HSJ’s round-up of the day’s must read stories and talking points

Patients could be forced to prove they can use NHS

A London teaching trust is working on proposals to deny free maternity care to “non-eligible” women from overseas, by requiring all patients to prove they are entitled to use the NHS.

The proposals have been revealed as part of a pilot scheme being devised by St George’s University Hospitals Foundation Trust.

The trust says the government is also working on new rules to ensure charges for overseas patients are enforced, and the Home Office is “very keen to formally support this pilot”.

The documents say if the pilot is successful “the aim would be to roll it out across the hospital to safeguard all ‘front door’ access”.

The board papers also reveal the Cabinet Office and DH are currently working on new national guidance which is “likely to advocate routine presentation of proof of identity and eligibility” for NHS care.

The papers say the cost of non-eligible overseas patients to the local system is £4.6m a year.

Currently frontline staff in A&E and obstetrics are responsible for trying to work out if a new patient is eligible for treatment. However, the papers say in many cases staff are “too embarrassed” to ask whether a patient is eligible, and there are “several categories for non-eligibility which makes the legal framework very complicated”. Clawing back money after treatment has been given can take many months and only leads to a small proportion of costs being recovered.

To avoid charges of discrimination, the trust says it would create a “blanket process for every woman referred or self-referred to St George’s for obstetric care”.

Another naughty list

NHS trusts face being named and shamed in the national media over their use of agency staff, as regulators turn up the heat on local leaders by yet another notch.

In its latest communication to trusts, regulators have warned trusts they are “falling short” of targets to slash agency spending, and may publish anonymised lists of the highest earning agency staff at individual organisations

They may also publish lists of agency staff employed for more than six consecutive months.

Although agency spending has fallen, it has not fallen quickly or sharply enough for national leaders’ liking.

The question is, do trusts really have it within their power to safely reduce agency spending by a greater amount than they already are?