NHS organisations should prepare to identify and potentially charge foreign VIPs if they need healthcare during the period of the Queen’s funeral, they have been advised.
NHS England guidance issued this morning lists considerations for local trusts in coming days.
These include: ”The organisation should have a method of identifying overseas visitors, including foreign dignitaries and VIPs, and have plans to manage these patients, and ensure that those not entitled to free healthcare at the point of use are charged appropriately.”
Thousands of overseas visitors – including many heads of state – are expected to arrive in London over the next week ahead of the funeral next Monday.
While some may be entitled to free treatment through arrangements such as the European Health Insurance Card, many will only be able to access limited services without charge – such as to A&E as an outpatient – and be liable to pay for other types of care.
Local NHS organisations have in recent years been encouraged by government to do more to recoup fees due from overseas visitors.
The NHSE guidance also warns there is potential for increased demand. This includes for mental health services, where it identifies the armed forces and veterans as an area where issues may be triggered because of the particular significance of the Queen as former head of the armed forces.
More generally, the guidance letter suggests there may be an increase in self-presenters across acute settings, primary care, social care, mental health and the third sectors. It suggests that some patients – especially those in mental health and community services – may be “destabilised” by the Queen’s death and need additional support.
The letter, from chief operating officer Sir David Sloman, says organisations should make certain patients with planned appointments are kept informed of whether they are going ahead and that any change to services are well-publicised. It adds there may be increased “no shows” during the mourning period.
It also warns that mass gatherings such as large screenings could affect ambulance services if areas become gridlocked. It is expected that other ambulance services will be asked to provide help to London Ambulance Service Trust because of the volume of people visiting London for the funeral.
The day of the funeral will be a bank holiday and GPs will be able to close core services. However, a separate letter from Ursula Montgomery, NHSE director of primary care, says that covid vaccinations scheduled in care homes should be delivered as normal.
NHS Agenda for Change pay rules on bank holidays mean NHS staff are likely to be entitled to an extra day off – either on the day itself or as an additional day off in lieu if they are needed to work on Monday.