Sarah Steele , senior research associate 1 , Cormac Devlin , intern 1 , David Stuckler , professor 2 , Martin McKee , professor 3 1Intellectual Forum, Jesus College, Cambridge, UK 2University of Bocconi, Milan, Italy 3London School of Hygiene and Tropical Medicine, London, UK Correspondence to: S Steele ss775{at}cam.ac.uk

Migrants with mental health needs will be hit hardest

Major changes to regulations on charging overseas patients for English NHS services came into force on 21 August with further alterations on 23 October 2017.1 The changes make care provided by NHS hospitals and local government, and in private facilities paid for by the NHS, chargeable, with limited exceptions. The greatest impact will be felt by mental health and community trusts, which until now have been exempted from charging. The government argued that these changes were minor and necessary “to drive a culture change in the NHS to embed identifying and charging overseas visitors and migrants not eligible for free NHS care.”2

Consistent with a recent memorandum of understanding between NHS Digital, the Department of Health, and the Home Office,3 the changes also require those delivering services to NHS patients to collect, match, and share data across government agencies. This process is facilitated by the Home Office, which now flags charging status on NHS systems: a green banner for eligible patients, an amber banner when …