City of Sanctuary has always stood up for equal access to healthcare and our health stream of Sanctuary is about influencing best practice in our local health systems to ensure that people seeking sanctuary have a positive experience and that their health care needs are met. This is why we support the Doctors of the World UK (DOTW) Safe Surgeries project, which supports GP Practices to break down the barriers for people registering for primary care.

Primary care is free for everyone in the UK, regardless of their immigration status, but many people seeking sanctuary struggle to get a GP to register them.

Since the introduction of the NHS charging regime in 2015, anyone who is ineligible for free NHS care, such as people with insecure immigration status, will pay 150% of the NHS tariff (the list of prices for different NHS services) for most health services. Those who cannot afford to pay have treatment withheld unless it is deemed urgent or immediately necessary.

Since charging was introduced, DOTW has been contacted by increasing numbers of people who have been denied access to NHS services for the diagnosis and treatment of serious health conditions (such as cancer, renal failure or tumours), denied treatment until their condition becomes life-threatening, or denied access to NHS community services (such as treatment for mental health conditions).

To ensure that treatment is never wrongly withheld and patients with serious health conditions get the care they need, DOTW has set up a project dedicated to advocating on behalf of patients to hospitals and NHS trusts where immediately necessary or urgent care has been denied.

They have built an established track record of successful outcomes for their patients. DOTW recently published an audit of the project, Delays and Destitution, which highlights the lengthy treatment delays and high levels of destitution experienced their patients.

Through the Hands Up for Our Health campaign, we’ve joined with DOTW and over 60 other organisations to call for the immediate suspension of the NHS charging regulations during Covid-19 to ensure everyone can see a doctor when they need to.

DOTW’s Hospital Access Project currently supports people who have been denied (or asked to pay upfront for) NHS secondary care (hospital) services and other relevant NHS community services (non-primary care) due to their immigration status.

They can also provide support and advice where individuals have been billed for treatment in relation to Covid-19, for example, for hospital admissions or treatment for Covid-19 or subsequent complications, or being refused/asked to pay upfront for ongoing/rehabilitative care.

The project can be reached at [email protected] or via the DOTW Advice Line on 0808 164 7686 (Monday-Friday, 10am-12pm), email is best. They can call back with an interpreting service for anyone who doesn’t speak English. If they have a high volume of cases, support will be prioritised based on clinical urgency, and they’ll try to advise referring organisations on how they might take steps to support the client themselves.

DOTW’s Hospital Access Project

People can get in touch with DOTW directly or be referred if they: 

• Have been refused NHS hospital or non-primary care related NHS services in the community (such has mental health services or palliative care) due to their immigration status, or have been asked to pay for such services upfront before treatment can be given
• Have been refused treatment for complications related to Covid-19 or rehabilitation treatment
• Have been charged for hospital or rehabilitation treatment related to having contracted Covid-19

The project can’t provide direct support for the following issues; however, it can give practical advice on how someone experiencing these issues could try and resolve them, and where to seek further advice if they need more support:

• If someone has received a bill after having treatment in an NHS hospital, but thinks they shouldn’t have been charged
• If someone has received a bill after having treatment in an NHS hospital, which they cannot pay in full or at all

DOTW can’t provide support for the following:

• If someone is unhappy with the treatment they have received from an NHS service
• Support to transfer treatment to another hospital