NHS Healthcare for Asylum Seekers in the UK: Your Rights and the New 2025-2028 Government Agreement

Key Takeaways

• On 30 July 2026, the Home Office, UK Health Security Agency, Department of Health and Social Care and NHS England published a National Partnership Agreement on the health and wellbeing of people seeking asylum in England, covering 2025 to 2028.
• The agreement does not create new legal rights. It commits four organisations to work together on health assessments, access, safeguarding, data sharing and funding. It applies to England only.
• Anyone in England can register with a GP free of charge. A practice cannot refuse you because you have no proof of address, no ID or no settled immigration status, as confirmed in the NHS entitlements: migrant health guide.
• People with an undetermined asylum claim, and those receiving section 95 support, are exempt from NHS hospital charges in England. Refugees and people granted humanitarian protection are also exempt.
• People on section 95 support are sent an HC2 certificate automatically within 21 days. It covers free prescriptions, NHS dental treatment, sight tests and vouchers towards glasses. People on section 98 or section 4 support must apply using form HC1.
• Asylum seekers are exempt from the Immigration Health Surcharge, while most work and study applicants pay £1,035 or £776 per person per year.
• For employers: asylum seekers normally cannot work. Where permission to work is granted after a 12 month wait, applications made from 26 March 2026 are limited to jobs on Appendix Skilled Occupations at RQF level 6 or above, and you must obtain a Positive Verification Notice before employment starts.
• WorkPermitCloud is an IAA-regulated legal and HR-tech firm supporting migrants and UK employers. We advise on immigration compliance, run HR compliance audits, provide UKVI-compliant HR software that tracks right to work expiry dates, handle Skilled Worker visa applications for people moving on from protection status into sponsored work, and list verified sponsored vacancies on WPC Jobs.

Introduction

On 30 July 2026, four government bodies signed and published a joint agreement on how the health and wellbeing needs of people seeking asylum in England will be met between 2025 and 2028. The document is a policy paper rather than a change in the law, but it matters. It is the first time the Home Office, the UK Health Security Agency, the Department of Health and Social Care and NHS England have set out a shared, published plan for people living in asylum accommodation in the community rather than in detention.

For people in the asylum system, the practical questions are simpler than the policy language. Can I see a doctor? Will I be charged? Do I have to pay for my medicine? What happens when the Home Office moves me to a different city? For employers and HR teams, the questions are different again. Can someone with a pending asylum claim work for us? What does a correct right to work check look like? What do we do when a member of staff is granted refugee status?

This guide answers both sets of questions. Every figure and rule below is taken from official sources on GOV.UK and NHS England, and each one is linked so you can check it yourself. You may also want to read our related guide on the UK asylum reform policy.

What the New National Partnership Agreement Actually Says

The National partnership agreement on meeting the health and wellbeing needs for people seeking asylum in England 2025-2028 was published on 30 July 2026 and applies to England. It builds on the existing national partnership agreement for immigration removal centre healthcare, but its focus is different. This agreement covers people living in the community in Home Office accommodation, which includes initial, contingency and dispersal accommodation, rather than people held in detention.

The document is explicit that it is not a special deal. It states that the partnership does not represent preferential treatment, and that healthcare in the UK is prioritised by public health and clinical need only. In other words, it is an agreement about how existing services are joined up, not about creating a separate health system.

The four partners and what each one does

Source: GOV.UK, National partnership agreement on asylum seeker health in England, published 30 July 2026.

Who signed it

The agreement is signed by the Director of Asylum Support at the Home Office, the Department of Health and Social Care, the Interim Chief Medical Advisor at UKHSA and the Chief Executive of NHS England.

Why the Agreement Was Needed

The agreement sets out the reasoning behind it. People seeking asylum are part of what the NHS calls inclusion health groups, which experience significantly worse health outcomes than the general population. The document points to stigma and social exclusion, overlapping risk factors such as poverty, violence and complex trauma, and inconsistent recording of asylum seekers in healthcare databases.

It also acknowledges practical barriers that are easy to overlook: people arriving from countries with limited preventative healthcare, difficult and sometimes traumatic journeys, a lack of trust in government-funded services, infection transmission risk in shared accommodation, language barriers and simply not knowing how the NHS works. Inclusion health populations are a target group under NHS England's Core20PLUS5 framework and its national framework for NHS action on inclusion health.

