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No Recourse to Public Funds (NRPF)

1. Using this Procedure and Further Guidance

This procedure should be used by practitioners in adult Care and Support who, through the course of their normal work, find themselves supporting a person with No Recourse to Public Funds (NRPF) through one or more adult Care and Support processes. The procedures will support practitioners to understand what NRPF is and what it means for their practice.

Additional practice guidance where required has been developed by the NRPF Network:

Assessing and Supporting Adults who have no recourse to public funds.

Assessing and Supporting Families with no recourse to public funds.

Supporting Migrants Lacking Mental Capacity in Relation to Immigration Matters.

2. What No Recourse to Public Funds means

If a person has no recourse to public funds (NRPF) it means they have no access to Local Authority housing, Local Authority homelessness assistance and most welfare benefits (although the list of benefits does change from time to time).

It does not mean that they have no access to adult Care and Support because social service funds are not public funds. However, there are some restrictions about meeting the needs of some people with NRPF which are explained in these procedures.

3. Which People have No Recourse to Public Funds

A person will have no recourse to public funds when they are 'subject to immigration control', as defined at section 115 of the Immigration and Asylum Act 1999.

A person will be subject to immigration control when they have one of the following types of immigration status:

Status Details
Leave to enter or remain, which is subject to the NRPF condition.

This includes:

  • Leave to enter as a visitor;
  • Leave to remain as a spouse;
  • Leave to remain as a student;
  • Leave to remain granted under family or private life rules.
Leave to enter or remain, which is subject to a maintenance undertaking. For example, indefinite leave to remain as the adult dependent relative of a person with settled status.
Leave to enter or remain as a result of a pending immigration appeal.  
No leave to enter or remain.

This includes:

  • Illegal immigrants;
  • Visa overstayers;
  • An asylum seeker;
  • Refused asylum seekers (where the right to appeal is exhausted)

Having NRPF is not determined by a person's employment status, as many people with NRPF are entitled to work.

4. Which People have Access to Public Funds

People with the following immigration status will usually be able to access public funds, subject to meeting any other qualifying requirements:

Status Details
Indefinite leave to enter or remain. People with this status will be able to access public funds, unless they have been granted the status as an adult dependent relative, in which case they can only access public funds after 5 years.
Right of abode.  
Exempt from immigration control.  
Refugee status.  
Humanitarian protection.  
Leave to remain granted under private or family life rules, or Hong Kong BN (O) leave. This will only be granted by the Home Office when the person is already destitute or at risk of imminent destitution.
Pre-settled status granted under the EU Settlement Scheme. However, to access public funds the person will also need to satisfy a 'right to reside' test.
Discretionary leave to remain.

Examples include:

  • People who are victims of trafficking or modern day slavery;
  • Domestic violence destitution concessions;
  • Unaccompanied Asylum Seeking Child (UASC) leave.

Further information about the different immigration statuses granted to people from EEA countries since Brexit can be found on the NRPF website.

See: EEA nationals and family members.

5. Access to Adult Care and Support

Access to Adult Care and Support generally

Assistance provided by social services, including adult Care and Support is not a public fund so access to it is not restricted by a person's NRPF status alone. The same duties and powers under the Care Act apply. For example:

  1. The duty to promote individual wellbeing;
  2. The duty to provide good information and advice;
  3. The duty to prevent, reduce and delay the need for Care and Support;
  4. The duty to assess on the appearance of need;
  5. The duty to make enquiries following a safeguarding concern;
  6. The power to meet urgent needs.

This means that an assessment of need cannot be refused on the basis that a person is subject to immigration control.

Access to adult Care and Support Services

If, following an assessment of need a person is found to have eligible needs for Care and Support the Local Authority duty to meet those needs (including the duty to develop a Care and Support Plan and the duty to review) applies unless:

  1. The person is in breach of immigration laws (for example is a visa over-stayer, an illegal entrant or a person who has been refused asylum);
  2. The person has already been granted refugee status by an EEA state;
  3. The person is a refused asylum seeker who has failed to comply with removal directions;
  4. The person is part of a refused asylum seeking family who has refused to take steps to leave the country.

If any of the above apply, a Human Rights assessment will be required prior to Care and Support Planning.

