Citation

Arkoulis N, Martin N. Lancet 2020; 395(10240): ee103-e104.

Copyright

(Copyright © 2020, Elsevier Publishing)

DOI

10.1016/S0140-6736(20)30173-2

PMID

32534651

Abstract

As one of the UK's largest tertiary burns centres, St Andrew's Burns Service has an ethical obligation to raise awareness about issues that compromise the care of patients. In 2017, new regulations placed a legal requirement on Health Authorities to establish patients' eligibility for free National Health Service treatment.1 An increasing number of patients ineligible for free care have been admitted to the St Andrew's Burns Service and subsequently presented with large invoices as soon as they recover. Unable to pay, the patients refuse further treatment and receive suboptimal rehabilitation before being lost to follow-up. This situation raises two questions, what is the actual cost burden of these patients who are ineligible? and, is such aggressive cost recovery ethical?

In October, 2019, we submitted requests under the Freedom of Information Act to all 25 UK Burns Services registered with the British Burn Association, examining costs incurred and recovered while treating patients with burns who are ineligible for free care since January, 2015 (the date of the first iteration of the new NHS charges).2 24 responses were received. The results showed substantial variability across the UK and a distinct lack of data specific to the cost of burn care (table). To establish greater clarity, we contacted stakeholders, including the Visitor and Migrant NHS Cost Recovery Programme, none of whom held information specific to burn care costs. Our data shows burn care for patients ineligible for free care has cost £1 960 501 since 2015; for comparison, the NHS England spending for the 2018-19 financial year alone is £114 billion. Even extrapolated for missing data, the cost is minimal...

Language: en