The agreement is clear that health services alone cannot fix this. It names local and national government, voluntary and community organisations, the private sector, the media and local communities as having a part to play, alongside wider determinants of health such as safe housing, nutritious food and social connection.

The Four Objectives and Ten Priorities for 2025 to 2028

The partnership is built around four shared objectives. Under those objectives sit ten agreed priorities, which will be delivered through a workplan setting out activities, owners, timelines and measures.

The ten priorities are worth reading closely if you work in this area, because they tell you where attention and money are likely to go over the next two years. Priority 3 (access to healthcare) and priority 5 (move on) are the two that most directly affect individuals in the system.

How the partnership will be governed

Oversight sits with the Strategic Senior Health Oversight Group at senior department level and the Tactical Senior Health Oversight Group at operational level, both currently co-chaired by the Home Office and DHSC. At regional level, the Home Office engages with integrated care boards, Strategic Migration Partnerships, local authorities, NHS England regional teams, Regional Directors of Public Health and UKHSA health protection teams.

Delivery is scrutinised by bodies that already exist, including the Independent Chief Inspector of Borders and Immigration, the National Audit Office and Treasury, the Care Quality Commission, local authority safeguarding boards, the Home Affairs Committee in Parliament, and Healthwatch.

What NHS Care Can Asylum Seekers Actually Access?

This is where the practical detail sits, and it comes from the NHS entitlements: migrant health guide published by the Office for Health Improvement and Disparities, not from the new partnership agreement.

Services that are free to everyone, whatever your immigration status

Some NHS services are free of charge to anybody in England, regardless of status, provided the person did not travel to the UK specifically to obtain that treatment:

• Accident and emergency services, including A&E departments, walk-in centres, minor injuries units and urgent care centres.
• Diagnosis and treatment of certain communicable diseases, including HIV and tuberculosis.
• Diagnosis and treatment of sexually transmitted infections.
• Family planning services, which does not include termination of pregnancy or fertility treatment.
• Treatment for a physical or mental condition caused by torture, female genital mutilation, domestic violence or sexual violence.
• Palliative care provided by a registered palliative care charity or community interest company.
• NHS 111.

GP and nurse consultations in primary care are also free to everyone, whether you register as an NHS patient or are seen as a temporary patient.

Groups exempt from NHS hospital charges

For hospital (secondary) care, England operates a residence-based system. People who are not "ordinarily resident" can be charged 150% of the national NHS rate. However, the overseas visitors hospital charging regulations exempt several groups entirely, including:

• Refugees, and people granted humanitarian protection or temporary protection, plus their dependants.
• Asylum seekers whose claim, including any appeal, has not yet been determined, plus their dependants.
• People receiving support under section 95 of the Immigration and Asylum Act 1999.
• Children looked after by a local council.
• Victims and suspected victims of modern slavery or human trafficking, plus a spouse or civil partner and children under 18 who are lawfully present.
• Prisoners and immigration detainees.

Registering with a GP: What You Need and What You Do Not

Registering with a GP is the single most useful thing a newly arrived person can do, and it is where most avoidable problems occur. The rules are clear. A practice is not required to ask for proof of identity, proof of address or immigration status. NHS guidance on how to register with a GP surgery confirms a practice cannot refuse someone because they lack proof of address or immigration status.

An application to join a practice can only be refused on reasonable grounds. It cannot be refused because of a medical condition or any protected characteristic such as age, disability, race, religion, sex or sexual orientation. If a practice does refuse:

• It must still provide any immediately necessary treatment requested, free of charge, for up to 14 days.
• It must notify the applicant of the refusal and the reason in writing within 14 days of the decision.

Anyone struggling to register can contact their local NHS England area team or the local Patient Advice and Liaison Service. Practices registering people who are not ordinarily resident will ask them to complete a GMS1 form with supplementary questions.

Help with Prescriptions and Dental Costs: The HC2 Certificate

In the UK, most people under 60 pay for prescriptions, eye tests and dental care. People on a low or no income can apply for an HC2 certificate, which gives full help with health costs. Anyone can apply regardless of immigration status. NHS England has published specific guidance to support HC2 applications for asylum seekers, last updated on 26 February 2026.

An HC2 certificate covers free NHS prescriptions, free NHS dental treatment, wigs and fabric supports, free sight tests, vouchers towards the cost of glasses or contact lenses, and necessary travel costs to and from hospital for NHS treatment under a consultant.