6. Identifying People with NRPF

Why Identifying People with NRPF is important for adult Care and Support

For the purposes of adult Care and Support it is important to identify people who have NRPF so that the right response is given for their circumstances. At an early stage this is likely to relate to the general and specific advice that should be given to them around:

  1. Housing;
  2. Welfare benefit entitlement; and
  3. Access to adult Care and Support services following any assessment process.

People with NRPF may also require specialist advice in relation to their immigration status.

People with NRPF have the same rights to good information and advice as everyone else, so it is important that their status as a person with NRPF is established at an early stage to ensure that the information and advice duty under the Care Act is met.

How to identify People with NRPF

Most people who access adult Care and Support will be able to access public funds. Therefore it is not recommended to carry out routine checks of everybody's NRPF status. Checks should only be made when there are concerns or where information known about the person or their situation warrants a check to be made.

Examples of people whose NRPF status you may need to verify include:

  1. People whose primary need appears to be for housing;
  2. People working in the sex industry (for example prostitution);
  3. People living in large groups in rented accommodation;
  4. Victims or potential victims of human trafficking;
  5. Victims or potential victims of modern slavery;
  6. Victims of Domestic Abuse where there are concerns about immigration status;
  7. People who tell you they entered the country to seek asylum (even if this was many years ago);
  8. People who tell you they are an illegal entrant
  9. People who are reported to be an illegal entrant or subject to immigration control; and
  10. People who are from EEA states.

Verifying NRPF status

It is important that a person's declared immigration status is verified officially. Normally this is via a biometric resident permit, on the reverse of which their immigration status and any NRPF conditions will be clearly recorded. Photocopies of both sides of the permit should be taken and kept as evidence that immigration status has been verified. Other types of evidence that can be accepted if presented are:

  1. An Immigration status document;
  2. A Visa/ residence permit in passport;
  3. A Stamp in passport;
  4. An Asylum registration card (ARC);
  5. A Home Office issued convention travel document or certificate of travel;
  6. An EEA e-visa or digital status; or
  7. A Home Office letter specifying what type of immigration permission has been granted.

If the person is unable to produce appropriate documentation, or the documentation they produce raises concern you should verify their status with the Home Office. There are 2 ways to do this:

  1. Contacting the Home Office Status, Verification, Enquiries and Checking email service using ICESSVECWorkflow@homeoffice.gsi.gov.uk; or
  2. If the Local Authority subscribes to the NRPF Network's Connect service they can access the Home Office database. If you are unclear about your access to NRPF Connect you should clarify this with a manager.
Information about the NRPF Connect service can be found on the NRPF Network's website

7. Providing Information and Advice

Information and advice around housing and welfare benefits

People with NRPF who are requesting information and advice around housing and welfare benefits will need to be signposted appropriately. In most cases the local authority housing department will be able to provide advice around housing, and the Citizen's Advice Bureau will be able to support with benefits.

The government has also produced a guide explaining what housing and financial support may be available for individuals and families waiting on asylum decisions. See: Asylum support.

Information and advice around immigration

The area of immigration law is extremely complex. As such, immigration advice can only be given by a person who is registered and regulated to provide it. This means that under no circumstances should you provide this advice yourself. Instead you must make sure that you signpost the person to an advisor who is regulated by either:

  1. The Law Society; or
  2. The Office of the Immigration Services Commissioner (OISC)

Both regulators have a website that you can access for information about regulated advisors in the area.

In addition to the above there is a national organisation able to provide information and advice about a range of matters affecting asylum seekers (and people who have been refused asylum). See Migrant Help or contact them by calling 0808 8000 630.

Information and Advice around adult Care and Support processes

Under the Care Act it is important that people are given information and advice about adult Care and Support processes at an early stage so that they:

  1. Understand which processes they will likely be involved in;
  2. Understand what the different processes involve; and
  3. Can prepare themselves in terms of thinking about their wellbeing and the outcomes that are important to them.

After assessment, the processes for a person with NRPF may be different to those people who have recourse to public funds, depending on their immigration status. It is important that people are able to receive the right information in an accessible way. This will not only help to ensure they understand what is likely to happen after any assessment of need takes place, but reduces the risk of any misinterpretation.

