Guidance

S2 healthcare visitor caseworker guidance (accessible)

Updated 5 October 2023

Version 4.0

About this guidance

This guidance tells you how, from 1 December 2020, to consider applications made for entry clearance and permission to enter or stay in the UK for S2 Healthcare Visitors, contained in ‘Appendix S2 Healthcare Visitor’ to the Immigration Rules.

The ‘S2 arrangement’ (named after the relevant EU administrative form and administered under Articles 20 and 27 of Regulation (EC) 883/2004) is a reciprocal arrangement on the EU-wide co-ordination of social security systems. It applies to European Economic Area (EEA) countries and Switzerland. The S2 arrangements allow people residing in the EEA or Switzerland, irrespective of their nationality, to obtain planned healthcare treatment in another EEA country (or Switzerland) at the expense of their home state. It also provides a right of entry for a person to accompany the patient to provide care and/or support.

The EU Withdrawal Agreement, the EEA EFTA separation agreement and the Swiss citizens’ rights agreement (hereafter referred to as ‘the agreements’) protect those rights. The agreements replicate the arrangements in Regulation (EC) 883/2004 and require a route of entry into the UK to be made available, free of charge, to people who, before the end of the transition period, had requested authorisation from their home state to receive a course of planned healthcare treatment provided by the NHS under the S2 arrangements. The S2 Healthcare Visitor route allows eligible patients to obtain permission to enter the UK, after the transition period ends, to allow them to undertake their treatment. These arrangements also apply to any person accompanying a patient for the purpose of providing them with care or support during the course of the patient’s planned healthcare treatment.

Eligible patients must have applied for authorisation for treatment under the ‘S2 arrangements’ from their competent institution (such as the NHS England equivalent in the relevant member state) by 11pm Greenwich Mean Time (GMT) on 31 December 2020. If the treatment is authorised, the competent institution will then issue the patient with a ‘S2 certificate of entitlement to scheduled treatment’ (also known as a ‘Portable Document S2’) which is used to evidence their right under this route.

Where this guidance refers to ‘EEA citizens’, it should be read as referring to EU, EEA and Swiss citizens but excluding British citizens.

Contacts

If you have any questions about the guidance and your line manager or senior caseworker cannot help you or you think that the guidance has factual errors then you can email the European Migration and Citizens’ Rights Unit.

If you notice any formatting errors in this guidance (broken links, spelling mistakes and so on) or have any comments about the layout or navigability of the guidance then you can email the Guidance Rules and Forms team.

Publication

Below is information on when this version of the guidance was published:

• version 4.0

• published for Home Office staff on 07 June 2021

Changes from last version of this guidance

Guidance on the extension process has been revised.

Who can apply

A person seeking to come to the UK as an S2 Healthcare Visitor must be a person who has a healthcare right of entry under:

• Article 32(1)(b) of the Withdrawal Agreement

• Article 31(1)(b) of the EEA EFTA separation agreement

• Article 26a(1)(b) of the Swiss citizens’ rights agreement

People who are British citizens, have right of abode or are exempt from immigration control

A person who is a British citizen, including dual British citizens, or who has right of abode in the UK cannot be granted permission to enter or remain under the Immigration Rules. This is because under section 1(1) of the Immigration Act 1971 a person with British citizenship or a right of abode is not subject to immigration control.

Certain current Commonwealth citizens have the right of abode in the UK and cannot make a valid application under the S2 Healthcare Visitor route. For further information about right of abode see: Right of abode guidance.

A person who is exempt from immigration control, for example, foreign diplomats, consular staff and members of certain international organisations, cannot be granted permission to enter or remain under the Immigration Act 1971. For further information see: Exempt (EXM)

If a person who has right of abode or an exemption from immigration control applies for an S2 Healthcare Visitor entry clearance or permission to enter or stay and you are satisfied that they have right of abode or an exemption, you should advise them that their application cannot be considered and will be treated as void.

