International Visitors

If you are visiting the United Kingdom and require treatment at Alder Hey Children’s NHS Foundation Trust (sometimes referred to as Alder Hey or the Trust), you may have to pay for your treatment.

This page will provide further details about treatment at Alder Hey for overseas visitors.

Resident of the UK?

NHS hospital treatment is not free for everyone. Anyone of any nationality who is not ordinarily resident in the UK at the time of treatment is an ‘Overseas Visitor’. This means that you may be charged for the treatment you receive at Alder Hey.

NHS hospitals have a legal obligation to establish whether a person is an overseas visitor and whether charges apply, or they have an exemption. Where there is no exemption, we must charge the person liable and recover the costs from them.

What is our guidance for international visitors?

The Department of Health overseas visitor charging regulations require all Trusts in England to identify and charge overseas visitors for the treatment they receive.

Establishing residency

Upon arrival at Alder Hey, you will be asked to confirm how long you have lived in the United Kingdom and may be asked to complete a form and provide documents to prove that you are ordinarily resident in the UK.

If you cannot provide documents, you may have to pay a deposit equal to the estimated cost of your treatment before you have an appointment or treatment.

Maternity services, or treatment the doctor or nurse thinks is immediately necessary or urgent, will not be withheld. However, charges will still apply, and you will receive an invoice after your treatment.

A person does not become ordinarily resident in the UK simply by:

Having British nationality
Holding a British passport
Being registered with a GP
Having an NHS number
Owning property in the UK
Having paid (or are currently paying) National Insurance contributions and taxes in this country

Whether a person is ordinarily resident is a question of fact, for which several factors are considered.

What type of documents can I provide?

The following documents can be used as proof of identity; you must provide one photographic document and any other documents as proof of address:

Current signed passport
Biometric Residence Permit issued by the Home Office
Valid UK photo-card driving licence
EU or Swiss national identity photo-card
Application Registration Card (ARC)
Valid armed forces or police photographic identity card

The following documents can be used as proof of address. They must contain your current address and be dated within the last six months:

Recent original utility bill i.e. gas, electric, water, landline (mobile phone bill is not acceptable)
Council Tax bill for the current year
Bank, Building Society or Credit Union statement
Recent original mortgage statement from a recognised lender
Current Council or Housing Association Tenancy Agreement or rent book
Notification letter from the Department for Work and Pensions confirming your National Insurance Number, entitlement to benefits or a state pension

Patients living in a European Economic Area (EEA)

If you access our services because the need arose during your visit to the UK, you will need to show your European Health Insurance Card (EHIC) or a Provisional Replacement Certificate (PRC).

If you do not have these documents with you and cannot demonstrate that you have an exemption to charges. You will be required to pay for your treatment and recover the costs from your ‘healthcare abroad team’ when you return home.

How can I obtain a Provisional Replacement Certificate (PRC)?

The responsibility is on the visitor to apply for a PRC and provide it to the Alder Hey. Please go to the European Commission website and enter your search criteria, you must contact your institution and make the necessary arrangements in order to obtain your PRC. Alternatively, you can download the EHIC app to your smartphone. Within the “I lost my card” section, select your country and your health insurance fund contact telephone, email and website address will be available.

Failure to pay

If you fail to pay for NHS treatment for which charges are appropriate, your future application to enter, or remain in the UK may be denied.

Necessary (non-medical) personal information may be passed via the Department of Health to the Home Office for this purpose.

Free treatment

Some NHS services are free to everyone. This includes family-planning services and treatment of certain infectious diseases. Treatment at the Emergency Department is free only up to the point an overseas visitor is admitted as an inpatient or given an outpatient appointment.

This means that emergency treatment elsewhere in the hospital or urgent treatment after admission is chargeable.