The information provided will depend on the person's individual situation. You should refer to Section 5, Access to Adult Care and Support if you are unsure what the implications are for different people's situations and what advice you should give about the Care and Support processes after assessment.

8. Establishing Needs

Referral for a needs assessment

Where the referral is for a needs assessment this should be processed in the normal way so long as the 'appearance of need' criteria is met. However, you should also confirm that the person is present in the Local Authority area. It can be common for people with NRPF to contact a different authority to the one in which they are residing without being aware that they have done so. If the person is not present in the area you should discuss whether they are able to contact the Local Authority in which they are present, although there is no obligation for them to do so as ordinary residence rules do not apply under the Care Act until after assessment.

Referral for urgent support without an assessment

Where the referral is for urgent support to be provided the Local Authority powers to provide urgent support without an assessment apply. However, arrangements should be made to carry out the assessment as soon as possible. This ensures that the Local Authority does not continue to meet needs that are the responsibility of the person's country of origin or another agency (such as the National Asylum Support Service) any longer than it is reasonable for them to do so.

Carrying out an assessment

First and foremost, the needs of a person with NRPF should be assessed in the same way as anybody else, regardless of their immigration status. As such the procedures for Establishing Needs should be followed.

Due to the specific circumstances that are likely to be affecting a person with NRPF there are additional considerations to be made to ensure that Care Act duties are fulfilled and the person's involvement in any assessment is maximised:

  1. There may be an increased need for interpreter services;
  2. There may be an increased need for advocacy services, and the advocate that supports a person with NRPF under the Care Act will need to be suitably skilled to do so;
  3. The practitioner carrying out any assessment may need to possess specific skills and knowledge around specific circumstances, such as Domestic Violence, Modern Slavery or Human Trafficking;
  4. The practitioner carrying out the assessment may need an enhanced knowledge of Human Rights Law and be competent to carry out a Human Rights Assessment;
  5. There may be an increased need for joint working and co-operation under the Care Act to ensure a holistic assessment of need.

9. Applying National Eligibility Criteria

Applying Eligibility Criteria

The National Eligibility Criteria should be applied in the same way for people who have NRPF as it is for other people. As such the procedures for the general application of the national eligibility criteria should be followed. However, there are some additional criteria that must be met in order for the duty to meet eligible needs to apply.

  1. Do the eligible needs arise from destitution?

    Under Section 21 of the Care Act, the local authority is not permitted to meet the care and support needs of anyone with the immigration statuses set out in Section 3, Which People have No Recourse to Public Funds, when their needs arise solely because of destitution.

    Definition of destitution for NRPF cases

    The definition of destitution in NRPF cases only is:
    1. A person does not have adequate accommodation or any means of obtaining it (whether or not his other essential living needs are met); or
    2. A person has adequate accommodation or the means of obtaining it, but cannot meet their  other essential living needs.

  2. Is the person one of the groups excluded from adult Care and Support services by schedule 3 of the Nationality, Immigration and Asylum Act 2002?

    Schedule 3 of the Nationality, Immigration and Asylum Act 2002 is the one part of immigration law that applies directly to the Care Act. It sets out specific excluded groups of people who are not automatically entitled to adult Care and Support services regardless of whether they have an eligible need:
    1. The person is in breach of immigration laws (for example is a visa over-stayer, an illegal entrant or a person who has been refused asylum);
    2. The person has already been granted refugee status by an EEA state;
    3. The person is a refused asylum seeker who has failed to comply with removal directions;
    4. The person is part of a refused asylum seeking family who has refused to take steps to leave the country.

If any of the above applies, the person's entitlement to adult Care and Support services is dependent on the outcome of a Human Rights Assessment.

Deciding the Eligibility Outcome

Use the flowchart below to support you to reach a decision about eligibility and next steps.

Deciding the Eligibility Outcome

Where there is no duty to meet needs

If, following application of the national eligibility and other criteria there is no duty to meet needs and there is no intention to meet ineligible needs under a power you must consider, as part of the information and advice provided whether the person is able to access support from the Home Office under the Immigration and Asylum Act 1999. Asylum support is only available to those who have claimed asylum.

More information about how to make an application for asylum support can be accessed at the Migrant Help UK website.

