A statutory instrument published on legislation.gov.uk has changed the NHS charging rules for overseas visitors in England with immediate effect. The National Health Service (Charges to Overseas Visitors) (Amendment) Regulations 2026 were made at 1.02 pm on 18 May 2026, laid before Parliament at 4.16 pm, and came into force at 6.00 pm the same day. The amendment is narrow but significant. It adds hantavirus disease to the list of conditions for which diagnosis and treatment are exempt from overseas visitor charges, while also tightening the rule where a person has travelled to the United Kingdom specifically to obtain that care.
The 2026 instrument amends the National Health Service (Charges to Overseas Visitors) Regulations 2015, the framework that governs when NHS bodies may charge people who are not ordinarily resident in the UK for relevant services. According to the explanatory note, the changes are made through amendments to regulation 9 and Schedule 1 of the 2015 Regulations. In practice, adding a condition to Schedule 1 means NHS providers in England must not charge an overseas visitor for diagnosis or treatment of that condition, subject to the limits set out elsewhere in the Regulations. The new entry covers hantavirus disease, including hantavirus pulmonary or cardiopulmonary syndrome and haemorrhagic fever with renal syndrome.
The more restrictive change sits in regulation 9. Legislation.gov.uk shows that the exemption for Schedule 1 conditions now applies only where the overseas visitor has not travelled to the UK for the purpose of seeking that diagnosis or treatment, unless the journey was made using a form of transport agreed with or funded by the Secretary of State. That matters operationally because it distinguishes between people who require care after arriving in England and people who travelled in order to obtain that care from the NHS. The revised wording keeps the exemption in place for eligible cases, but prevents it from applying automatically where treatment travel was planned without an authorised or funded transport arrangement.
The Regulations also include a backdated protection for recent hantavirus cases. A new paragraph inserted after regulation 9(3) provides that the exemption applies where an overseas visitor received services for the diagnosis or treatment of hantavirus disease on or after 1 May 2026 but before the new paragraph came into force at 6.00 pm on 18 May 2026. The explanatory note states that charges must not be made or recovered for care delivered during that period, and that any sums already paid are to be repaid. For NHS trusts and overseas visitor managers, that creates a clear requirement to review any hantavirus-related charging decisions made between 1 May and 18 May 2026.
The instrument extends to England and Wales but applies to England only, which is standard drafting where territorial extent and practical application do not fully match. It was made under sections 175 and 272(7) and (8) of the National Health Service Act 2006 and signed, by the authority of the Secretary of State for Health and Social Care, by Sharon Hodgson, Parliamentary Under-Secretary of State. The explanatory material also notes that the relevant powers are exercisable only in relation to England. For readers tracking secondary legislation, this is an England-only amendment to the existing overseas visitor charging regime rather than a broader change to NHS access rules across the UK.
The policy effect is targeted but clear. From the evening of 18 May 2026, overseas visitors in England who need diagnosis or treatment for hantavirus are brought within the exemption framework used for listed conditions, while the Government has also clarified that the exemption is not intended to cover self-arranged travel to the UK for planned access to that care. The explanatory note says no full impact assessment has been prepared because no, or no significant, impact on the private, voluntary or public sector is foreseen. Even so, the administrative effect is immediate for hospital finance teams, overseas visitor officers and clinicians, who now have to apply the revised rule and identify any repayments due for the period beginning on 1 May 2026.