Overseas patients

To be entitled to free NHS-funded hospital and community care, you need to be “ordinarily resident” in the United Kingdom. This means you must be legally resident in the United Kingdom. Nationals of countries outside the European Economic Area (EEA) must also have indefinite leave to remain in the UK in order to be “ordinarily resident” here.

An overseas visitor is defined in the Department of Health Overseas Charging Regulations as any person who is not “ordinary resident” in the UK.  This may therefore include British nationals who now live overseas (ex-pats) who may therefore not be entitled to free NHS hospital care.

NHS trusts have a legal obligation to identify patients who are not entitled to free NHS treatment and to make and recover charges for the NHS services provided.  

These obligations are set out in the guidance published by the Department of Health.

To establish your eligibility we may ask you questions about your residential status. You should be prepared to provide evidence if requested. Evidence may include proof of identity and a proof of address dated in the last three months.

Provision of treatment to overseas visitors in A&E

Treatment received in our Emergency Department (A&E) is free.  If you are admitted to hospital as an inpatient or receive any outpatient appointments charges will apply. 

  • For those overseas citizens in possession of a valid European Health Insurance Card (EHIC) please present your card to our A&E reception staff.     
  • If your country of residence has a reciprocal agreement covering your emergency treatment in the UK please advise our A&E reception staff.

In these instances, we will re-coup the cost of your care from your country of residence.

Payment in advance for treatment

National guidance states that for treatment assessed by a clinician as non-urgent the full estimated cost of treatment must be paid before treatment is provided.  This will include the cost of initial assessment and investigations to make a diagnosis.

We will always provide treatment that a clinician has assessed as immediately necessary or urgent.  All maternity treatment is regarded as immediately necessary.  Treatment is not free however by virtue of it being immediately necessary or urgent and you will still be charged.

There are some NHS services which are free to everyone.  Please see pages 30 and 31 of the Overseas Visitor Charging Regulations.  EEA citizens with an EHIC card should present their card to reception staff.  

Overseas visitors with private health insurance

If you have private health insurance you must provide a letter of guarantee from your insurer to cover the full cost of your treatment.  If you are unable to provide a letter of guarantee you will need to cover the costs of your treatment and seek reimbursement from your insurer.

Contact details

Please contact the Overseas Visitors Department for further guidance and support or to book an appointment to provide your documentation.  

Our offices are open Monday to Friday 9am-5pm except bank holidays.


Tel: 0121 333 8319