The Local Authority can refer an asylum seeker or refused asylum seeker to the Home Office for support. Support for accommodation and/or subsistence is provided by the National Asylum Support Service (NASS).

10. Human Rights Assessment

This section provides an overview of Human Rights Assessments. When completing a Human Rights assessment, you should also refer to the guidance from the NRPF Network as required.

See: When and how to undertake a Human Rights assessment.

When a Human Rights assessment should be carried out

A Human Rights assessment is required whenever a person has eligible needs under the Care Act but they belong to one of the excluded groups in Schedule 3 of the Nationality, Immigration and Asylum Act 2002.

The purpose of a Human Rights assessment

The purpose of a Human Rights assessment is not to determine whether the person is eligible for Care and Support services under the Care Act. All of the people in Schedule 3 are excluded because they have a valid legal residency status in another country. It is therefore the responsibility of that country to provide for their Care and Support needs unless it is not practically or legally possible for the person to return to that country or doing so would breach their human rights.

The purpose of a Human Rights assessment is to find out whether barriers exist in relation to practicalities, legalities or human rights and identify measures that can be taken to overcome said barriers. Only when barriers are proven insurmountable should the UK provide the person with Care and Support services.

Remember, when carrying out a Human Rights assessment you are not making a decision about immigration. You are not qualified to do so and this is not your role or the purpose of the assessment. You should:

  1. Use the reports and views of the Home Office as a starting point;
  2. Work in ways that reflect the views of the Home Office and any decision made by them;
  3. Refer any new information to the Home Office for consideration.

Carrying out a Human Rights assessment

There is no statutory format for carrying out a Human Rights assessment. If your organisation does not have a template, you can use the NRPF Network template.

Step One: Practical and Legal Barriers

The first step in a Human Rights assessment is to establish whether there are any practical or legal barriers to the person returning to their country of origin. For example:

  1. The person may not have access to relevant travel documents;
  2. The person may be waiting to hear the outcome of an asylum claim they have made;
  3. The person may be waiting to hear the outcome of an appeal they have made to a previously refused asylum claim;
  4. The person may be awaiting trial for an offence in the UK;
  5. The person is medically unfit to travel under any circumstances.

If there are legal or practical barriers present you should consider the action that you can take to overcome them. This will usually involve liaising with the Home Office to let them know of the person's needs for Care and Support so that this can be taken into account in respect of their asylum claim. Often the Home Office can step in to provide practical support to obtain travel documents or to liaise with the country of origin about the person's situation to facilitate a return home to the right support they need.

In all cases you should discuss the best course of action with a manager and it may be appropriate to take your own legal advice before proceeding.

During the time that it takes to remove any practical or legal barriers to the person returning home you should make arrangements to provide Care and Support services to meet any eligible needs. A failure to do so would in itself be a breach of the person's article 3 human right to humane treatment (see step 2 below).

If the practical or legal barriers are insurmountable then Care and Support must be provided and it would be unlawful to withhold it. If step 1 of the Human Rights assessment identifies this to be the case then step 2 is not required.

Step 2: Would returning to the country of origin be a breach of the person's human rights?

If the Human Rights assessment has determined that there are no practical or legal barriers to the person returning to their country of origin (or if the legal or practical barriers have been successfully removed) the next step is to consider the possible human rights implications of the person returning.

The European Convention of Human Rights sets out the basic rights that every person should expect to be upheld. The rights were enshrined into UK law in 1998 via the Human Rights Act. Each right is often referred to as an article. This is the number given to it in the list of rights. The first article is for the state to uphold human rights.

  1. The right to life;
  2. The right not to be tortured or suffer inhuman or degrading treatment;
  3. The right not to be enslaved;
  4. The right not to be unlawfully detained;
  5. The right to a fair trial;
  6. No punishment without law;
  7. The right to family and private life;
  8. The right to freedom of thought, conscience and religion;
  9. The right to free expression;
  10. The right to marry;
  11. The right to an effective remedy if your rights are breached;
  12. The right not to be discriminated against.

Some human rights are known as 'absolute rights', which means that they must always be upheld. Other rights are known as 'qualified rights' which means that they can be breached if breaching them is proportionate and necessary to uphold another legal responsibility or an 'absolute right'.

