Health Impact assessment (HIA) of the changes to NHS Charging Regulations for migrants in the North East
PHE ePoster Library. Coleman H. Sep 10, 2018; 221255; 122
Dr. Hayley Coleman
Dr. Hayley Coleman
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Abstract
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Abstract Background: In 2013 the Government announced changes to NHS charging regimes for overseas visitors and migrants, with further amendments in autumn 2017. This included the extension of charges to previously exempt migrants; community delivered secondary care; and NHS-funded services provided by non-NHS organisations. The changes will affect vital community and preventative services for migrants, including midwifery and mental health. Aim: To explore the potential effects of changes to NHS charging practices on migrant populations, in the North East. Methods: A rapid desk HIA was conducted, including literature review and workshop with thirteen stakeholders.Results: Stakeholders felt the changes will impact negatively on migrant's quality of life, both directly through poor health, creating barriers and deterrents to service access and utilisation. But, also indirectly through reduced social integration and functionality. Unintended consequences were also highlighted, including over-reliance on A&E and primary care with shifted costs to already pressured services. Increased resource implications and potential public health risk, through communicable disease/infection transmission, were also concerns.Recommendations: Education for organisations and migrant communities is needed with collaborative working. Utilisation of 'advocates' was recommended; alongside sharing of best practice and standardisation across services to support equitable access and service navigation. Robust evaluation and data collection is also required to ensure national feedback and impact assessment. Conclusion: We believe the changes will have negative consequences, widening health and social inequalities for a vulnerable population with complex needs, and contrasting key NHS values. Education and communication with relevant stakeholders is essential to support and mitigate these.
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