Table 1 Characteristics of included studies
Study type | Reference | Location | Population | Methods | Setting | Scale of charge (£) | Timing of payment | Method of presenting charge | Information about repayment plans or challenging charges | Outcomes |
|---|---|---|---|---|---|---|---|---|---|---|
Qualitative | (Maternity Action, 2018) [30] | London/ Nearby | Migrant women – undocumented migrants, EU citizen, refused asylum seekers, those with temporary visas | Interviews | Maternity care | £2100-£6900 | Mostly billed after pregnancy but some received bills in advance of receiving treatment One-off charges 1–30 days to pay | Letters, invoices, and telephone calls | Information offered to some patients but not all | Perceived incorrect charging Requiring external assistance Inability to pay Refusal care Deterrence Fear of further charging Fear of data sharing Mental health impact |
Qualitative | (Feldman, 2020) [27] | London/ Nearby | Migrant women | Semi-structured interviews | Maternity Care | £2000 to £6500 | Mostly billed after pregnancy (up to a year) but some during pregnancy One-off charges | Letters, invoices and telephone calls | Information offered to some patients but not all | Deterrence Fear of further charging Fear of data sharing Inability to pay Perceived Incorrect charging Refusal of care Requiring external assistance Mental health impact |
Qualitative | (Gardner, 2021) [28] | UK | Migrants including refugees, undocumented migrants, temporary visa holders and those with indefinite leave to remain | Online survey | Not described | Not described | Not described | Not described | Not described | Fear of charging Fear of data sharing |
Qualitative | (Healthwatch Hackney, 2020) [29] | Hackney, London | Migrant women including refugees | Semi-structured interviews | Maternity care | £1000 to £15,000 | Not detailed for all charges One case of a cumulative charge for two pregnancies as a one-off charge retrospectively | Not described | Not described | Fear of charging Fear of data sharing Deterrence |
Mixed-Method | (Murphy et al., 2020) [32] | United Kingdom (mostly London) | Children’s healthcare practitioners (HCPs) | Digital survey | Pediatric Care | Not described | Not described | Not described | Not described | Deterrence Fear of data sharing Refusal of care HCP beliefs and confidence navigating regulations Physical health impact Perceived incorrect charging |
Qualitative | (Nellums et al., 2021) [31] | East London | Migrant women – all undocumented | Semi-structured interviews | Maternity | £3072 to £11,500 | Not described | Not described | Not described | Delay in healthcare access Fear of charging Fear of data sharing Inability to pay Lack of information |
Quantitative | (Potter et al., 2020) [35] | Barts Health NHS Trust, London | Adults born outside of the UK on the LTBR | Infectious disease surveillance data | Secondary care (TB treatment) | Not described | Not described | Not described | Not described | Delay in diagnosis and treatment |
Qualitative | (Doctors of the World, 2020) [26] | United Kingdom | Migrant women – asylum seeker, refused asylum seeker, other | Interviews | Secondary care (Cancer services) | One case of £8,397 | One off charge in one case study Upfront payment before treatment given in one case study | Invoice | Monthly repayments in one case study | Delay in treatment Refusal of care Perceived incorrect charging Deterrence |
Mixed-methods | (Shortall, 2015) [34] | London | Pregnant migrant women | Telephone questionnaire | Maternity care | £1500-£6000 One-off charges | Retrospective | Not described | One case of a patient paying monthly | Delay in clinic attendance Fear of further charging Fear of data sharing |
Mixed-methods | (Patients not Passports, 2020) [33] | England and Wales | Members of advocacy organisations | Online survey followed by semi-structured telephone interviews | Not described | Not described | Not described | Not described | Not described | Deterrence Fear of charging Fear of data sharing Refusal of care Lack of awareness of exemptions |