NHS care. Information about a patient’s mental health is treated as confidential and will not normally be shared without consent, except in limited circumstances such as where there is a serious risk of harm to the individual or others, or where disclosure is required by law.

Personal data is protected under the Data Protection Act 2018 and the UK GDPR. Patients have the right to access their medical records, request corrections where information is inaccurate and understand how their data is processed.

Patients also have the right to be informed about proposed treatments and to give or withhold consent. Healthcare professionals must explain the risks, benefits and alternatives to treatment in a way that the patient can understand.

If a patient is dissatisfied with their care, they can use the NHS complaints procedure. Independent advocacy services may also be available to support patients in understanding their rights and raising concerns appropriately.

Section H: Maternity and Child Healthcare

Maternity services in the UK are designed to provide comprehensive care throughout pregnancy, childbirth and the postnatal period. For migrants who are ordinarily resident or covered by the Immigration Health Surcharge, maternity care is accessible within standard NHS pathways, subject to routine patient charges where applicable.

It is important to understand that maternity services are classified as immediately necessary treatment under the NHS overseas visitor charging framework. This means that care must not be refused or delayed because of inability to pay. However, where a person is not covered by the IHS or another exemption and is treated as an overseas visitor, charges may still be raised for maternity care after treatment is provided.

1. Antenatal and postnatal care

Once pregnancy is confirmed, the usual first step is to book an appointment with a midwife or GP. This typically occurs between 8 and 12 weeks of pregnancy. Regular antenatal appointments are then scheduled to monitor the health of both mother and baby. These may include blood tests, urine tests, blood pressure checks and ultrasound scans.

Two primary ultrasound scans are generally offered:

• A dating scan at around 12 weeks to estimate the due date.
• An anomaly scan at around 20 weeks to assess fetal development.

Most births take place in hospital settings, although midwifery-led units and home births may be options for low-risk pregnancies where clinically appropriate. Following birth, postnatal care is provided either in hospital or at home, with follow-up visits from midwives and, subsequently, health visitors.

For individuals not covered by the IHS and not otherwise exempt, NHS trusts may seek to recover the cost of maternity services. However, treatment cannot lawfully be withheld because of charging status.

2. Child healthcare and immunisations

The NHS provides a structured programme of healthcare and developmental checks for children. These include:

• Newborn physical examination within 72 hours of birth.
• Newborn hearing screening.
• Six to eight week GP check.
• Health visitor developmental reviews at key milestones.
• Routine childhood immunisation schedule.

Childhood vaccinations protect against conditions such as diphtheria, tetanus, polio, measles, mumps and rubella. These immunisations are provided through NHS primary care services.

NHS dental services are free for children under 18, or under 19 if in full-time education, subject to the relevant national rules. GP services for children are also generally free of charge, regardless of immigration status.

As with adult care, hospital-based treatment for children may be subject to overseas visitor charging rules if the child is not ordinarily resident and not covered by the IHS or another exemption. Parents should therefore ensure immigration status is kept under review, particularly where leave to remain is time-limited.

3. Charging risks and immigration status changes

Healthcare entitlement is closely linked to immigration status. Where a migrant’s leave to remain expires and no valid extension application is pending, their charging status may change. This can affect entitlement to free secondary care, including ongoing maternity or specialist treatment.

Individuals should therefore ensure that immigration applications are submitted in good time before expiry of leave. Where immigration status is complex or uncertain, specialist advice may be appropriate, particularly where there are ongoing healthcare needs.

Although NHS bodies operate under their own statutory charging regime, immigration status remains central to determining whether a patient is treated as ordinarily resident or as an overseas visitor for secondary care purposes.

Section I: Common Challenges Accessing Healthcare in the UK

Migrants in the UK may face practical and systemic challenges when accessing healthcare services. These can include language barriers, uncertainty about charging rules, difficulty understanding entitlements, and anxiety about how immigration status may affect access to treatment.

While the NHS operates separately from immigration enforcement, misunderstandings about data sharing and charging can deter individuals from seeking care. Understanding how the system works, and what safeguards exist, is therefore critical.

1. Overcoming language barriers

Language barriers are one of the most common obstacles for migrants accessing healthcare. Limited English proficiency can make it difficult to describe symptoms, understand diagnoses, or follow treatment instructions.

The NHS provides interpreting services in most clinical settings. These may include:

• Face-to-face interpreters
• Telephone interpreting services
• Video interpretation in some settings

Patients can request an interpreter when booking an appointment or upon arrival at a healthcare facility. Professional interpreters are generally preferred over family members to ensure accuracy, confidentiality and safeguarding.

Many NHS information resources are also available in multiple languages. Healthcare providers are expected to take reasonable steps to ensure patients can understand information relevant to their care.

2. Understanding healthcare charging and immigration status

A common concern for migrants is whether seeking healthcare could affect their immigration status. NHS charging assessments are conducted under separate legislation from immigration enforcement, primarily through the NHS (Charges to Overseas Visitors) Regulations 2015.

