In January 2021 the IMA received a number of complaints about the new UK issued European Health Insurance Card (EHIC). The complaints referred to concerns that an email inbox designated by the NHS Business Services Authority (NHSBSA), the public authority that administers activities relating to reciprocal healthcare on behalf of the Department of Health & Social Care (DHSC), to enable applicants to submit supporting evidence for their EHIC applications had reached capacity very quickly and would not accept evidence submissions. As a result, many EU, EEA and EFTA citizens were unable to progress their applications for the new UK EHIC. In addition, concerns were raised with the IMA about delays experienced by those who had successfully applied. It was reported that there had been little or no communication to update applicants of their application status.
Concern was expressed about the potential consequences of these systemic issues with the application process and the delays experienced thereafter, these being that citizens may be denied or have difficulties accessing healthcare in EU EEA & EFTA countries.
Part II of the European Union (Withdrawal Agreement) Act 2020 and Part II of the EEA EFTA Separation Agreement, confers a relevant right on citizens resident in the UK and Gibraltar through the co-ordination of social security systems including access to healthcare.
Summary of Actions and Evidence
Having carefully considered the issues identified in the complaints and other information available in the public domain the IMA sought additional information from DHSC relating to the concerns shared.
The DHSC in conjunction with NHSBSA helpfully provided information as to the technical difficulties experienced with the mailbox and the prompt action taken to resolve this. Additionally, information was shared as to how action was being taken to resolve individual concerns when this was identified on social media channels. However, the DHSC confirmed that it had a backlog of applications and delays were being experienced in processing of applications. The DHSC explained that this was, at least in part, due to the receipt of multiple card applications with differing evidential requirements.
The DHSC detailed the additional steps planned by the NHSBSA to deal with the backlog of applications experienced. The effectiveness of such will be monitored by the IMA.
As a consequence of the delays being experienced by applicants and concerns around communication the IMA engaged with the DHSC and NHSBSA with a view to identifying improvements to the service provided to citizens applying for the new UK EHIC. The DHSC and NHSBSA responded positively to the proposal and identified a series of actions that could be taken in an attempt to resolve the concerns identified.
Summary of Decision
The DHSC and NHSBSA have agreed to undertake the following actions with the objective of improving the service provided:
a) Add information about processing delays to the NHS.uk website to help manage expectations until the backlog is reduced.
b) Strengthen information about what to do whilst waiting for your EHIC including applying for a PRC, if eligible, on the NHS.uk website.
c) Continue to issue proactive statements on social media sites should delays occur.
d) Add a message to the automated telephone system used for telephone applications to advise about delays.
Summary of Monitoring and Compliance
The IMA considers that the action proposed will resolve the systemic concerns raised within the complaints received and information reviewed.
The IMA will monitor the DHSC and NHSBSA compliance with these actions for a period of six months from 28 May 2021. The IMA will publish an update at the end of the monitoring phase.
UPDATE: Conclusion of Monitoring and Compliance
The IMA have concluded the monitoring period of the new UK issued EHIC application process and backlog of applications in December 2021.
It has become evident from data requested from DHSC and NHSBSA that the backlog has been significantly reduced since the IMA began the monitoring period back in April 2021.
The backlog has been reduced from over 12,000 applications pending to an average of 392 between September 2021 and November 2021. The oldest application outstanding in these figures sits at 3 working days, meaning there is no longer a delay for applicants applying for the new UK issued EHIC.
On this basis, the IMA have been satisfied by the work undertaken by DHSC and NHSBSA to ensure the backlog of new UK EHIC applications has been reduced to a manageable number, upholding EU, EEA and EFTA citizens’ rights in accessing the UK issued EHIC health insurance card.
The complaints submitted to us help build a picture of where there are common, wide-reaching, or systemic issues with how UK public bodies are implementing the Withdrawal Agreement(s) for EU and EEA EFTA citizens’ rights.