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I did not make it clear enough in the first version of this question. I asked about health care for UK citizens (with UK passports and the right to live and work in UK) who have not been resident in UK.

A couple of previous questions (https://travel.stackexchange.com/questions/68711/emergency-health-care-in-england-for-a-non-resident and https://travel.stackexchange.com/questions/102316/healthcare-in-uk-for-non-resident-citizenss) say that for non-resident UK citizens, emergency care is free, then once you're stable you need to go home for care, or NHS will bill you.

How could you get residence status? What are the criteria UK gov uses to determine whether you're a resident? Length of stay? Employment? Paying rent? What if you got a job in the UK but only two weeks into it you need hospital-based expensive care?

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  • Related: UK government website How charges for NHS healthcare apply to overseas visitors Sep 21, 2023 at 21:48
  • You pay a health surcharge while applying for temporary stay visas like a student visa, skilled worker visa etc. Once you get ILR (Indefinite Leave to Remain), you don't have to pay health surcharge (you of course still pay National Insurance based on your income). For those on a visitor status, you have to pay (either through insurance or out of pocket). This was a just a brief overview. Sep 21, 2023 at 23:56
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    @Traveller and others: This question is about a British citizen. They definitely wouldn't need a visa and I don't think this whole healthcare surcharge business applies.
    – Relaxed
    Sep 22, 2023 at 7:08
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    @Relaxed You’re right. The part of my comment that still applies to British citizens is Ordinary Residence
    – Traveller
    Sep 22, 2023 at 7:55
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    @Traveller This link seems extremely useful!
    – Relaxed
    Sep 22, 2023 at 16:24

1 Answer 1

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What are the criteria UK gov uses to determine whether you're a resident?

The NHS works on a residency based system where anyone who has ‘ordinary residence’ is eligible for free healthcare. Some NHS services are not free, like dentistry, prescriptions, and eye tests, unless the patient is exempt from paying towards these costs.

Certain criteria have to be met to be considered ‘ordinarily resident’, which is not the same as nationality or immigration status.

You do not automatically get ordinary residence status just because you have a registered GP, own property or pay National Insurance contributions. You cannot have ordinary residence if you are:

  • A non-EEA or Swiss national without indefinite leave to remain
  • An EEA/Swiss national not resident in the UK
  • An undocumented irregular migrant or failed asylum seeker.

The Department of Health & Social Care Guidance: Ordinary residence tool, explains establishing ordinary residence and eligibility for free NHS secondary care for the following groups:

  • UK Nationals
  • from 1 July 2021, EEA/Swiss Nationals with EUSS
  • non-EEA/Swiss Nationals with indefinite leave to remain

Definitions

A person is ordinarily resident if they are living in the United Kingdom:

  • lawfully
  • voluntarily
  • for settled purposes as part of the regular order of their life for the time being, whether for a long or short duration

The concept of “settled purpose” has been developed by the courts. There may be one purpose or several, it may be specific or general, and it may be for a limited period. All that is necessary in this context is that the purpose for living in the UK has a sufficient degree of continuity to be described as settled.

Questions to consider include:

  • Have they been in the UK for the last 6 months or more?
  • Do they intend to remain in the UK for 6 months?
  • Is their stay in the UK one of several regular and significant stays?
  • Does their housing situation in the UK appear stable?
  • Can they show that they are paying utility bills and council tax at their UK address?
  • Are they employed, self-employed or a recognised job seeker in the UK?
  • Do any close family also live in the UK?
  • If the person has recently come to the UK, is there evidence of activity in another country that suggests that they are establishing residence here?
  • If they have recently been absent from the UK, was that absence temporary and not indicative of migration overseas?

For each question, the guidance provides examples of evidence the patient may have.

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    This is all the information I needed. Thank you. Sorry I did not accept sooner, I've had a cold.
    – Flynn
    Sep 27, 2023 at 20:00
  • So being a British citizen gives you the absolute right to enter the UK and become a resident, but you can't just declare yourself to be a resident, and it takes some time.
    – gnasher729
    Sep 27, 2023 at 22:46
  • I wonder if a UK citizen without money and job who returns to the UK (which is his right) and ends up homeless, will become a resident without stable housing situation, utility bills, council tax, job, close family.
    – gnasher729
    Sep 27, 2023 at 22:48
  • @gnasher729 I do not think a returning British citizen in that kind of vulnerable situation who needed medical treatment would be refused it, or required to pay. See eg Looking after homeless patients in GP and Homeless applications: immigration and residence
    – Traveller
    Sep 28, 2023 at 6:42

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