Articles 2, 3, 4 and 6 are all absolute rights.

Articles 8, 9, 10 and 11 are all qualified rights.

When carrying out a Human Rights assessment for the purposes of adult Care and Support you must be sure that if the person returns home their absolute rights will not be breached.

Examples when a right would likely be breached

  1. A person has a fear of persecution because of their sexuality. The country of their origin is well known for torturing and imprisoning people on the grounds of their sexuality and the Home Office advises that the risk of persecution is high.
  2. A person is gravely unwell and would be unlikely to survive a journey back to their country of origin.

Examples when a right would not likely be breached

  1. A person has been refused asylum but left her country of origin due to domestic abuse. The country of origin offers good support to victims of domestic abuse and support can be arranged there to ensure that she is safe and the risk of further abuse is minimised.
  2. A person is seriously unwell and requires daily medical treatment. Their country of origin is able to provide adequate treatment, although the quality of care may not be the same standard as that in the UK.

Recording the outcome of a Human Rights assessment

The outcome of the Human Rights assessment must clearly state:

  1. Whether there are any practical or legal barriers that prevent the person from returning to their country of origin;
  2. Whether any action has been agreed to overcome the practical and legal barriers identified (and how the situation will be monitored);
  3. If Step 2 has been completed, whether a return to the country of origin would be a breach of the person's human rights and the evidence upon which this decision has been based;
  4. What the next steps/actions will be in terms of supporting the person to either return to their country of origin, make a claim for asylum, appeal a claim for asylum in the UK or provide adult Care and Support services;
  5. What the plans are to review and monitor the situation and support the person to be able to return to their country of origin.

11. Meeting Needs and Review

Meeting needs and review after a needs assessment

If a person with NRPF has been found eligible for adult Care and Support following a needs assessment the Care and Support should be agreed, arranged and reviewed in the normal way under the Care Act. This will involve:

  1. Establishing Ordinary Residence (normal rules apply)
  2. Allocating an indicative personal budget;
  3. Care and Support Planning;
  4. Agreeing a final personal budget;
  5. Arranging any support and services that the Local Authority will arrange; and
  6. Arranging to review the Care and Support Plan.

People with NRPF can choose to manage their personal budget in the same variety of ways as any other person including through a Direct Payment if the Local Authority deems this to be appropriate.

Meeting needs and review after a Human Rights assessment

If needs are to be met following a Human Rights assessment the Care and Support should be agreed, arranged and provided in the normal way. However the review and monitoring function should reflect the need to not only monitor the effectiveness of the Care and Support but also to review progress in any action plan to support the person to return to their country of origin (or claim Asylum in the UK).

Providing Accommodation

If the person has complex needs that require a particular type of accommodation in order to ensure their care and support needs are met, this should be commissioned in the normal way e.g., a residential or nursing care placement. The accommodation should be provided for as long as it is required to meet care and support needs.

Where the above does not apply but the person with care and support needs is homeless or at risk of homelessness, consideration should be given to the need for temporary accommodation.

For example, if a person with needs for personal care and support is ‘sofa-surfing’ overnight but has nowhere to spend their days they are likely to need temporarNeed to know Any decision to end, suspend or vary a Direct Payment must not lead to eligible needs being unmet. Where there is no continuation of services, you must arrange interim services as required to ensure eligible needs are met. accommodation support.

Under Section 23 of the Care Act this would normally mean making a referral to the Housing Authority, because adult social care cannot provide anything under the Care Act that is the responsibility of the Housing Authority to provide. However, as the person has NRPF status, they are not eligible for temporary housing under the Housing Act 1996. This means that section 23 of the Care Act does not apply, and temporary accommodation needs can be met by adult social care or through alternative services.

Need to know

Even though a person with NRPF who is homeless (or threatened with homelessness) is not eligible for temporary accommodation under the Housing Act 1996, there is still a statutory requirement under section 213B, to refer their case to the Housing Authority, with the person’s consent.

For further information, see: A guide to the duty to refer.

Providing temporary accommodation

It is your responsibility to familiarise yourself with available local policy and guidance about adult social care provision of temporary accommodation to people with NRPF.

