FOI240104: Medical treatment for overseas national patients

Released 23 May 2024

Request:

Initial request received on 02 April 2024 (our reference FOI240001):

Please could you provide me with information for each of the financial years 2023/24, 2022/23, 2021/22, 2020/21 and 2019/20 in relation to overseas patients at your trust:

1. How many non UK residents and overseas national patients were treated by your trust?
2. How many of the overseas national patients have unpaid medical bills – and what is the total cost for each of the financial years stated above?
3. For the unpaid medical bills, what types of medical procedures or operations were carried out?
4. How many bills have been written off each financial year in relation to overseas nationals and which countries were the patients from?

Assistance provided to the applicant under section 16 [duty to assist] on 29 April 2024:

Please accept our sincere apologies for coming back to you so late in the processing period, however, in preparing our response it became clear that our information leads interpreted your request in different ways and we are unable to provide some of the information you are seeking. Please note the following comments regarding your application for information:

Firstly, it is important to note that 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.

The legacy Trusts used different administration and reporting systems and therefore data relevant to periods of time prior to the merger will require separate research and validation.

Due to the time and effort required to compile this historical information, the provision of data prior to April 2021 may not be possible within the ‘appropriate limit’ as outlined in the Fees Regulations and section 12 [cost limit] provision of the FOIA may be applicable.

Regarding questions 1-2, can you please confirm you require historical information relevant to the two legacy Trusts prior to the merger in April 2021? This may have an impact on the amount of information we can provide within the ‘appropriate limit’ governed by section 12 provision [cost limit] of the FOIA.

With regard to question 3 and part of question 4, information relevant to the specific ‘medical procedures or operations carried out’ or the ‘countries where the patients were from’ is not held on our financial systems.

Any attempt to compile this data would require cross-referencing our financial data with data held on our patient administration systems and information held only within individual patient records. We estimate this would involve a manual audit relevant to around 1,000 patient records over the period requested.

Due to the time and effort required to provide this information, section 12 [cost limit] provision of the FOIA is applicable.

The total amount of outstanding charges relevant to overseas treatment activity is published each year in our annual reports which are accessible from our website.  Annual reports relevant to the legacy Trusts are also accessible from our website.

Since this information is reasonably accessible via other means, section 21 exemption of the FOIA is applicable.

Reply received from applicant on 01 May 2024:

Thank you for drawing my attention to the cost-limit concerns relating to this particular request.

Would it be possible to answer questions 1 and 2 for 2021/22, 2022/23 and 2023/24 if supplying the legacy trust data prior to 2021 exceeds the cost limit?

Can we drop question 3? And I’ll search the annual report for question 4.

In line with the section 45 FOI Code of Practice, the revised request was allocated a new reference number (our reference FOI240104) and the statutory deadline reset.

Information disclosed:

1. Please refer to the table below for the number of ‘non UK residents and overseas national patients’ that were treated by the Trust over the periods requested.

2. Please refer to the table below for the number of patients indicated in the table provided for question 1, who have unpaid medical bills and the total amount outstanding over the periods requested.

The Trust attempts to recover these funds directly with the patients involved and if unsuccessful the debts are referred to a collection agency.