People who are Irish citizens

An Irish citizen is a person who is an Irish citizen as a matter of Irish law. Irish citizens enjoy a status in the UK under the Common Travel Area arrangements that is not reliant on the UK’s membership of the EU. They will continue to be able to come to the UK without permission after free movement ends except in a very limited number of circumstances (where subject to a deportation order, exclusion decision or international travel ban).

This means that Irish citizens do not need to apply for entry clearance, or permission to stay under the S2 Healthcare Visitor route. A non-Irish non-British person accompanying an Irish citizen patient can still apply to come to the UK under the S2 Healthcare Visitor route (or come via Ireland on the basis of Article 5 deemed leave if they are not required to apply for entry clearance in advance of travel), even if the Irish citizen patient does not apply or seek to enter on the basis of Article 5 deemed leave. In such circumstances, the Irish citizen patient must still be able to demonstrate they would otherwise be eligible to apply for the S2 Healthcare Visitor route.

People eligible to apply

The S2 Healthcare Visitor arrangements apply to patients who are undergoing S2 authorised healthcare treatment in the UK. They also apply to any accompanying persons, such as the patient’s carer or a family member, to enable them to provide care or support to the patient during their course of planned healthcare treatment in the UK.

The patient and/or the accompanying person can be of any nationality provided they are residing in the European Economic Area (EEA) or Switzerland.

Patients applying under this route will need to provide both their:

• S2 certificate of entitlement to scheduled treatment, having applied for authorisation to their competent institution for authorisation to have treatment in the UK before 11pm GMT on 31 December 2020

• relevant evidence of identity and nationality

An accompanying person applying under this route will need to provide all of the following:

• details of the patient’s S2 Healthcare Visitor entry clearance or permission to stay or alternatively a (copy of) the patient’s S2 certificate of entitlement to scheduled treatment and relevant identity documents

• evidence of their residing in the EEA or Switzerland

• their relevant evidence of identity and nationality

Patients and accompanying persons who are non-visa nationals (which includes EEA citizens), are not required to make an application for entry clearance in advance of travel. Patients and accompanying persons who are visa nationals are required to make an application for entry clearance in advance of travel, regardless of where they arrive in the UK from.

Entry via the Common Travel Area

Non-visa nationals who are not Irish, who travel to the UK from Ireland, after travelling to Ireland from a country outside the Common Travel Area (CTA) and who at the time of entry to the UK meet the above criteria will automatically have statutory permission to be in the UK under the Immigration (Control of Entry Through Republic of Ireland) Order 1972 (the ‘1972 Order’). Eligible individuals coming to the UK from Ireland under the S2 Healthcare Visitor route are deemed to have been granted 6 months leave (‘Article 5 deemed leave’). Deemed leave is leave that has not been endorsed by way of a stamp into an individual’s passport – as individuals travelling from Ireland to the UK will not necessarily encounter a Border Force officer.

Where Article 5 provisions apply, a person is treated as having 6 months leave to enter, starting from the date they entered the UK, with a prohibition on taking employment or occupation. Individuals who leave the UK for Ireland, and then return to the UK without having left the Common Travel Area will be deemed as having a further 6 months leave to enter. Further information on the requirements for Article 5 deemed leave will be available in the Common Travel Area guidance from 31 December 2020.

Patients and accompanying persons who entered the UK under these arrangements, or have Article 5 deemed leave, will be eligible to apply for further permission to stay from within the UK where the planned treatment covered by the original S2 certificate of entitlement to scheduled treatment is longer than 6 months or has been extended.

Application process

Applicants must use the specified application process as detailed on GOV.UK, and submit the required biometrics and supporting documents.

Complete applications should be processed on an expedited basis, broadly in line with the priority visa standard of 5 working days, and a right of administrative review and appeal is available for certain decisions.

Fee

There is no fee for an application for an entry clearance or permission to enter or stay for S2 Healthcare Visitors.

Applicants who are required to use a UK visa application centre (UKVAC) to verify their identity as part of their application for permission to stay may be required to pay to use these services, where they are provided by commercial partners.

