GES NewsFlash

United Kingdom–Immigration: NHS surcharge 2015

24 April 2015


This newsflash provides a brief overview of the National Health Service (NHS) surcharge followed with frequently asked questions to assist with your understanding.

NHS surcharge explained

To remind you, the NHS surcharge was implemented from 6th April 2015 as follows:

  • The NHS surcharge is £200 per person, per year and will be applicable to those applying for a Tier 2 General visa over 6 months. It will be paid upfront for the duration of the visa. For example, for a family of four applying for visas for three years, the health care surcharge payable at the time of application will be £2,400.
  • The fee will also be applicable when extending leave to remain inside the UK.
  • At present, Tier 2 Intra Company Transfer migrants will not be subject to the surcharge.

Frequently Asked Questions

Below we have set out some frequently asked questions and responses we received from the UK Visa and Immigration when liaising with them on the NHS surcharge:

Scenario - Migrant changes employment in the UK

Question - Would the NHS charge be reduced for the time they had left on their current leave and only pay the balance for the new leave? Otherwise, if the circumstances arise, there could be double payment for a part of the leave?

Answer - If someone makes a fresh application, for example to move to a new sponsor, they would be required to pay the immigration health surcharge alongside this immigration application, for the full duration of the leave for which they may be granted. In the event they are granted, they will be refunded the difference in the surcharge between the sum they paid with the first application and with the second (except for periods of less than 6 months). In practice this means that applicants in this situation will not be paying the surcharge twice for the same period of leave.

Scenario - Migrant doesn’t manage to travel within the initial 30-day visa granted under the new Biometric Immigration Document (BID) process

Question - Presumably, when they apply for the initial 30-day visa, they will be required to pay the NHS charge. If the migrants don’t use the initial 30-day visa, they will have to apply for a new 30-day visa, would the system recognise that this is a second 30-day visa and not ask for NHS payment again?

Answer - If someone is granted leave to enter the UK and they do not travel within the validity of their 30-day multi-entry vignette, they will be required to apply and pay a fee for a new 30-day vignette.

The vignette is proof of someone’s permission to enter the UK and allows them to travel. If they have already paid the surcharge alongside their earlier entry clearance application, they will not be required to do so again.

Scenario - Individual(s) leave the UK earlier than expected and granted on their visa

Question - Could you please explain the rationale behind not allowing the NHS surcharge to be refunded?

Answer - The surcharge is a contribution to the NHS for services which someone may or may not use during their stay in the UK. It is not intended to cover an individual’s specific treatment. In the event that someone decides to leave the UK earlier than expected, it is possible for them to reenter the UK during the validity of the visa, during which time they may access health services.

Scenario - Refund Process

Question - Is there a refund process in place and details on how this will work in practice? If so, are you able to share this with us?

Answer - This will be an automatic process and will be set out in published guidance. The applicant will not need to take any action. The only time when an applicant would initiate a refund is when they wish to withdraw an application.

Scenario - Accessing the NHS services during a grant of leave

Question - Would it be possible in practice given for an example for a Tier 2 migrant who leaves the UK early, the sponsor is required to report the end of employment within 10 working days and, therefore, the individual would not be able to reenter the UK on their Tier 2 visa as this would no longer be valid. Would they still be able to reenter the UK to access the NHS services only?

Answer - Someone is not permitted to enter the UK solely for the purpose of using the NHS. The published guidance will make clear that the surcharge will not be refunded where someone leaves the UK early, where the Home Office curtails their leave, or where they successfully obtain entry clearance but do not travel.

Deloitte’s view


Deloitte reviewed the NHS surcharge process in great detail and took into account the practicalities on how the NHS surcharge will be issued and used on a day-to-day basis for both migrants and the sponsoring business. This brought about the above questions which the UK Visas and Immigration (UKVI) kindly responded to clarify, which we hope you and your businesses will find useful.


If you have any questions concerning the issues in this GES NewsFlash, please contact a GES professional at our Deloitte offices as follows:

Jurga McCluskey
+44 20 7007 7668

Tsveta Bogdanova
+44 20 7007 2499

Jessica Pattinson
+44 20 7007 8367

Anthony Michael
+44 20 7007 4370

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