In England, refused asylum seekers are not necessarily entitled to secondary NHS care free of charge. Their ability to access care depends on:
- whether the care is immediately necessary/urgent or non-urgent
- whether specific exemptions apply
Information on the factors that doctors should consider when making a judgment about the urgency of a patient’s treatment, exempt services and persons who are exempt from charging is available in our guidance on access to healthcare for overseas visitors
Immediately necessary, urgent and non-urgent treatment
Refused asylum seekers must always receive immediately necessary and urgent treatment regardless of their chargeable status or ability to pay. The patient may be billed at a later date.
For non-urgent care, NHS Trusts and some community services are required to charge refused asylum seekers who are not exempt before providing the care.
Making a judgement about the urgency of a patient’s clinical needs is your responsibility as a doctor.
People who are exempt from charging
Refused asylum seekers who are supported by the Home Office are exempt from charges for NHS treatment. Some people may be exempt from charges for other reasons, for example if they have been victims or suspected victims of trafficking or modern slavery.
Refused asylum seekers’ entitlement to NHS care can change during the course of treatment. Patients who become chargeable during a specific course of treatment are able to complete the course free of charge.
It is the role of the Trust, not doctors, to identify these patients and assess their eligibility.
Services exempt from charging
Refused asylum seekers are able to receive some services free of charge regardless of their overall entitlement to NHS care.
This includes treatment in an accident and emergency department, for many communicable diseases and for conditions caused by certain types of violence, such as torture, domestic violence or sexual violence.