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Quick guide: S2 Healthcare Visitor entry clearance

This page is a quick reference guide to the process for making a decision on an S2 Healthcare Visitor entry clearance application, made outside the UK.

When considering an S2 Healthcare Visitor entry clearance application you need to consider if:

• the applicant has submitted a valid application

• the applicant meets all the mandatory application checks

• the applicant meets the eligibility and suitability requirements of an S2 Healthcare Visitor

• the applicant is an accompanying person, are they resident in the European Economic Area (EEA) or Switzerland and have they provided the required patient information

• the applicant is a child, has their welfare been considered and have they provided the required parental consent

• the applicant has access to sufficient funds to cover all reasonable costs in relation to their visit, including their financial requirement, without working or accessing public funds

• all the relevant recording requirements have been completed

Quick guide: S2 Healthcare Visitors at the border

This page is a quick reference guide to the process for making a decision on an S2 Healthcare Visitor seeking entry at the UK border.

When considering an S2 Healthcare Visitor application, you need to consider if:

• the applicant meets all the mandatory application checks

• the applicant does not have an entry clearance or existing permission to enter, do they need entry clearance

• the applicant meets the eligibility and suitability requirements of an S2 Healthcare Visitor

• the applicant is an accompanying person, are they resident in the European Economic Area (EEA) or Switzerland and have they provided the required patient information

• the applicant is a child, has their welfare been considered and have they provided the required parental consent

• the applicant has access to sufficient funds to cover all reasonable costs in relation to their visit, including their financial requirement, without working or accessing public funds

• all the relevant recording requirements have been completed

Quick guide: extension of stay as an S2 Healthcare Visitor

This page is a quick reference guide to the process for making a decision on an application to extend permission to stay in the UK as an S2 Healthcare Visitor.

When assessing an application for permission to stay as an S2 Healthcare Visitor you should consider if:

• the applicant has submitted a valid application

• the applicant meets all the mandatory application checks

• the applicant continues to meet the eligibility and suitability requirements of an S2 Healthcare Visitor

• the applicant has provided evidence of ongoing treatment

• the applicant is an accompanying person, have they provided the required patient information

• the applicant is a child, has their welfare been considered and do they have they provided the required parental consent

• the applicant has submitted two passport sized facial photographs of themselves

• the applicant has access to sufficient funds to cover all reasonable costs in relation to their extended stay without working or accessing public funds, including their financial requirement

• all the relevant recording requirements have been completed

Assessing an application

This page gives information on dealing with applications from S2 Healthcare Visitors.

Valid applications

See: paragraphs HV.1.1 to HV.1.7 of Appendix S2 Healthcare Visitor.

Applications for entry clearance must be made whilst the applicant is outside the UK using the required online application process and on the online form ‘Apply for an exempt, diplomatic or official visit vignette, or S2 Healthcare Visitor visa’

Applications for permission to stay must be made whilst the applicant is in the UK using the required paper application process using the form ’Application to extend stay in the UK: FLR(IR) (S2 Healthcare Visitor applications only)’ which is available on request from the S2 Healthcare Visitor Extensions (Only) Inbox. The applicant must have, or have last held, permission as an S2 Healthcare Visitor’.

For a European Economic Area (EEA) citizen making an application they must provide their:

• valid passport or valid national identity card

For a non-EEA citizen making an application they must provide their:

• valid passport or other travel document which satisfactorily establishes their identity and nationality

Applicants must enrol the required biometrics. The biometric requirement for permission to stay is submission of two passport sized facial photographs of themselves.

An application which does not meet all the validity requirements for an S2 Healthcare visitor is invalid and may be rejected and not considered.

Coronavirus (COVID-19) implications for identity document validity

Some EEA states have extended the validity of passports and national identity documents as result of restrictions associated with coronavirus (COVID-19).

