The term ‘fraudulent access to the NHS’ refers to when a patient falsely represents themself as entitled to NHS care without charge, fails to disclose they are chargeable, or an NHS staff member who has abused their position to facilitate the fraudulent access.
The financial vulnerability estimate has been improved through a continued collaborative approach with policy holders to maintain a more accurate and up-to-date figure. Furthermore, travel is almost back to pre-pandemic levels as this is the first full financial year in which COVID-19 travel restrictions have not been in placej.
£86.5m
vulnerable from an expenditure of £2 billion
It is likely that patients without exemptions will return to or enter the UK with the specific intent of accessing secondary care without charge, yet permanently reside abroad. It is a realistic possibility for overseas visitors to use a visitor visa and a legitimate NHS number to gain access. Intelligence suggests access to maternity care, chemotherapy treatment, and surgery have been facilitated without charge, sometimes ongoing for over a decade.
An individual falsely representing themself to avoid legacy debts owed to the NHS whilst attempting to incur further charges is a realistic possibility. It is likely patients will use a false address, false documentation, or the identity of another individual who is ordinarily a resident in the UK to avoid charges for secondary care.
It is highly likely that some patients will abuse primary care in the NHS by continuing to receive repeat prescriptions whilst permanently residing abroad. Primary care is free at the point of delivery, including for overseas visitors, however it is possible for an organised approach to be taken to collect prescriptions on behalf of people who have left the UK.
Information reports received for Fraudulent access to NHS care from overseas visitors
The change in the number of fraud reports received in relation to Fraudulent access to NHS care from overseas visitors from 2019 - 2020 to 2023 - 2024 is illustrated in the chart below:
| 2019 - 2020 | 2020 - 2021 | 2021 - 2022 | 2022 - 2023 | 2023 - 2024 |
|---|---|---|---|---|
| 2019 - 2020439 | 2020 - 2021290 | 2021 - 2022310 | 2022 - 2023297 | 2023 - 2024405 |
Horizon scanning
COVID-19 travel restrictions in the UK were lifted in 2022, although on 05/01/2023 certain restrictions were briefly re-introduced. The amount financially vulnerable to Fraudulent access to NHS care from overseas visitors could increase as the upward trajectory in travel continues.
- On 18/03/22 all COVID-19 travel restrictions were lifted.