Frimley Health NHS Foundation Trust

3. Ms T complains on behalf of her father, Mr T, about the care and treatment he received from the Trust. Specifically, she complains the Trust:

• wrongly prescribed her father potassium powder even though he had recently experienced hyperkalaemia • did not communicate with her father in a sensitive or appropriate way • failed to prepare her father’s discharge paperwork on time • moved him to the cardiac ward when this was not necessary • incorrectly calculated the cost of his treatment and • failed to provide a full breakdown of the invoice.

4. Ms T says as a result of these failings, her father now has a debt of over £6,000 on his name. She says her father has become increasingly anxious and stressed, particularly as he lives alone in India with a full-time carer and has limited financial means. She says the delay in preparing his discharge paperwork meant he stayed in hospital longer than needed, which increased the cost of his invoice. She says her father has lost trust in the NHS, feels frightened to return to the UK for future medical care and is worried the debt could affect any future immigration applications.

5. As an outcome to her complaint, Ms T wants the invoice to be waived. If this is not possible, she wants the Trust to reduce the amount to a level her father can realistically afford, as she says he cannot pay even one sixth of the current invoice. She is therefore seeking a substantial reduction in the charges.

6. Mr T lives in India and came to the UK for a short visit. He had travel health insurance covering the trip until the day after his return flight home in November 2024.

7. While in the UK, he had a routine blood test as part of registering with a GP. He was then contacted and admitted urgently to A&E for hyperkalaemia. The hospital treated him and discharged him. He was invited back for a follow up appointment a few days after his planned return date. Shortly before this appointment, he developed chest pain and went to A&E, where he was treated for arrythmia and admitted for monitoring.

8. Staff moved Mr T to a ward the following day. He told staff he wanted to be discharged. Staff said they were preparing the paperwork and expected he could go home that evening. Staff then moved him to the cardiac ward, and explained they had not yet completed his discharge paperwork. As a result, he stayed in hospital another night. Staff discharged him the next day and prescribed potassium powder to take home.

9. The Trust sent Mr T an invoice for the sum of over £6,000, for treatment he received during his stay.

12. Before we decide if we should investigate a complaint in more detail we look at whether there are signs the organisation involved has got something wrong. We do this by comparing what should have happened with what did happen. If what happened fell far short of what should have happened, we call this a failing.

13. When we see indications of a failing, we next look at whether that failing had a negative impact on the person in question. If we think it did, we will go on to consider what, if anything, the organisation has done to try and put things right.

14. There are other occasions when we decide there are other reasons why we should not investigate a complaint made to us. This includes if the outcome sought is not achievable. We saw this applies in Ms T’s case.

15. Ms T wants the Trust to waive her father’s invoice in full. She believes he should not have been charged the amount shown on the invoice. If this is not possible, she wants the Trust to reduce the amount to a level her father can realistically afford, as she says he cannot pay even one sixth of the current invoice. She is therefore seeking a very substantial reduction in the charges.

16. NHS charges for overseas visitors are set by the law. Hospitals must use national regulations and codes, such as the Overseas Visitors Regulations when calculating charges. These rules apply across the NHS and cannot be changed by individual trusts. We do not have the power to cancel, reduce or alter invoices that have been correctly raised under these legal requirements.

17. The Trust explained to Ms T it is legally required to charge people who are not ordinarily resident in the UK for their NHS treatment. It told her the invoice was calculated in line with the Overseas Visitors Regulations and that the charges were applied correctly. It also offered a payment plan to help Mr T manage the cost. We have not seen any suggestion the Trust used the wrong rules or applied the regulations incorrectly.

18. Ms T told us her father cannot afford to pay the invoice. We recognise Ms T is concerned about her father’s ability to pay. However, affordability does not give us the legal authority to waive the charges or reduce them to the very low level she seeks. The Overseas Visitors Regulations state ‘relevant bodies do not have the power to waive or cancel charges, and Secretary of State for Health and Social Care can only do so in certain situations where there are exceptional humanitarian reasons.’

19. Even if we investigated her concerns about the discharge delay or the accuracy of the invoice calculation, and even if we found the Trust should have done something differently, this would not allow us to waive the invoice in full or make the substantial reduction Ms T is asking for. Mr T’s admission would still be chargeable as an overseas visitor. The outcome she seeks is not achievable for us.

20. We understand Ms T feels frustrated and worried about the size of the debt and the impact on her father. We also realise she brought this complaint because she wants to help him.

21. Because the outcome she seeks is not something we can achieve, we cannot take her complaint forward. For these reasons, we have decided not to take any further action on this complaint.

22. We recognise this is not the outcome Ms T was hoping for. We hope we have explained our decision clearly and our statement assures Ms T we have considered her concerns carefully. We would like to thank Ms T for bringing her complaint to our attention.

1. We have carefully considered Ms T’s complaint on behalf of her father, Mr T, regarding the care and treatment Mr T received from Frimley Health NHS Foundation Trust (the Trust). We are sorry to hear of the distress caused by the invoice generated following Mr T’s admission.

2. We have decided not to take any further action on Ms T’s complaint. Ms T wants the Trust to waive the invoice it sent her for her father’s treatment, and if this is not possible, for the Trust to reconsider the invoice. We are unable to achieve this outcome. We will explain our reasons for this below.