FOI230211: Up-front healthcare treatment charges for overseas patients

Released 18 July 2023

Request:

Initial request FOI230158:

This request has eight questions. In this request, “NHS healthcare treatment” specifically excludes private patients seeking to use paid-for private services offered by the Trust. It includes non-urgent follow-ups to urgent healthcare treatment.

1. Does the Trust impose upfront charges for non-urgent NHS healthcare treatment to overseas visitors, migrants and former UK residents who are ineligible for free healthcare under government guidelines? If not, please explain why, in the context of those guidelines.

If the answer to question 1 is ‘no’, the Trust need not provide responses to questions 2-8.

2. The number of overseas visitors, migrants and former UK residents who were charged upfront for NHS healthcare treatment by the Trust since January 2021 – please note this includes patients who did not subsequently proceed with the treatment

If the answer to question 2 is ‘zero’, the Trust need not provide responses to questions 3-8.

3. The total costs charged for the treatments referred to in question 2 (including where the patient did not proceed with the treatment)

4. The number of overseas visitors, migrants and former UK residents who did not proceed with NHS healthcare treatment by the Trust after being quoted an upfront charge (timeframe is since January 2021)

Notes to question 4:

Sending an invoice to a patient for an upfront charge counts as quoting an upfront charge

Patients who did not proceed with treatment include those who declined treatment and those who simply did not attend scheduled treatment, as well as any patients who were refused treatment by the Trust.

5. Of the number of patients provided in response to question 4, please state how many did not attend scheduled treatment/appointment (rather than cancelling in advance).

Note to question 5:

If the Trust does not record information in a manner that would enable question 5 to be answered within the section 12 cost limit, please state that the information is ‘not held’ for this question and process the remainder of this request.

If the Trust has not provided information for question 5, or has responded with ‘zero’, please proceed to question 7.

6. What was the financial loss to the Trust caused by the missed scheduled treatment/appointments referred to in response to question 5?

Note to question 6:

If the Trust does not record information in a manner that would enable question 6 to be answered within the section 12 cost limit, please state that the information is ‘not held’ for this question and process the remainder of this request.

7. Any data the Trust holds on the reasons for the refusal/inability of the patients referred in response to question 4 to pay the imposed upfront charges (such as preference to return home for treatment, or inability to meet the cost of treatment)

8. Any data the Trust holds on the conditions the patients referred to in response to question 4 wished to be treated for (this may be provided as categories of healthcare, such as ENT and nephrology), or alternatively the treatments that were subject to the imposed charges (these may be grouped into overarching categories for data protection reasons)

Assistance provided under Section 16 on 19 June 2023:

University Hospitals Sussex NHS Foundation Trust has only been in operation since 1 April 2021, following the merger of Brighton and Sussex University Hospitals NHS Trust and Western Sussex Hospitals NHS Foundation Trust.

On the basis that you are seeking information for from January 2021, can you please confirm if you would be happy to accept data only for the new Trust only from April 2021? 

Should you require the information for the legacy Trusts and University Hospitals Sussex NHS Foundation Trust, we will have to report by financial year (or part there-of) due to the date of the merger, and not by calendar year as you have requested.

Can you please confirm this is acceptable? Information about the Trust’s hospitals can be found on our website

Please note whilst we are in the process of aligning services under the merged Trust, the overseas patients units of the legacy Trusts continue to function separately to ensure there is no disruption to these services. As a result we are unable to provide consistent responses across the whole Trust for your questions.

Please can you confirm you are happy for us to split our response to represent the relevant hospitals under the legacy Trusts?

Response received 19 June 2023:

April 2021 is fine.

In line with the section 45 FOI Code of Practice, the revised request was allocated new reference number FOI220211 and the statutory deadline reset.

Information disclosed:

1. Yes, we do impose upfront charges for non-urgent NHS healthcare treatment to overseas visitors, migrants and former UK residents who are ineligible for free healthcare under government guidelines.

2. Please see the table below for information relevant to this part of your request:

3. Please see the table below for information relevant to this part of your request:

4. 0 (nil)

5. 0 (nil)

6. Not applicable, no scheduled treatments or appointments were missed.

7. Not applicable

8. Not applicable