Where it is provided, examples of temporary accommodation support could include residential care, supported living, Shared Lives placement, a B&B or a short-term tenancy with a private landlord.

Temporary accommodation should be provided for as long as it is required to reduce the risk of homelessness or until the person’s immigration status changes and they can access support from the Housing Authority.

Exploring alternative accommodation options

The following is a list of alternative temporary accommodation options that can be explored.

Caption: Alternative accommodation options
   
Option Details/information
Night shelters List of night shelters on the Pavement Magazine.
NRPF specific accommodation providers NACCOM website (The No Accommodation Network).
Home Office support for people seeking asylum Via Migrant Help.
Children’s services Children’s services can provide accommodation support where a child is in need.
VCSE sector support Subject to local availability.
Homelessness organisation Homeless England database of all homelessness organisations.

(Source: GOV.UK Guidance – Discharging people at risk of experiencing homelessness.)

Providing a subsistence payment

Because people with NRPF will not be able to access the same welfare benefits you will need to consider whether any subsistence payments are required in order to ensure that Care and Support needs are met, or you may need to support them to access charitable support and other financial support outside of the public purse. The local Citizen's Advice Bureau will be able to provide information and advice about this.

For example, if a person with Care and Support needs has children living in another area but cannot afford to visit them you may wish to provide proportionate transport costs to facilitate this.

It is your responsibility to familiarise yourself with available local policy and guidance about the provision of subsistence payments to people with NRPF.

Charging for Care and Support services

People with NRPF can be financially assessed to make a contribution to the cost of their Care and Support services in the same way as anyone else.

12. Carers with NRPF

Carers who have NRPF

In general the same procedures for people with Care and Support needs who have NRPF apply for carers with Support needs who have NRPF:

  1. Urgent needs for Support can be met without an assessment using powers under the Care Act to do so;
  2. Carers with NRPF have the right to an assessment under the Care Act;
  3. Duties to promote wellbeing, prevent Support needs and provide good information apply;
  4. The same eligibility criteria applied for people with Care and Support needs applies for carers with Support needs;
  5. A Human Rights assessment is required when a carer has eligible needs but belongs to a group excluded from Care and Support services under Schedule 3 of the Nationality, Immigration and Asylum Act.

The only differences are:

  1. The duty to assess carers applies when there is an appearance of need now or likely to be an appearance of need in the future (for people with Care and Support needs the appearance of need has to be present at the time of the assessment);
  2. If a carer is not eligible for Support following appropriate assessments the Local Authority must consider the implications of this for the person with Care and Support needs. The Local Authority has a duty to meet the eligible needs of the person if the carer is no longer able to do so.

When the Carer and the person with Care and Support needs both have NRPF

Sometimes both the carer and the person with Care and Support needs will have NRPF. In this situation assessments must be carried out as outlined in these procedures for both parties.

Under the Care Act the needs assessment and carers assessment can be combined if the person and carer agree this to be appropriate.

When the Carer has access to public funds but the person with Care and Support needs does not

Under the Care Act a carer's eligibility to assessment and Support is not determined by the needs or eligibility of the person they care for. As such, a carer who has access to public funds that is providing care to a person with NRPF should receive an assessment and Support to meet their eligible needs in the exact same way as a carer who is providing care to a person who has access to public funds. However:

  1. To meet the carers needs you must not provide a service to the cared for person unless the relevant assessments have been carried out to determine that the person with Care and Support needs is eligible to receive a Care and Support service in the UK; and
  2. If you have cause to suspect that the cared for person may be an illegal entrant, a potential victim of modern slavery or a potential victim of human trafficking you must notify the Home Office.

13. People with NRPF who are Receiving After-Care under Section 117 of the Mental Health Act 1983

The Mental Health Act 1983 does not apply any exclusions based on a person's NRPF or immigration status.

This means that a person with NRPF detained under Section 3, 37, 45A, 47 or 48 of the Act is entitled to receive free Section 117 aftercare services upon discharge in the same way as anyone else. This includes a personal health budget and accommodation (where accommodation is considered a Section 117 need).

For further information about Section 117 Aftercare, including when accommodation can be provided, see: Section 117 Aftercare.

At the point when Section 117 Aftercare ends, the normal rules set out in this procedure apply.

