London NHS trust sorry for delay to man's care over immigration status

A north London NHS health trust has apologised after an A&E receptionist tried to delay a man's care over his potential immigration status.

BBC London reporter Anna O'Neill took her neighbour to North Middlesex University Hospital in Edmonton as he was in pain and unable to urinate.

However, when she tried to check him in for treatment a receptionist accused him of coming "for free treatment".

The trust said it would "use" the incident to train staff.

On arriving at A&E, the receptionist was told the man did not have a British passport or an NHS number and was not registered with a GP, but had not been able to urinate for more than 24 hours and may be at risk of sepsis due to him vomiting and having a high temperature.

After being told he needed to provide more information before he could be seen, the BBC began recording the conversation.

The man, who did not wish to be named, was visibly struggling to speak and stand but the receptionist said he had to fill out extra forms and accused him of coming "for free treatment", adding "he's not even bothered to get a GP".

"The trouble is he's lived here all this time and he's not done the legal requirements and this is the repercussions unfortunately," she added.

When challenged about whether forms were initially required in an emergency situation, she continued asking questions about his "original" address and first language, adding: "If I went to his country they wouldn't see me."

She then began explaining an NHS charging department would "chase" his case and he may be charged for further treatment.

When asked if they could "worry about all that afterwards" the receptionist responded: "It doesn't work like that unfortunately. That's not how we work in the NHS. It's not my rules."

The man's immigration status is unknown but there is no suggestion he is in the UK illegally.

Although foreign nationals may be charged for treatment if they are not legally resident in the UK, NHS guidance says emergency primary care is free for all and should not be delayed or refused to anyone, regardless of their immigration status, and that any attempt to do so may be illegal.

The National Institute for Health and Care Excellence (NICE) classifies acute urinary retention as a medical emergency.

The man was eventually sent to a triage team and was seen hours later by a doctor, given morphine, fluids and anti-sickness medication.

After further treatment he is now at home and told BBC London he is feeling much better but is certain it would have been a different story without help.

Following the incident, Labour MP for Hornsey and Wood Green, Catherine West, submitted a parliamentary question to health minister Helen Whatley asking what guidance is given to A&E departments "to ensure staff are aware that A&E services are free of charge regardless of immigration status".

Ms Whatley replied guidance is given to the NHS which "makes it clear that some services, including accident and emergency, are free at the point of delivery for everyone".

A spokesperson for the North Middlesex NHS Trust apologised "for any distress [the patient] experienced when he first came to North Mid for emergency care".

They said the trust was "keen to speak with him individually" and wished him a "rapid recovery with ongoing privacy".

The trust has looked into the incident and would "use this episode" to be clearer with staff that "registration, including the use of formal ID or GP details, is not a prerequisite for the emergency element of care", the spokesperson added.

They said the trust would also "reiterate to all our staff the importance of interacting sensitively with all patients, especially those in distress or who may be unfamiliar with the NHS".

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