Rights to access healthcare for migrant and/or undocumented children

This guidance highlights the barriers that currently exist for certain migrant and/or undocumented children with regards to access to healthcare and attainment of a healthy life. This is in the context of recent increase in efforts to charge certain migrant and/or undocumented groups using NHS services.

First published: November 2020
Reviewed and updated: April 2022

Below is the background, aim and contents of the guidance. You can download the full document below.

You can also download a flow chart which outlines the charging regulations and exemptions to help clinicians support families.


The NHS was founded on the principle of universal healthcare. However, recent NHS charging regulations have increased restrictions to healthcare access for many migrant children, their families and other undocumented patients.

Healthcare professionals are seeing an increased number of children facing barriers to healthcare access and are increasingly asked to play a role in the implementation of charging regulations.1  There is significant concern that the NHS charging regulations are leading to delays in and denials of care, as well as eroding trust between healthcare professionals and patients.

The RCPCH is one of a number of medical colleges that  have called for suspension of the regulations, subject to a full review of their impact on individual and public health.


The aim of this guidance is to provide healthcare professionals with the knowledge and tools to advocate for migrant children and their families.

It provides tools for clinicians to recognise those most vulnerable and provides advice on how to best advocate and support. This RCPCH guidance is supplementary and clinicians should use this in conjunction with their local Trust policy.

What is covered?

  • When and to whom the charging regulations apply - this includes a list of the services and criteria where children may be charged
  • The children and services that are exempt from charging
  • Details for the four nations of where in the process the charging is applied - this includes guidance on determining immediately necessary/urgent care
  • Practical considerations including what to do if you think your patient is being wrongfully charged
  • Children and young people's rights to other public services
  • Guidance related to vulnerable groups including child trafficking and modern slavery,  unaccompanied asylum seeking children, maltreated children and children experiencing domestic abuse
  • There is also an extensive list of resources to help clinicians support migrant and/or undocumented children and families
  • 1Government U. Guidance on implementing the overseas visitor charging regulations. In: Health Do, editor. 2018.