A Survey of North East Trusts' Implementation Practices of the 'Visitor and Migrant NHS Cost Recovery Programme'.
PHE ePoster Library. Coleman H. 09/12/17; 186618; 169
Dr. Hayley Coleman
Dr. Hayley Coleman
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Abstract
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Abstract Introduction: Following an update to NHS Charging Regulations within the Immigration Act(2014), the DoH developed a two-year phased 'Visitor and Migrant NHS Cost Recovery Programme'. The aim was to provide clearer guidance and more robust patient-eligibility identification systems. It also placed legal obligation on NHS bodies to make and recover charges for treatment provided to ineligible patients. Medical professionals and migrant charities expressed concern the programme may worsen health inequalities, result in discriminatory practices and miss communicable disease prevention opportunities. Although little research is available, case-studies reported eligible patients being charged, causing stress to an already vulnerable population. Methods: Ten NHS trusts in North East England were surveyed to provide insight into their programme implementation practices. Results: All trusts responded. The results demonstrated wide variation in implementation practices and guidance interpretation. Initial screening was mainly conducted by frontline staff; with specialist teams providing follow-up, although team formation and seniority varies. Multiple trusts utilized DoH screening questions and template documents. Most trusts reported that whilst the guidelines and template documents were useful, the level of resources available to implement the programme were insufficient. There were concerns around programme awareness and staff training was insufficient in many trusts. However, examples of good-practice with community involvement were identified. Conclusions: There is wide variation in programme implementation with insufficient capacity and training provided for frontline staff. Further work to increase awareness and support, sharing good-practice and formal evaluation is required. Consideration of economic implications and research around staff and community perception is also needed.
Abstract Introduction: Following an update to NHS Charging Regulations within the Immigration Act(2014), the DoH developed a two-year phased 'Visitor and Migrant NHS Cost Recovery Programme'. The aim was to provide clearer guidance and more robust patient-eligibility identification systems. It also placed legal obligation on NHS bodies to make and recover charges for treatment provided to ineligible patients. Medical professionals and migrant charities expressed concern the programme may worsen health inequalities, result in discriminatory practices and miss communicable disease prevention opportunities. Although little research is available, case-studies reported eligible patients being charged, causing stress to an already vulnerable population. Methods: Ten NHS trusts in North East England were surveyed to provide insight into their programme implementation practices. Results: All trusts responded. The results demonstrated wide variation in implementation practices and guidance interpretation. Initial screening was mainly conducted by frontline staff; with specialist teams providing follow-up, although team formation and seniority varies. Multiple trusts utilized DoH screening questions and template documents. Most trusts reported that whilst the guidelines and template documents were useful, the level of resources available to implement the programme were insufficient. There were concerns around programme awareness and staff training was insufficient in many trusts. However, examples of good-practice with community involvement were identified. Conclusions: There is wide variation in programme implementation with insufficient capacity and training provided for frontline staff. Further work to increase awareness and support, sharing good-practice and formal evaluation is required. Consideration of economic implications and research around staff and community perception is also needed.
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