How to get an HC2 certificate by type of asylum support

Source: NHS England, Guidance to support HC2 application for asylum seekers (publication reference PAR1883), updated 26 February 2026.

Three practical points that catch people out

• On the online HC1 form, the question asking whether you are supported by UK Visas and Immigration assumes everyone answering "yes" is on section 95. If you are on section 98 or section 4, tick "no", otherwise the form will tell you it is not the right one for you.
• If you need a prescription or dental care before your certificate arrives, tick box "L" on the back of the prescription form. A pharmacy or dental practice cannot refuse to serve you on this basis.
• HC2 certificates for asylum seekers normally last six months. Unless you are on section 95, you must submit a new HC1 before the expiry date shown on the certificate.

The NHS Low Income Scheme Helpline is 0300 330 1343 and has interpreters available. Migrant Help can be reached on 0808 801 0503. More detail is on the NHS Low Income Scheme pages.

Asylum Support and Accommodation: The Backdrop to the Agreement

The partnership agreement is built around the accommodation pathway, so it helps to understand what asylum support involves. Under the Immigration and Asylum Act 1999, the Home Office has a discretionary power to support asylum seekers and their dependants who would otherwise be destitute. According to GOV.UK asylum support guidance, this is what is provided:

Source: GOV.UK, Asylum support: What you'll get. Rates are those published at the time of writing and are reviewed periodically.

If you are considering an application, the eligibility rules for asylum support and the Home Office guidance on living in asylum accommodation are both worth reading. The latter is available in several languages.

Why Asylum Seekers Do Not Pay the Immigration Health Surcharge

One of the most common questions we receive is why an asylum seeker gets NHS care without paying the Immigration Health Surcharge when a Skilled Worker or student pays thousands of pounds upfront. The answer is that the two routes work on completely different legal bases.

The surcharge is charged as part of a visa application for a stay of more than six months. People seeking asylum or applying for humanitarian protection, and their dependants, are exempt from paying it. Their exemption from NHS hospital charges instead comes from the overseas visitors charging regulations described above.

Source: GOV.UK, Pay for UK healthcare as part of your immigration application. Surcharge rates correct at the time of writing.

Health and Care Worker visa applicants are also exempt from the surcharge. If you are moving from protection status into sponsored employment, our Skilled Worker visa service and our guide to UK immigration changes in 2026 explain what happens next.

Refused Asylum Seekers: Where the Rules Change

Entitlements narrow if a claim is refused and appeal rights are exhausted. The position in England is as follows.

• Primary care stays the same. Refused asylum seekers can register with a GP and receive free primary care services, as can anyone else regardless of immigration status.
• Free secondary care continues only if the person receives section 4(2) support from the Home Office, section 21 support from a local authority, or support under Part 1 of the Care Act 2014.
• Any course of treatment already underway before the refusal continues free of charge.
• Treatment that clinicians consider immediately necessary or urgent will be provided even if payment has not been made in advance.
• Maternity care is always provided, even where charges apply.
• A&E, diagnosis of infectious diseases (even where the result is negative) and treatment of those diseases where the test is positive remain free.

If you disagree with a decision on your claim or your support, our immigration appeals signposting service can point you to the right route.

What This Means for UK Employers and HR Teams

Employers rarely think of an asylum health agreement as their business. In practice, three parts of this landscape sit squarely with HR.

a) Asylum seekers normally cannot work, and the rules changed in March 2026

Home Office permission to work guidance (version 18.0, updated 26 March 2026) sets out the position under Part 11B of the Immigration Rules. People who claim asylum are not normally allowed to work while their claim is considered. They may apply for permission to work only if their claim has been outstanding for more than 12 months through no fault of their own.

Source: GOV.UK, Permission to work and volunteering for asylum seekers, version 18.0, 26 March 2026.

Other points that matter for recruitment. There is no provision to grant permission to work to dependants on a claim, even after 12 months. Children under 18 are not given permission to work. Any permission granted ends when the claim is refused and appeal rights are exhausted. Applications must be made on form PTW1, and the decision notice (ASL 4264) should be retained by the applicant as evidence. It is the responsibility of the applicant and the employer to check that the job is on the correct list, meets the salary threshold and matches the applicant's qualifications.

b) The right to work check is different, and getting it wrong is expensive

An asylum seeker with permission to work holds an Application Registration Card, not a share code or a passport endorsement. GOV.UK guidance on checking a job applicant's right to work is explicit: where someone presents an Application Registration Card, you must ask the Home Office to check their status through the Employer Checking Service. The card must state that the work you are offering is permitted. The Home Office will send a Positive Verification Notice, which you must keep. Do not start employment before you have it.