Caseworkers will need to consider the latest position in the relevant country and check this with a senior caseworker, however the information in the table was accurate as of 06 April 2021.

The validity of the secure French national identity card (laminated), issued to people aged 18 or over from 1 January 2004 to 31 December 2013, has been increased from 10 years to 15 years. Therefore, any such card is to be treated as having a validity period of 15 years, regardless of the expiry date printed on the card.

The table below sets out which other countries have made changes, which documents they apply to, and the impact on the expiry date.

Table showing the validity of passports and national identity documents:

Country	Document	Changes to expiry date
Bulgaria	Passport and national identity card	Any document which has expired (or is due to expire) between 13 March 2020 – 31 July 2021 is to be accepted as valid until 31 July 2021
Croatia	Passport and national identity card	Any document expiring on or after 13 March 2020 is to be treated as having no expiry date. This rule will apply until 30 days after the official proclamation of the end of the COVID-19 pandemic in Croatia
Hungary	Passport and national identity card	Any document expiring between 11 March 2020 – 3 July 2020 is to be treated as valid indefinitely Any document expiring on or after 4 November 2020 is to be treated as valid indefinitely
Italy	Passport and national identity card	Any document expiring from 31 January 2020 is to be treated as valid for proving the holder’s identity until 30 April 2021. However, it cannot be used as a travel document
Portugal	Passport and national identity card	Any document expiring after 26 February 2020 is to be accepted as valid until 31 March 2021. Any expired document is to be accepted as valid after 31 March 2021 where the holder can prove that they have an appointment to renew the document
Romania	Passport and national identity card	Any document expiring on or after 1 March 2020 is to be accepted as valid until 90 days following the end of the state of alert in Romania
Slovakia	National identity card	Any identity card expiring between 9 April 2020 – 30 April 2020 is to be accepted as valid until one month following the official termination of the state of crisis situation by the Government of the Slovak Republic Any identity card expiring between 1 May 2020 – 31 May 2020 is to be accepted as valid until 2 months following the official termination of the state of crisis situation by the Government of the Slovak Republic Any identity card expiring between 1 June 2020 – 30 June 2020 is to be accepted as valid until 3 months following the official termination of the state of crisis situation by the Government of the Slovak Republic Any card expiring on or after 1 July 2020 until the official termination of the state of crisis situation by the Government of the Slovak Republic is to be accepted as valid until 4 months following the official termination of the state of crisis situation by the Government of the Slovak Republic
Spain	National identity card	Any card expiring between 14 March 2020 - 13 March 2021 is to be accepted as valid until 13 March 2021

Treating an application as void

An application must be treated as void where:

• the applicant is a British citizen (including a dual British citizen) or otherwise has the right of abode in the UK

• the applicant dies before their application is decided

• the applicant is a person who is exempt from immigration control: see Who can apply

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Assessing a visit for S2 authorised healthcare treatment

See: Appendix S2 Healthcare Visitor.

Burden of proof

You must assess whether the applicant meets the requirements in the S2 Healthcare Visitor rules. You must be satisfied that the applicant is entering the UK for the purpose of undergoing S2 authorised scheduled treatment or accompanying/joining an individual undergoing S2 authorised scheduled treatment.

It is the applicant’s responsibility to ensure they provide evidence to satisfy you that they meet the requirements of the S2 Healthcare Visitor rules.

You must assess all the information provided by the applicant and any other evidence that may be relevant to the case. Make an assessment considering all factors relevant to the application.

Patients undergoing S2 authorised healthcare treatment in the UK must have been granted funding authorisation under the S2 arrangement. Further detail on the S2 arrangement is available on the EU website. Applicants who are granted funding authorisation receive an S2 certificate of entitlement to scheduled treatment (also known as a ‘Portable Document S2’) from the competent institution in their home state. The certificate sets out details of the patient, their treatment and the treatment facility.

Requesting further information

For the purposes of deciding whether the applicant meets the eligibility requirements you should request that the applicant provides the required information or evidence if this is missing from their application.

