The Royal Cornwall Hospital Trust has reclaimed over £200,000 from people who were not entitled to free NHS care.

During the 2012-13 financial year, the overseas team at the Royal Cornwall Hospitals Trust has ensured over £210,000 owed to the NHS by overseas visitors has been reclaimed.

Of this, £136,341 went directly back to RCHT, and the remainder, nearly £76,000, was reclaimed by the NHS from EEA Member states.

There is now more awareness of overseas visitors and the need for their eligibility for free healthcare to be checked.

Kevin Bolt,  from Patient Services, said: “The NHS is not free to everyone and hospital charges apply to some patients and this applies to both inpatient and outpatient settings managed by the hospital. The NHS is funded through taxation and it is in the public interest to reclaim healthcare costs from non-exempt patients.

“In the last year the amounts of money we have reclaimed, either directly billing non-exempt patients or claiming the costs of their treatment through reciprocal arrangements has increased considerably. This is largely because of the work Andria Dawson and the overseas team have been doing within the Trust.”

This work has included attending ward and departmental meetings so that both clinical and non-clinical staff have increased awareness of the Department of Health’s Charging Regulations and the requirement for hospitals to identify and charge non-exempt patients.

By identifying patients early, the team are able to meet with overseas visitors while they are still at the hospital and verify whether an exemption applies to hospital charges and to see documentary evidence that validates their exemption under the NHS regulations.

Mr Bolt said: “The vigilance of the Trust’s staff has made a great deal of difference and we want to thank staff in all departments for the efforts that are being made in identifying overseas visitors. Staff are also more aware that they need to ask if there is an EU Health Insurance Certificate (EHIC) for patients attending hospital who come from the European Economic Area. Those patients with an EHIC are excluded from charges but the costs of their treatment are claimed back from the EU member state, back into the UK Government Treasury through the Department of Health.”

The Paying Patients team deal with two groups of overseas visitors – patients from the EU, and those from non-EU countries.

While the first group are relatively easy to deal with, the second group – non-EU patients – can be more difficult. Andria Dawson, Private Patients and Overseas Visitor Officer, says: “These patients can be more challenging particularly if we aren’t notified when they are in hospital. It often means talking to patients and insurance companies all over the world and the sums involved often aren’t small. It can add up to thousands of pounds. With these patients it is not about exemption certificates but more about whether they have insurance or families who are able to pay or organise payment plans. We have many merchant sailors who fall into this category and most of the shipping agents are very good and actually call us to confirm payment details for patients attending the hospital but not always! It’s always worth giving us a call to check.”

Mr Bolt says often people don’t realise there may be a charge, especially if they are ex-pats. “Ex-pats often think they don’t have to pay and if they are in receipt of a UK pension then that is true but if they are not, they could be liable to NHS charges. UK citizens returning from a period of residency abroad could still be liable for NHS charges under the Department of Health regulations as the test is whether a patient has been ordinarily resident and settled in the UK for the last 12 months.

“The Channel Islands can be particularly confusing. Only Jersey has a reciprocal agreement with the UK for its residents requiring NHS care when visiting the mainland. The other Channel Island states do not have a reciprocal arrangement, so be sure to take holiday insurance when travelling to Guernsey as there is no reciprocal agreement between the mainland and the State for healthcare cover that is free of charge.”