As part of the 2017/18 contract negotiations we have agreed with NHS Employers contractual changes that will help to identify patients with a non-UK issued EHIC (European Health Insurance Card) or S1 form or who may be subject to the NHS (Charges to Overseas Visitors) Regulations 2015.
This will allow the NHS to recover costs from the patient’s country of origin for any care provided which comes under the NHS (Charges to Overseas Visitors) Regulations 2015. This currently applies only to secondary care provision. Practices should note that this does not affect the entitlement of such patients to register with a GP.
Download guidance and sample forms
What practices will need to do
From October practices are required to provide patients with a supplementary question form as part of the registration process. This is included as part of a revised GMS1, or can be provided separately if the practice uses its own registration forms. This will allow patients to self-declare if they hold either a non-UK issued EHIC or a S1 (formerly E106), and provide the relevant details. The practice will not be required to follow up with the patient if they do not fill in these details.
For patients that do provide these details practices will be required to record that the patient holds either a non-UK issued EHIC or a S1 form in the patient’s medical record and then send a copy of the GMS1 and supplementary questions to:
NHS Digital at [email protected]
The DWP Overseas Healthcare Team at [email protected]
Where a patient presents an S1 form practices should also send a copy of this to the DWP Overseas Healthcare Team at the same address to allow it to be registered.
All other aspects of the registration process remain unchanged and practices should have received copies of leaflets to provide to patients to explain the process.
Further guidance, including detail on NHS Digitals recommended processes, can be access via NHS Employers.
Information relating to overseas visitors
(1) A contractor must—
(a) record the information specified in paragraph relating to overseas visitors, where that information has been provided to it by a newly registered patient on a form supplied to the contractor by the Board for this purpose; and
(b) where applicable in the case of a patient, record the fact that the patient is the holder of a European Health Insurance Card or S1 Healthcare Certificate(e) which has not been issued to or in respect of the patient by the United Kingdom, in the medical record that the contractor is required to keep under regulation 67 in respect of the patient.
(2) The information specified in this paragraph is—
(a) in the case of a patient who holds a European Health Insurance Card which has not been issued to the patient by the United Kingdom, the information contained on that card in respect of the patient; and
(c) in the case of a patient who holds a Provisional Replacement Certificate(f) issued in respect of the patient’s European Health Insurance Card, the information contained on that certificate in respect of the patient.
(3) The information referred to in paragraph (2) must be submitted by the contractor to NHS Digital—
(a) electronically at [email protected]; or
(b) by post in hard copy form to EHIC, PDS NBO, NHS Digital, Smedley Hydro, Trafalgar Road, Southport, Merseyside, PR8 2HH.
(4) Where the patient is the holder of an S1 Healthcare Certificate, the contractor must send that certificate, or a copy of that certificate, to the Department for Work and Pensions—
(a) electronically to [email protected]; or
(b) by post in hard copy form to the Overseas Healthcare Team, Durham House, Washington, Tyne and Wear, NE38 7SF.
Can practices continue to use their bespoke forms?
If using their own registration forms, practices can meet the requirement by providing the supplementary questions alongside the pre-exisitng form.
The registration form and the supplementary questions should be emailed as a single black and white attachment per patient, not exceeding 5mb in size.
Where do I send the forms?
Forms can be sent either via email or post to the following addresses:
Email: [email protected]
Post: EHIC, PDS NBO, NHS Digital, Smedley Hydro, Trafalgar Road, Southport, Merseyside, PR8 2HH
Email: [email protected]
Post: Overseas Healthcare Team, Durham House, Washington, Tyne and Wear, NE38 7SF
The patient does not have their S1 form. Do I need to follow this up?
If the patient does not have their S1 form they can be registered in the normal way and there is no requirement for the practice to chase this up. The obligation is on the patient to ensure that their form is registered.
Can GP practices return the forms in batches?
Should a GP practice receive very high volumes of returns, for example, a university GP practice, then forms can be returned in batches.
It is recommended that each patient has only one attachment, and that the total batch of attachements does not exceed 20mb.
Do temporary overseas patients need to complete the GMS1 supplementary questions?
No, the GMS1 form should only be used to register permanent patients. GP practices should continue to use the GMS3 form for temporary patients.
If they have a non-UK EHIC and need to seek secondary care, they should present their EHIC at that point in time.
Do I need to check the patient's ID or immigration status?
The process is based on self-declaration and the practice does not need to check a patient’s identification. Practice staff are unlikely to be qualified to do this and should not attempt to interpret a patient’s immigration status.
What happens if a patient doesn't fill in their EHIC/S1 details?
If the patient does not fill out the additional section for the EHIC/S1 details then the practice should register them as normal. There is no requirement for the practice to follow this up with the patient.
Will this affect the funding that I receive for these patients?
Patients providing these details will be registered with the practice as normal and will not be treated any differently for the purposes of service provision or funding in the practice.