Where you decide to request more information or evidence from the applicant, the request must specify a timeframe of 14 calendar days from the date of the request, after which you may consider and decide the application based on all the information and evidence before you.

You must not ask for or accept a written guarantee or undertaking from the applicant that they will leave the UK when their permission to enter or stay expires.

Evidence

A patient seeking to come to the UK as an S2 Healthcare Visitor must be travelling for the purpose of undergoing S2 authorised healthcare treatment and must present a valid ‘S2 certificate of entitlement to scheduled treatment’ (also known as a ‘Portable Document S2’).

Accompanying persons seeking to come to the UK as an S2 Healthcare Visitor must be travelling with the purpose of accompanying, or joining, the patient undergoing S2 authorised healthcare treatment. They must submit evidence to show that they are resident in an EEA state or in Switzerland and must present:

• evidence that the patient holds a valid entry clearance or permission to stay in the UK as a S2 Healthcare Visitor

Or, alternatively:

• the patient’s ‘S2 certificate of entitlement to scheduled treatment and either the patient’s valid national identity card or passport issued by an EEA state (if they are an EEA citizen) or the patient’s passport or other travel document which satisfactorily establishes their identity and nationality (if they are a non-EEA national)

Photocopies of these documents are acceptable.

All applicants must provide evidence of funds to support their stay in the UK for the full duration of treatment. See: financial requirement.

Where you have reasonable doubt as to the genuineness of any photocopies of evidence submitted by an accompanying person you should request the applicant submit the original, as provided in paragraph HV.7.5 of the Immigration Rules.

If you have concerns about the genuineness of any document, you should try to verify it at source.

If you have reasonable doubts about the arrangements for scheduled treatment given to you by the applicant or the validity of the S2 certificate of entitlement to scheduled treatment, you should contact the medical practitioner overseeing the treatment in the UK, or the treatment facility in the UK to verify the evidence is genuine.

If you need to make checks on the evidence, and details of the practitioner overseeing the treatment have not been submitted you can search the relevant database. For example:

• The General Medical Council list of registered medical doctors, (or you can contact them using their telephone enquiry service on 0845 357 3456)

• The Nursing and Midwifery Council list of registered nurses and midwives

• The Health and Care Professions Council’s register of health and care professionals

If you cannot find the practitioner overseeing the treatment in the relevant regulator’s register, or if the individual is not a medical practitioner covered by the registers, you must make enquiries with the treatment facility where the treatment is due to take place to confirm whether the practitioner carries out work there and whether they are treating the patient.

Length of treatment

See: paragraph HV.10.1 of Appendix S2 Healthcare Visitor.

6-month entry clearance

The majority of S2 certificates of entitlement to scheduled treatment are likely to cover periods of treatment of 6 months or less. In these instances, an entry clearance of up to 6 months should be considered.

If the S2 certificate of entitlement to scheduled treatment covers a period of treatment longer than 6 months, an entry clearance of up to 6 months should be considered, with the applicant then required to make an application in the UK for permission to stay for further periods of 6 months (as necessary), before their entry clearance expires.

Extension of stay

See: paragraphs HV.6.2, HV.7.4 and HV.10.2 of Appendix S2 Healthcare Visitor.

In country applications for 6 months further permission to stay should be considered where circumstances dictate that an individual’s treatment period needs to be extended beyond the initial grant of permission to enter or Article 5 deemed leave. There are no restrictions on the number of 6-month extensions that can be applied for, so long as these periods are covered by the patient’s original S2 certificate of entitlement (or an extended or renewed S2 certificate of entitlement to scheduled treatment or letter from the doctor or other health professional providing the treatment in the UK detailing the further treatment required).

Applicants must, at the time of the application, be an S2 Healthcare Visitor or have Article 5 deemed leave as set out in paragraph HV.1.4 of Appendix S2 Healthcare Visitor. Applicants cannot apply for permission to stay where they are in the UK on another basis.

