Step by step advocacy guide
Challenge any member of staff you see asking a patient for ID.
Find out why they are asking and if it’s necessary for treatment.
Challenge decisions by OVMs or other healthcare professionals to charge patients.
Is the treatment urgent or immediately necessary?
Does the patient meet any of the charging exemptions
Is this treamnet urgent or immediately necessary?
For example, you could question how a treatment like renal dialysis can ever be considered to not be immediately necessary. You should question how a health provider can be sure that an individual’s condition will not deteriorate if you do not offer them treatment such as chemotherapy. You should question how, as a health provider, you are in a practical or ethical position to decide whether a person is able to access treatment within a specific time frame that will not result in the deterioration of their condition in their country of origin. You should question who is liable if delaying or refusing treatment for a patient on the basis of their residency or immigration status, or because of the decision that they should pay upfront for treatment, results in significant deterioration of the patient’s health.
Inform the patient about the charging regulations
You can learn about them here
Offer support - give Health Rights Card
For patients who seem as though they may disengage with healthcare providers as a result of charging regulations, encourage them that their health is important and empower them by providing them with information in the form of multilingual health rights cards which you can find on our website.
Most people don’t know about ID checks and charging yet. There are lots of ways you can help raise awareness, just follow the link above.
Make formal complaints and record harm
When you think harm or discrimination might have occurred or there was potential for it to occur. This could be as a result of being asked to pay upfront for treatment; being told that they will be billed or receiving a bill retrospectively; or, fear of having information shared with the Home Office for immigration enforcement.
Document instances when patients have been deterred from accessing care. Additionally, you can submit incident reports using your trust’s formal system (e.g. Datix) when you observe situations where patients are at risk of harm or discrimination. This can include “near miss” incidents, for example if care is delayed but no actual harm occurred, or if a patient discloses fear about the impact of the regulations on them, even when in reality they are exempt.
Use examples or case studies that you and your colleagues have documented of harm as a result of the charging regulations and data sharing agreement to raise your concerns with your consultant or management.