The consequences of skipping this are set out on GOV.UK: a civil penalty of up to £60,000 for each illegal worker, publication of your business details by Immigration Enforcement, and, where you knew or had reasonable cause to believe there was no right to work, up to five years imprisonment and an unlimited fine. A correct check is a complete defence. Our employer's guide to right to work checks and our guide to the UK digital ID card and right to work walk through the process step by step, and the Home Office employer's guide is the authoritative source.

c) Volunteering is allowed at any stage, but the boundary is strict

Asylum seekers may volunteer at any point in the process without permission to work. The Home Office actively encourages it. The line, however, is firm. Volunteering must not amount to employment or job substitution. There should be no payment beyond reasonable travel and meal expenses actually incurred, no contractual obligation on either side, and the role must be with a registered voluntary or charitable organisation, a fundraising body for one, or a public sector organisation. Working as an employee for a charity is treated exactly like employment anywhere else.

d) When someone is granted status, the picture changes completely

People granted refugee status, humanitarian protection or other leave to remain have unrestricted access to the labour market. No sponsorship and no Employer Checking Service verification are needed once they can evidence their status. For employers building a compliant process around all of this, our HR compliance service, immigration compliance support and UKVI-compliant HR software keep right to work evidence, expiry dates and reporting duties in one auditable place.

There is also a wellbeing dimension that HR teams should not dismiss. The partnership agreement documents trauma, language barriers and low health literacy as common in this population. Practical steps such as signposting GP registration, allowing time off for health appointments and providing interpreted materials cost very little and make a measurable difference. If you also sponsor workers, our sponsor licence service covers the wider compliance framework.

England, Scotland, Wales and Northern Ireland

The new partnership agreement applies to England only. Entitlement rules also differ across the UK, which matters if someone is dispersed or moves.

Source: GOV.UK, NHS entitlements: migrant health guide, section on vulnerable migrants.

Scotland-specific information for individuals is available from NHS inform.

What to Watch Over the Next Two Years

The agreement runs to 2028 and commits the partners to a workplan with owners, timelines and metrics. Three things are worth tracking:

• Health assessments on arrival. The first objective commits to expanding and improving access to a systematic health and wellbeing assessment early in the asylum journey. If delivered, this would be the most visible change for individuals.
• Data flow between organisations. Priorities 4 and 8 focus on linking information systems so that a person moved between regions does not lose continuity of care. Poor data flow is currently one of the biggest practical failures in the system.
• Changes to the accommodation estate. Priority 9 explicitly anticipates that the design of asylum accommodation will change over 2025 to 2028 in response to government policy, and commits services to adapt alongside it.

We publish updates on developments like these on the WorkPermitCloud blog.

How Can WorkPermitCloud Help?

WorkPermitCloud is an IAA-regulated legal and HR-tech firm specialising in UK business immigration and HR systems. If you have protection status and want to move into sponsored employment, we handle Skilled Worker visa applications and partner and family visas, and you can search verified sponsored vacancies on WPC Jobs. If you are an employer, our immigration compliance and HR compliance services make sure right to work checks, Employer Checking Service verifications and follow-up checks are done correctly, and our UKVI-compliant HR software evidences all of it automatically. You can also book an appointment or browse our blog library for related guides.

Conclusion

The National Partnership Agreement published on 30 July 2026 will not change anyone's legal entitlement to NHS care. What it does is put four organisations on the record about how they will work together for the next two years, with named objectives, ten priorities and published scrutiny arrangements. For a system that has been criticised for fragmented data, inconsistent assessments and lost continuity of care when people are moved, that is a meaningful step.

For individuals, the more useful message is that the entitlements already exist. You can register with a GP without documents. You are exempt from hospital charges while your claim is undetermined. You can get free prescriptions and dental treatment with an HC2 certificate. Knowing these three things, and acting on them early, makes a bigger difference than any policy paper.

For employers, the message is about precision. The permission to work rules changed on 26 March 2026, an Application Registration Card requires an Employer Checking Service verification rather than a document check, and a mistake costs up to £60,000 per worker. If you are unsure about any of it, speak to us.

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