| Chapter
8: Notes for Stage 1 Officers Conducting Patient Interviews |
Statutory/Manual
References |
| General Principles |
|
| 1. Eligibility to use the NHS
services depends mainly on residence in the UK, and on other qualifying
provisions set out in the Regulations. Overseas visitors who have been in the UK for less
than 1 year are liable to pay NHS charges, unless they fall into another exempt category. |
1989 Reg 4 & Chapter 11 |
| 2. Stage 1 is designed to
identify quickly those patients who should not be charged for NHS services.
In most cases patients exempt from NHS charge will be identified after a few questions.
However, the procedure must apply to all new patients since any attempt at selection could
be interpreted as arbitrary or discriminatory. The procedures apply to: |
Appendix E |
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i. those attending the NHS hospital for the first time; and
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ii. those starting NHS care - such persons are included
because a patient’s entitlement to exemption from NHS charges may change (for
example, where the patient’s length of stay in the country subsequently exceeds 12
months or where the patient decides to be treated privately).
|
1989 Reg 4(b) |
| Services exempt from NHS
charges |
|
| 3. Stage 1 does not
apply to: |
Chapter 10 |
|
A&E or Casualty Department (or in pre-treatment
'holding' wards attached to these departments);
|
1989 Reg 3 (a) |
|
Family planning services;
|
1989 Reg 3 (bb) |
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Special clinics for treatment of sexually transmitted
diseases (but does apply for HIV/AIDS see Chapter 10)
|
1989 Reg 3(c) |
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Treatment in respect of Schedule 1 (infectious) diseases;
|
1989 Regs and Chapter 10 |
|
Those detained under Mental Health legislation; and
|
1989 Reg 3(e) |
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Those subject to a probation order under Section 230 of the
Criminal Procedure (Scotland) Act 1995.
|
1989 Reg 3(f) |
| Vulnerable Groups |
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| 4. Stage 1 is generally
inappropriate in NHS departments and hospitals for geriatric and mentally disordered or
learning disabled patients. Staff registering these patients should be aware of the rules
regarding liability to NHS charges, and bring to the attention of their senior officers
particulars of any patient who, on the information presented to them, appears to be an
overseas visitor. |
|
| Registration Procedure: Stage
1 |
|
| 5. Stage 1 procedure should take
place only when it has been assessed as clinically appropriate to do so. |
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| 6. The registration form or file
cover should have answer boxes corresponding to those shown at Section 2 of
Appendix E. These forms should be completed by the Stage 1 officer
according to the instructions on the questionnaire. Where a pre-registration form is used
for an overseas patient, the Stage 1 answers should be checked for all first attendances. |
Appendix E |
| 7. Every effort should be made to
avoid inference of prejudice. If a patient complains that he or she is being discriminated
against the Stage 1 officer should refer the patient to a senior officer (normally the
Stage 2 officer). |
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| 8. The established out of hours
admission arrangements should have the same application for overseas patients as they do
for UK residents. |
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| 9. A patient may be exempt from
NHS charges in his or her own right, or because he or she is a spouse or
child of someone who is exempt. If the answer to question 1 is clearly "yes",
repeat it in a suitably modified form about the husband or wife, or (for children) about
both parents. |
|
| 10. If the answer either to the
original or modified question 1 is clearly "yes" tick the "not
liable" box in Section 2 of Appendix E. No further questions are
necessary. The patient is exempt from NHS charges. Where doubt exists, the Stage 1 officer
should advise the Stage 2 officer. |
Appendix E |
| 11. If the answer to question 1
is "no" or no clear answer can be obtained, ask question 2. Where no
clear date of entry to this country is given: |
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i. place a tick in the "for Stage 2" box; then
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ii. inform the appropriate Stage 2 officer without delay.
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| 12. The Stage 1 officer should: |
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i. tell the Stage 2 officer of any language or
communication difficulty.
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ii. tell the Stage 2 officer where doubts exist over the
validity of the answers given.
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