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There are a few questions here about emergency care for visitors in the UK accessing the NHS. None addressed my question.

From the NHS website:

Unplanned treatment on a temporary visit to England

Some NHS services or treatments are exempt from charges so that they are free to all (although prescription, dentistry and other charges may still apply). These include:

  • accident and emergency services – not including emergency treatment if admitted to hospital

My question is specifically for emergency care for an ailment such as a broken bone which requires surgery that takes place the same day. If the patient insists on being discharged that same day (even against doctors wishes), will the cost of the medical care be classified as free? Does admission specifically refer to staying overnight?

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  • An added note, as you are a US citizen: if you have insurance that covers you when abroad (either existing or added travel insurance), generally it would not be paid or reimbursed if you leave Against Medical Advice (AMA). Health care providers would require you to sign an acknowledgement of AMA, which becomes part of the medical record, and relieves both provider and insurer of liability.
    – Giorgio
    Nov 11, 2018 at 0:13

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In Accident and Emergency you receive emergency care and triage. The target is a maximum of 4 hours between arrival at A&E and either discharge or admission. This target is not always met but you should understand that in A&E you will receive resuscitation if your heart has stopped, but not surgery to set a broken bone.

So if you present at A&E with a suspected broken bone, they will treat you to stop your bleeding and administer pain relief. That is free to anyone. They will then offer to admit you as an inpatient. If you are admitted you will be liable for the cost of your care.

If the patient does not consent to treatment (as is their right) then they would be discharged from A&E, and not incur any fee. However, in this case, they would still have a broken bone.

Being admitted does not necessarily mean staying overnight. You may be admitted as an outpatient (you are not assigned a bed, but receive treatment and then leave) or a daypatient (you are assigned a bed for the duration of your treatment, but do not stay overnight).

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Not necessarily - you can be admitted as an outpatient, day patient, or an inpatient https://www.nhs.uk/using-the-nhs/nhs-services/hospitals/going-into-hospital-as-an-inpatient-or-outpatient/ A&E provides medical care for life-threatening emergencies; less serious injuries are treated at ‘urgent care centres’. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/742251/guidance-on-implementing-the-overseas-visitor-charging-regulations-may-2018.pdf#page64

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  • Your answer is not clear. What does admitted to the hospital mean? The link you provided implies every visit to the hospital is an admission. That would mean there is no free service for visiting the hospital by a visitor.
    – Augustine of Hippo
    Nov 10, 2018 at 19:45
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    @HonoraryWorldCitizen I suspect in this case the dividing line is the transfer from A&E to the main hospital. Certainly the law on admittance is for in-patients, whether day or overnight. (see paragraph 9 of legislation.gov.uk/uksi/2015/238/pdfs/uksi_20150238_en.pdf)
    – origimbo
    Nov 10, 2018 at 20:04
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    What @HonoraryWorldCitizen refers to, I believe, is A&E: assessment and, as appropriate, treatment (exam, imaging, labs, sutures, cast, medication etc.). In patient admission from A&E is separate (discharged from A&E, then admitted to the hospital) and that's when they become responsible for both the emergency services and in-patient costs. For those not covered, e.g., foreign tourists, NHS advises them up front if care is chargeable before treatment begins. Sometimes, treatment is the only option; surgery requires admission and consent BTW, even if it's not overnight.
    – Giorgio
    Nov 10, 2018 at 20:39

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