Understanding Access to Healthcare in Northern Ireland
Access to healthcare services in Northern Ireland is crucial for the well-being of residents and eligible visitors. Family Practitioner Services play a significant role in providing advice, training, and verification for entitlement to publicly funded healthcare. The main legislation, including the Health and Personal Social Services (Northern Ireland) Order 1972, defines the provision of integrated health services for the people of Northern Ireland. Legislation addresses the entitlement of both ordinarily resident individuals and those who are not ordinarily resident but require health services. Various types of patient registration, such as Ordinarily Resident and Eligible Visitors, are managed by the healthcare system to ensure access to healthcare for different groups.
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Presentation Transcript
Access to Healthcare Family Practitioner Services
About us We are a team within Family Practitioner Services in BSO We work closely with the GP registrations team We provide advice to GP staff and patients on entitlement We provide awareness and specialist training for HSC staff on entitlement to publically funded healthcare We conduct post registration verification work We are the key HSC liaison point with the Home Office
Health Care in NI Health is a devolved matter in the UK Rules of entitlement vary between the four countries Rules of entitlement vary between Primary Care and Secondary Care In NI entitlement is primarily for those who are ordinarily resident Some visitors may access publically funded healthcare but must demonstrate that they meet an exemption or have paid the health surcharge to the Home Office
Main Legislation Health and Personal Social Services (Northern Ireland) Order 1972, Part II, s.4. Provision of integrated health services for the people of Northern Ireland People of Northern Ireland are those ordinarily resident . The definition of ordinarily resident is set out in UK Case Law R -v- Barnet LBC ex parte Shah [1983]. Lord Scarman provided the following definition: Ordinary residence is established if there is a regular habitual mode of life in a particular place "for the time being", "whether of short of short or long duration", the continuity of which has persisted apart from temporary or occasional absences. The only provisos are that the residence must be voluntary and adopted for "a settled purpose". Voluntary is determined as being here lawfully.
Legislation Continued Immigration Act 2016 Provision of Health Services to Persons Not Ordinarily Resident Regulations (Northern Ireland) 2015 (as amended) EU Withdrawal Agreement EEA EFTA Separation Agreement Swiss Citizens Rights Agreement EU Trade and Co-Operation Agreement
Types of Patient Registration Registered with BSO Ordinarily Resident Eligible Visitors for example: Asylum Seekers Missionaries Former Residents Registered locally with GP Temporary Residents who are fully registered with another GP in NI Visitors from another part of the UK
Patient Registration Journey Patient Completes HSCR1/HS200 form and provides document confirming lawfully in the UK Practice add info to links and send paperwork to BSO Patient receives a medical card and letter advising of verification work BSO Add to NHAIS Pt meets threshold of electronic verification No further action taken 12-14 wks post registration the patient enters verification process Team write to Patient who must complete further form and provide additional documents Pt does not meet threshold of electronic verification
What does the GP Practice need to do Ask patient to complete the form Ask for proof of lawfulness in the UK Add patient information to GP links Send form and lawfulness document(s) to BSO Optional for BSO: Proof of address Other documents *unless there is a requirement for the patient to provide all documents in advance of registration
Example Documents to Prove Lawfulness in the UK British/Irish - Passport or birth certificate and identity EU Nationals (and family members) - EU Settlement Scheme, or a Permit issued by the Home Office Overseas Nationals - Permit issued by the Home Office. This can be indefinite leave or a valid until date If the EU or overseas national does not have a permit, you should speak to the Team regarding entitlement
Registration Journey continued Patient Completes HSCR1/HS200 form and provides document confirming lawfully in the UK Practice add info to links and send paperwork to BSO Patient receives a medical card and letter advising of verification work BSO Add to NHAIS Pt meets threshold of electronic verification No further action taken 12-14 wks post registration the patient enters verification process Team write to Patient who must complete further form and provide additional documents Pt does not meet threshold of electronic verification
Post registration Verification Process Details for each adult patient are verified by data matching using NHS Eligibility software Details shared include: Name Dob Address and postcode No information is received about the patient We receive a threshold score, which indicates the accuracy of the information provided by the patient
Process when threshold isn't met Access to Healthcare Team will send a questionnaire along with a letter outlining the process The patient needs to complete the form and demonstrate that they are ordinarily resident Lawfully in the UK Residing in Northern Ireland Have a settled purpose in Northern Ireland or The patient may wish to benefit as an eligible visitor. To do this they must demonstrate how they meet an exemption under the PNOR 2015 or paid the health surcharge Patients who don t respond or fail to demonstrate their entitlement will be removed from the GP list
Process for non responders Letter to patient & email to the GP practice advising not enough information to establish entitlement Patient will have an additional 2 weeks to provide information needed If still no response they will be deducted
Whats next Digital Platform being constructed for Primary Care Electronic patient entitlement aid to be explored and developed HSCR1 to be amended to account for changes post Brexit Interactive training / reference resource being developed
Common misconceptions Anyone can register with a GP Only if they can demonstrate their entitlement If you have a HCN you are entitled Only if currently reside in Northern Ireland If you are issued with a medical card you are entitled Only if your entitlement has been verified by the BSO and you currently reside in Northern Ireland If you were born in Northern Ireland you are entitled Only if you currently reside in Northern Ireland
Common misconceptions If you are married to a person from Northern Ireland you are entitled Only if you are lawfully residing in Northern Ireland If you hold a British Passport you are entitled Only if you are currently residing in Northern Ireland You are entitled to get healthcare anywhere in the UK Only immediately necessary Once registered with a GP you will always be entitled Only if you are currently residing in Northern Ireland
