Fraudulent access to the NHS from overseas visitors

Fraud relating to inappropriate access to NHS secondary care by foreign nationals who avoid payment for services delivered.

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 that they are chargeable, or an NHS staff member has abused their position to facilitate the fraudulent access.

It is a possibility that the year-on-year decrease in reporting correlates with the downward trajectory in travel to the UK , this is also likely to be linked to the decrease in the financial figure vulnerable to fraud. The reduction likely occurred as a direct result of travel restrictions due to COVID-19, also possibly acting as a deterrent to those wishing to travel for NHS healthcare without charge. Additionally, ward restrictions prevented Overseas Visitor Managers (OVMs) walking freely around hospitals, therefore, it is a realistic possibility that their ability to converse with and advise medical staff was limited.

£39.3m

is a conservative estimate of the vulnerability to fraud

NHS services including testing, treatment and vaccinations for COVID-19 are free to all patients after the virus was incorporated into schedule 1 of the NHS Regulations in January 2020 . However, it is highly likely that some patients used a false identity to obtain vaccines, this could be as a direct result of no requirement for an ID to be presented prior to receiving vaccines.

It is highly likely that some individuals use their visitor visa to access the NHS without charge. Therefore, an overseas visitor with a visitor visa, legitimate NHS number and false address may routinely access care without charge.

The high cost of healthcare across the globe is potentially encouraging some people to enter the UK with the specific intent of seeking NHS maternity care without charge. As maternity care cannot be delayed for an advance payment, patients are likely to use a false identity or leave the UK soon after treatment to avoid payment.

There is the possibility that as travel resumes to pre-pandemic levels fraudulent access may see an increase in reporting. From 18/03/22 all COVID-19 travel restrictions were removed by the government and quarantine hotels were to be withdrawn towards the end of the month . Additionally, COVID-19 testing will no longer be free to all from 01/04/22. The NHSCFA will continue to monitor the reporting levels as the landscape changes.

Information reports received for fraudulent access

The change in the number of fraud reports (allegations) received in relation to Fraudulent access to the NHS from overseas visitors from 2017-18 to 2021-22:

6.38%

decrease in reporting compared to last year

2017 to 2018 2018 to 2019 2019 to 2020 2020 to 2021 2021 to 2022
530 453 351 329 308