PATIENTS NOT PASSPORTS: Migrants Access to Healthcare During the Coronavirus Crisis | June 2020 access in practice. Non-EEA migrants have to pay up to 150% of the cost of secondary and community care services. • Data sharing with the home office. Regulations introduced in 2015 offered guidance for NHS Trusts to report patients with NHS debt to the Home Office, which can then be used as a reason to refuse visa applications or deny entry to the country at the border. As part of determining a person’s eligibility for care NHS Trusts often share patients’ personal details, such as their address, with the Home Office which are then used by immigration enforcement teams. This set of policies has faced significant opposition. The British Medical Association (BMA) has called for a full and independent review of the charging regulations, while the Academy of Medical Royal Colleges and the Royal College of Midwives had also called for their immediate suspension even prior to the coronavirus crisis.6,7 A national network of campaign groups working locally to oppose NHS charging and data-sharing are organising under the banner of the Patients Not Passports campaign, supported by Docs Not Cops, Medact, Migrants Organise, and the New Economics Foundation. These campaigns work alongside those directly impacted by NHS charging, such as the Justice for Simba Campaign and Windrush Action, uniting broad sections of their communities in opposition. There is a growing body of evidence demonstrating the significant harm caused by these Hostile Environment policies in the NHS. Studies from the British Medical Association (BMA), the Equality and Human Rights Commission, and Doctors of the World show the deterrent effect of the policies on all migrants, including refugees and asylum seekers, despite them being exempt from charging under the current regulations.8,9,10,11 Our research builds on this existing evidence, finding that policies enacted under the umbrella of the Hostile Environment are deterring migrants from seeking and accessing healthcare and that this remains the case during the pandemic. 57% of survey respondents report that their members or clients have avoided healthcare due to fears of being charged for NHS care, data sharing, or other migration enforcement concerns (see Figure 2). Furthermore, in response to an open question about barriers faced by those they support, 35% list barriers directly connected to the Hostile Environment, including fears of being charged for treatment, fears of data sharing and the denial of care. FIGURE 2: HAVE YOUR MEMBERS/CLIENTS EVER AVOIDED SEEKING HEALTHCARE DUE TO FEARS OF BEING CHARGED FOR NHS CARE, DATA SHARING OR OTHER MIGRATION ENFORCEMENT RELATED CONCERN (%) 60 50 40 30 20 10 0 Yes No Don’t know 9