Most primary care services, including GP consultations, are free of charge regardless of immigration status. Secondary care may be chargeable unless the individual is ordinarily resident, covered by the Immigration Health Surcharge or exempt under specific provisions.

Outstanding NHS debt over a certain threshold and duration can, in some cases, be considered in future immigration applications. This means it is important not to ignore hospital invoices where they are lawfully raised. Where charges are disputed, individuals should engage with the NHS trust promptly to clarify their charging status.

3. Knowing where to seek help and advice

Access to reliable information can significantly reduce confusion and anxiety. Key sources of support include:

• The NHS website, which provides information on services, rights and local providers.
• NHS 111 for non-emergency medical advice.
• Community organisations supporting migrants and refugees.
• Charities such as Citizens Advice and Mind.

For individuals whose healthcare concerns intersect with immigration issues, it may also be appropriate to seek specialist immigration advice to ensure visa status remains valid and to understand how any NHS debt or charging issues could affect future applications.

Being proactive, keeping documentation organised and seeking clarification early can prevent many of the common problems migrants encounter when navigating the UK healthcare system.

Section J: Summary

Access to healthcare in the UK depends on a combination of immigration status and NHS charging regulations. Paying the Immigration Health Surcharge generally allows migrants to access NHS services on a similar basis to someone who is ordinarily resident, but it does not remove standard NHS patient charges such as prescription or dental costs.

GP services are typically free to all, regardless of immigration status. Secondary care, including hospital treatment, may be chargeable unless the individual is covered by the IHS or another exemption under the overseas visitor charging framework.

Emergency care must not be refused on the basis of inability to pay, and certain treatments are exempt from charge regardless of immigration status. However, NHS debt can in some circumstances have immigration consequences, so it is important to address invoices or disputes promptly.

Foreign nationals relocating to or visiting the UK should understand their visa category, the implications of the Immigration Health Surcharge, and the difference between primary and secondary care charging. Taking early steps to register with a GP and keeping immigration permission under review will help ensure uninterrupted access to healthcare.

Section K: FAQs

1. What is the Immigration Health Surcharge and why do I have to pay it?

The Immigration Health Surcharge (IHS) is a fee paid as part of many UK visa applications where permission to stay exceeds six months. It allows migrants to access NHS services during the period of their immigration permission on broadly the same basis as someone who is ordinarily resident in the UK. The IHS does not remove standard NHS patient charges such as prescription charges in England or dental fees.

2. Do visitors to the UK get free NHS treatment?

Visitors, including those travelling under the Standard Visitor visa, are generally treated as overseas visitors for NHS charging purposes. A&E treatment up to the point of admission is free for everyone. However, most secondary care, including hospital admission and elective treatment, is chargeable unless a specific exemption applies.

3. Is GP registration linked to immigration status?

No. GP services are generally free and practices should not refuse registration solely because a person lacks proof of address, identification or specific immigration documentation. Primary care is not subject to the same charging regime as hospital-based secondary care.

4. Are asylum seekers and refugees charged for NHS treatment?

Recognised refugees are generally treated as ordinarily resident in the UK. Asylum seekers with ongoing claims are typically exempt from charges for secondary care. The detailed position can depend on immigration status and support arrangements. See our guidance on asylum in the UK and refugee status for further information.

5. Does paying the IHS mean I never have to pay for NHS treatment?

No. Paying the IHS does not remove standard NHS patient charges such as prescription costs in England, NHS dental charges or optical costs. It also does not override local commissioning decisions or waiting times. It primarily affects whether a person is treated as chargeable for most secondary care under the overseas visitor charging regulations.

6. What happens if I receive an NHS bill?

If you are treated as an overseas visitor and receive hospital treatment, the NHS trust may issue an invoice. It is important to review the invoice carefully and respond promptly. If you believe you are exempt or covered by the IHS, provide evidence of your immigration status. Unpaid NHS debt over a certain threshold and duration may be considered in future immigration applications.

7. Can emergency treatment be refused if I cannot pay?

No. A&E services are free up to the point of admission, and urgent or immediately necessary treatment must not be withheld because of inability to pay. However, charges may still be raised afterwards if the patient is not exempt under the regulations.

8. How do I access mental health support?

Mental health support is usually accessed through a GP referral, although some services such as NHS Talking Therapies allow self-referral. In a crisis, individuals should attend A&E or call 999. Crisis care must not be refused on charging grounds.

9. Are maternity services free?

Maternity services are classified as immediately necessary treatment and must not be refused or delayed because of charging status. However, if a patient is not covered by the IHS or another exemption, NHS trusts may still seek to recover the cost of care.

10. Does NHS debt affect immigration applications?

Outstanding NHS debt above the relevant threshold and meeting the required duration criteria can be taken into account in certain future immigration applications. Individuals should therefore address any invoices promptly and, where appropriate, seek advice to clarify their charging status.

Section L: Glossary

Section M: Useful Resources