Non-visa nationals who entered the UK via eGates, or were verbally granted permission to enter on arrival by a Border Force officer, within the last 6 months while in possession of a valid S2 certificate of authorisation to scheduled treatment (or while accompanying or joining such a person), and have otherwise met the requirements of this route, should be considered an S2 Healthcare Visitor.

Non-visa nationals (who are not Irish) who entered the UK via Ireland within the last 6 months while in possession of a valid S2 certificate of entitlement to scheduled treatment (or while accompanying such a person), and have otherwise met the requirements of the 1972 Order, should be considered to hold Article 5 deemed leave. Further information on the requirements for Article 5 deemed leave will be available in the Common Travel Area guidance from 31 December.

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Evidence

You must check that patients applying for (further) permission to stay entered the UK as an S2 Healthcare Visitor (or hold Article 5 deemed leave) and continue to meet the requirements of this route.

Patients who initially entered for a planned treatment period longer than 6 months and who are applying for an extension to complete their treatment must have provided the following:

• the S2 certificate of entitlement to scheduled treatment originally used to enter the UK under this route, which demonstrates that the length of treatment extends beyond the permission to enter granted

Patients who initially entered for a planned treatment period of less than 6 months and are now applying for an extension to complete that treatment must have provided the following:

• the renewed or extended S2 certificate of entitlement to scheduled treatment which covers the period of the extension sought or, where this cannot be provided, the original S2 certificate of entitlement to scheduled treatment used to enter the UK under this route and a letter from the doctor or other health professional providing the treatment in the UK detailing the further treatment required

You must check that accompanying persons applying for (further) permission to stay entered the UK as an S2 Healthcare Visitor (or hold Article 5 deemed leave), continue to meet the requirements of this route and have provided the patient’s evidence set out above.

Accompanying persons may provide a photocopy of this evidence.

Where you have reasonable doubt as to the genuineness of any photocopies of evidence submitted by an accompanying person you can request the applicant submit the original, as set out at paragraph HV.7.5 of Appendix S2 Healthcare Visitor.

If you have concerns about the genuineness of any document, you should try to verify it at source.

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Applications at the border

See: paragraphs HV.3.1 to HV.3.3 of Appendix S2 Healthcare Visitor.

A non-visa national seeking to come to the UK as an S2 Healthcare Visitor for 6 months or less may apply for permission to enter on arrival in the UK.

All applicants will need to satisfy you that they meet the requirements of the S2 Healthcare Visitor route.

Whether you ask for supporting evidence will depend on the questions you ask and the answers the applicant gives.

Evidence

All applicants must provide evidence of identity and nationality:

• if they are an EEA citizen, a valid national identity card or passport issued by an EEA state

• if they are a non-EEA citizen, a valid passport or other travel document which satisfactorily establishes their identity and nationality

Applicants who are patients must also provide both of the following:

• a valid S2 certificate of entitlement to scheduled treatment

• evidence of funds to support their stay in the UK for the full duration of treatment - see financial requirement

Applicants who are accompanying persons must also provide evidence:

• they are accompanying a patient to the UK at the time of their entry into the UK or joining a patient in the UK and that patient meets the requirements as an S2 Healthcare Visitor

• they are resident in the EEA or Switzerland

• of funds to support their stay in the UK for the full duration of treatment. See financial requirement

Evidence the accompanying person is accompanying or joining a patient who meets the requirements as an S2 Healthcare Visitor must include:

• valid evidence of the patient’s permission to enter or permission to stay in the UK as an S2 Healthcare Visitor

Or, alternatively:

• the patient’s S2 certificate of entitlement to scheduled treatment:

  • if the patient is an EEA citizen, the patient’s valid national identity card or passport issued by an EEA state

  • if the patient is a non-EEA citizen, the patient’s passport or other travel document which satisfactorily establishes their identity and nationality

Accompanying persons may provide a photocopy of this evidence.

