I am writing to confirm that I have now completed my search for the information which you requested on 4 September 2025.

Request

You asked us:

1. I also understand that NHS BSA has re-examined this internal guidance at some point between 7 May 2025 and 28 August 2025. I would be grateful if you could provide me a copy of both versions of this guidance, and any explanatory notes or other information produced as part of this re-examination.

2. I would be grateful if you could send me any other information, policies, guidelines, or similar documents used by NHS BSA to make decisions on IHS reimbursements other than the publicly available guidance.

The NHS Business Services Authority (NHSBSA) received your request on 4 September 2025.

We have handled your request under the Freedom of Information Act 2000 (FOIA).

On 2 October 2025, we responded to your request by providing a partial response. We supplied answers to questions 1 and 3, while advising that we do hold the requested information for question 2, and that we needed additional time to consider the public interest in disclosing information which you requested.

Our response

Question 1 - I would like information on how the Immigration Health Surcharge (IHS) Reimbursement Service determines what would be considered a Health and Social Care job role or employer.

Under Section 21 of the FOIA we are not required to provide information in response to a request if it is already reasonably accessible to you.

The information you requested is available on the GOV.UK website at:

https://www.gov.uk/government/publications/immigration-health-surcharge-applying-for-a-refund/immigration-health-surcharge-guidance-for-reimbursement-2020

For information regarding the criteria that would determine whether a job role or an employer is within Health and Social Care, refer to the GOV.UK website for guidance above. Specifically, refer to section 2 ‘Summary of eligibility criteria’, sub-section titled ‘Eligible work’ and document titled ‘Annex A’. Further information can also be found under Section 3 ‘Reimbursement Process’.

The guidance is also reflected on the NHSBSA Knowledge Base website – Immigration Health Surcharge. NHSBSA follows this guidance to base our decisions on.

You can access this on the link provided:

https://faq.nhsbsa.nhs.uk/knowledgebase/category/?articlecategory=Immigration%20health%20surcharge%20%28IHS%29&id=CAT-05789&parentid=

Please see the following link to view the section 21 in full -https://www.legislation.gov.uk/ukpga/2000/36/section/21

Question 3 - I would be grateful if you could send me any other information, policies, guidelines, or similar documents used by NHS BSA to make decisions on IHS reimbursements other than the publicly available guidance.

Besides the information requested for question 2, we do not hold any additional information other than what is publicly available on the GOV.UK website and the NHSBSA Knowledge Base website outlined above. This is due to NHSBSA processes being governed by the information provided within the GOV.UK guidance.

Question 2 - I also understand that NHS BSA has re-examined this internal guidance at some point between 7 May 2025 and 28 August 2025. I would be grateful if you could provide me a copy of both versions of this guidance, and any explanatory notes or other information produced as part of this re-examination.

Please find attached the document requested. However, some of the information you requested is being withheld as it falls under the exemption in section 31(1)(a) of the Freedom of Information Act (law enforcement) as disclosure would be likely to prejudice the prevention of crime. Revealing details about checks carried out by staff could allow applicants to tailor their claims to increase the likelihood of approval, potentially enabling them to manipulate the application process.

In applying this exemption, we have balanced the public interest in withholding the information against the public interest in disclosing the information.

Please see the web link below to see the exemption in full.

https://www.legislation.gov.uk/ukpga/2000/36/section/31
Please see the below factors in favour of maintaining the exemption, and in favour disclosure of the information.

Factors for Disclosure

• Public accountability and transparency in relation to the effective delivery of the service
• Ensure fairness to ensure that applicants understand their entitlement/eligibility to claim

Factors for withholding

• Some of the information would be valuable to someone with fraudulent intentions and would show them how to adapt their claim to bypass checks which are carried out in the checking of claims.
• Resulting fraudulent claims would result in a waste of public money spent in refunds given, and the following efforts to recover that money.

Supporting information

The internal guidance NHSBSA uses is based on the information provided under Annex A on the GOV.UK website as mentioned in our answer to question 1. During the periods you have outlined, this guidance hasn’t changed. However, as part of our routine internal review, it was identified that the interpretation of this guidance was not clear and was therefore not being applied consistently when processing IHS applications. As a result of this review, additional internal guidance was created to ensure that a consistent approach is applied. It is this guidance which is attached.

There are several web links contained within the document. Unfortunately, during the redaction process, these links in the final document are not “clickable”. Please see the attached document which provides the web links contained in the guidance document. Some other links in the document do not point to external websites. Some allow creation of an e-mail template to send to colleagues, others are “anchor links” which take users to another section of the guidance document.

Updates

When this data was being collated and reviewed, it has come to our attention that on page 1 of the document, “Skilled worker” and “Tier 2 worker” visas are the same thing. It is unlawful to update information which is subject to a FOIA request, which is why we have not changed it. However we intend to update the guidance to reflect that Tier 2 and Skilled worker Visa are one in the same, and clarify what that for the listed occupations the Visa holder can apply to either UKVI or via application link provided.

Data Queries

Please contact foirequests@nhsbsa.nhs.uk ensuring you quote the above reference if you have any specific questions regarding this response; or, if you feel you may be misunderstanding or misinterpreting the information; or, if you plan on publishing the data.

Reusing the data and copyright

If you plan on producing a press or broadcast story based upon the data please contact communicationsteam@nhsbsa.nhs.uk. This is important to ensure that the figures are not misunderstood or misrepresented.

The information supplied to you continues to be protected by the Copyright, Designs and Patents Act 1988 and is subject to NHSBSA copyright. This information is licenced under the terms of the Open Government Licence detailed at: http://www.nationalarchives.gov.uk/doc/open-government-licence/version/3/

Should you wish to re-use the information you must include the following statement: “NHSBSA Copyright 2025” This information is licenced under the terms of the Open Government Licence:

http://www.nationalarchives.gov.uk/doc/open-government-licence/version/3/

Failure to do so is a breach of the terms of the licence.

Information you receive which is not subject to NHSBSA Copyright continues to be protected by the copyright of the person, or organisation, from which the information originated. Please obtain their permission before reproducing any third party (non NHSBSA Copyright) information.