Need to know

If it is decided that a person with NRPF who is either homeless or at risk of homelessness is not entitled to accommodation as part of their Section 117 aftercare services, alternative accommodation solutions will need to be explored. See Section 11, Meeting Needs and Review.

14. Meeting Health Needs

The Local Authority does not have any responsibility to meet health needs. However, it is important for you to know what health services can be accessed by people who have NRPF for the purposes of providing good information and advice.

GP services

GP services are free and accessible to all, even if the patient does not live in the GP's locality.

GP's can register anyone at their practice on either a permanent or temporary basis and in order to register as a patient at a GP practice a person does not have to present evidence of their address, passport or NHS number.

GP's are not permitted by law to exclude people with NRPF or who are subject to immigration control from registering at their practice unless they are excluding all potential registrants (for example if their lists are closed due to capacity).

Where a person has been refused registration with a GP a letter should be provided to them by the GP stating the reasons for refusal. If the person feels that they have been unfairly excluded they are able to appeal under discrimination law.

NHS Walk-in centres

NHS walk-in centres are free and accessible to all, regardless of where a person lives and whether they have NRPF.

A & E services at hospital

A & E services are accessible to all and life-saving and immediately necessary treatment is free.

Charging for Healthcare

The NHS will provide a service to meet any healthcare need. However they have guidelines about what health services they will charge for and who will be charged.

People subject to charging are:

  1. People with visit visas;
  2. Visa over-stayers and illegal entrants; and
  3. Refused asylum seekers who are not in receipt of asylum support from the Home Office or Care and Support under the Care Act.

As a general rule:

  1. Anything that is life-saving or immediately necessary is free;
  2. The treatment of contagious diseases is free;
  3. If one of the exemptions relating to age, pregnancy or medical condition applies, people will be able to access free prescriptions, dental care, and sight tests. People may also be able to apply to the NHS Low Income Scheme;
  4. All other services, including urgent and planned treatments will be chargeable.

If a person receives a chargeable health service any debt they owe to the NHS is taken into consideration by the Home Office when it makes decisions about any claim for asylum that the person may have submitted.

NHS Continuing Healthcare and funded nursing care

If a person is assessed as eligible for NHS Continuing Healthcare or funded nursing care this must be provided free of charge, regardless of their NRPF or immigration status.

If a person qualifying for NHS Continuing Healthcare is also homeless, the responsibility to arrange and fund temporary accommodation as set out in Section 11, Meeting Needs and review would also fall to the NHS.

15. Requirements to Notify the Home Office

Under Schedule 3 of the Nationality, Immigration and Asylum Act 2002 you are required to notify the Home Office of:

  1. Any person you suspect or know to be unlawfully present in the UK;
  2. Any person who has been refused asylum who you suspect or know to be non-compliant with removal directions.

Under the Modern Slavery Act 2015 you are required to notify the Home Office of any person who you suspect or know to be a potential victim of modern slavery or human trafficking. Guidance about how to do this can be found at GOV.UK website.

Where relevant you should notify the person or carer in question of your duties to notify the Home Office of their situation and advise them of your intention to do so.

16. The Importance of Local Policy

Local Policy is vital in ensuring that practitioners know of any specific local arrangements for supporting a person or carer with NRPF with a Care and Support/Support need. Local Policy should set clear protocols for the following:

  1. The response that should be provided to a person with NRPF that requests support from adult Care and Support;
  2. How the Local authority will ensure that it is able to meet requirements of the Care Act in relation to the skills, knowledge and competencies of practitioners working with people and carers who have NRPF;
  3. What provisions are in place for adult Care and Support to meet any accommodation needs for a person with NRPF and Care and Support needs;
  4. What subsistence payments can be made available and in what circumstances;
  5. What the position is relating to the meeting of urgent needs;
  6. What the position is relating to the meeting of ineligible needs;
  7. When Direct Payments will be offered and any situations when they will not be available;
  8. What arrangements are in place to review the situation of a person under a Schedule 3 exclusion who is being provided with interim Care and Support;
  9. Any other matter arising where a local protocol is deemed necessary.
It is your responsibility to familiarise yourself with available local policy.

tri.x adults procedures