Where you have reasonable doubt as to the genuineness of any photocopies of evidence submitted by an accompanying person you can request the applicant submit the original, as set out at paragraph HV.7.5 of Appendix S2 Healthcare Visitor.

If you have concerns about the genuineness of any document, you should try to verify it at source.

If the applicant is a child, see: Children.

If an applicant is successful, they may be granted up to 6 months permission to enter, subject to a condition prohibiting access to public funds, study and work.

There are different arrangements for those travelling via Ireland – please refer to the deemed leave section in the CTA guidance.

Children

This page gives information on how to consider S2 Healthcare Visitor applications from children.

Child welfare duty

See: paragraphs HV.8.1 to HV.8.3 of Appendix S2 Healthcare Visitor.

The Home Office has a statutory duty to have regard to the need to safeguard and promote the welfare of children in the UK under section 55 of the Borders, Citizenship and Immigration Act 2009. For more information, see Safeguard and promote child welfare.

You must make sure a child’s welfare is taken into account when considering an application from someone under the age of 18.

You must only grant the application when you are satisfied that the child will be adequately accommodated, and all duty of care obligations have been met.

Child not travelling or residing with their parent or legal guardian

Where a child is not travelling or residing in the UK with their parent or legal guardian (as defined in the Immigration Rules), you must be satisfied that care and reception arrangements are adequate and that the requirement for parental consent has been met.

See recording requirements for UKVI: child not travelling or residing with their parent or guardian, for information you must record.

If details are missing, unclear or other factors raise concerns about the child’s welfare, you must make further enquiries to confirm the identity and residence of the host and make sure the child is expected.

If you remain concerned about the child’s welfare in the UK, you must refuse the application.

At the border

If you have any concerns about a child’s welfare you must contact your local authority Children’s Services department or the police where appropriate.

Children’s Services will advise on the suitability of the sponsor and will take the child into their care, if they agree that the sponsor is unsuitable or if there is no responsible sponsor. See: Border Force children’s guidance.

Parental consent and responsibility for care in home country

If a parent or legal guardian is making the application on behalf of the child, this will usually satisfy the requirement for parental consent.

In an exceptional circumstance where the application is not made by the parent or legal guardian, and there are no other factors which give cause for concern, a letter from the parent or legal guardian confirming their relationship to the child and consenting to the child’s application will be sufficient to establish that this requirement has been met. This does not preclude you from asking for further evidence if required.

If there is nothing from the parent or guardian to support the application and no reasonable explanation why this is the case, the application must be refused.

If an application is made by someone other than the parent or guardian, unless that person is a social worker representing a local authority that holds parental rights and cares for the child, you must make enquiries about the identities of accompanying adults.

Unless you have cause for concern, you do not need to make detailed enquiries into the acceptability of adults who are to accompany the child.

See recording requirements for UKVI: parental consent and responsibility for care in home country, for information you must record about accompanying adults.

If you have any concerns relating to child trafficking you must consult the victims of modern slavery guidance.

Border Force: parental consent

If there is no parental consent, refer to the Border Force children’s guidance.

Accompanied children (visa nationals)

Issuing entry clearance to an accompanied child

If a child is travelling in the company of an adult, the adult’s name and passport number must be included on the child’s S2 Healthcare Visitor entry clearance.

If the child intends to travel with 2 adults one after another during the validity of the S2 Healthcare Visitor entry clearance (for example, the child may arrive with one parent who is a patient and then travel to France with the other who is an accompanying person), each of the adult’s passport numbers must be entered on the vignette. The passport numbers are sufficient as there is not enough space on the vignette to allow for the names of 2 people as well as the passport numbers.

See endorsements and LTE/ LTR codes for the information you must include on the vignette.

Accompanied children at the border

If the child is not travelling with the adult identified on their S2 Healthcare Visitor entry clearance, and there are safeguarding concerns they may be refused.

