Healthcare charging for migrants in the UK: awareness and experience of clinicians within sexual and reproductive health and HIV.

Abstract

Forced migration is at record levels, leading many European countries to seek to limit immigration or control access to public services. The UK has introduced upfront healthcare charging for overseas patients, with exceptions for certain groups and services. Confusion over these regulations amongst healthcare professionals risks care being inappropriately delayed or denied. This is pertinent within sexual and reproductive health and HIV care where sensitivity and timely management are essential. We conducted a survey exploring clinicians' knowledge of healthcare charging regulations and terminology, their confidence and experience on this topic and their ability to evaluate case-based scenarios. Of 343 valid responses, 78% reported encountering refugees, asylum seekers or undocumented migrants in practice. Only 39% felt confident in their understanding of healthcare entitlements. Terminology was appropriately defined by 66%, but only 53% of case-based scenarios were answered correctly. About 71% reported needing further training in this area, and many comments indicated a desire for educational resources. SRH and HIV professionals demonstrated limited knowledge of healthcare charging for migrants, despite working with these groups. This could undermine their ability to deliver appropriate advice and care to these potentially vulnerable patients. Training and support for these staff is essential.