If you have concerns over the identity of the accompanying adult, you must:

• check the passport number, initial and surname in the passport of the accompanying adult against the details recorded for the child’s S2 Healthcare Visitor entry clearance on the CRS computer record

• advise the visa application centre that issued the S2 Healthcare Visitor entry clearance so they may make a note against the record, in case subsequent applications are made by the same person

In cases where a Border Force officer observes that the accompanying adult has travelled with the child but remains airside and does not accompany the child into the UK, the terms of the S2 Healthcare Visitor entry clearance will not be met. Further enquiries must be made of the child and of the accompanying adult, if the latter can be found. In such cases it may be appropriate to refuse the child entry.

If the accompanying adult has legitimately obtained a replacement passport since the issue of the child’s S2 Healthcare Visitor entry clearance, the old cancelled passport is acceptable as evidence of identity to allow the child’s entry.

If the original passport has been retained by the issuing authority, the new passport is acceptable if it:

• gives the original passport number in full

• contains an official endorsement confirming it replaces the previous passport

Photocopies of the original passport are not, on their own, reliable evidence of identity.

Unaccompanied children

A child with an entry clearance vignette endorsed with ‘unaccompanied child visitor’ may travel with or without an accompanying adult. You must pay particular attention to applications and to the circumstances of a child coming to the UK on their own or where a child has obtained entry clearance and intends to complete a course of treatment over multiple trips but is unable to advise in advance who they will travel with on subsequent trips to the UK.

Financial requirement

This page gives information on the financial requirement for S2 Healthcare Visitors.

Showing sufficient funds

See: paragraphs HV.4.1 to HV.4.3 of Appendix S2 Healthcare Visitor.

Check the applicant has access to sufficient funds to cover all reasonable costs in relation to their visit, without working or accessing public funds. The funds must be sufficient for the duration of their planned visit to the UK, including the cost of the return or onward journey, and, where relevant, for the period of any application for extension of stay. There is no set level of funds required for an applicant to show this.

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For entry clearance and permission to stay applications you should look at the application form and any financial supporting documents to assess this requirement.

The applicant must show that any funds they rely upon are held in a financial institution to which Appendix Finance, paragraph FIN 2.1 applies.

Their income or savings, minus their financial commitments, must be sufficient to meet the likely costs they will incur in the UK and be reasonable expenditure in light of their financial situation.

An S2 Healthcare Visitor’s travel, maintenance and accommodation may be provided by a third party if you are satisfied they can and will provide support to the S2 Healthcare Visitor for the intended duration of their stay. If you are not satisfied, you should refuse.

Where a child is applying to come to the UK as an S2 Healthcare Visitor or seeking to extend their stay, they are not expected to have funds in their own name, instead they may meet the requirement by showing they have access to funds from their parents or a third party.

At the border, if an unaccompanied child is travelling to the UK, the consent from their parent or legal guardian must confirm the applicant’s reception, living and care arrangements in the UK.

Maintenance and accommodation provided by a third party

Maintenance and accommodation support can be provided by a third party under rule HV.4.3 where the support meets the requirements of rules HV.4.1 and HV.4.2 of Appendix S2 Healthcare Visitor.

Where you have doubts around the intentions of the third party to provide this support, you should request further information or evidence from the applicant if this is missing from their application.

Where you decide to request more information or evidence from the applicant, the request must specify a timeframe of 14 calendar days from the date of the request, after which you may consider and decide the application based on all the information and evidence before you. Where you continue to have doubts around the intentions of the third party to provide this support, you must refuse the application.

Other third-party support (non-financial)

Only third parties covering travel, maintenance and accommodation are mentioned in the S2 Healthcare Visitor rules. Sometimes third parties such as MPs may provide undertakings in support of an S2 Healthcare Visitor application. These cannot be considered as a guarantee that the applicant will comply with the terms of their entry clearance or permission to enter or stay. You should not actively seek out such an undertaking or accept an offer to provide one.

Where a third-party undertaking is provided with an application, you may consider it as a factor relevant to establishing the applicant’s credibility and intentions, but it should not be accepted as evidence of funds.

See ‘Recording requirements for UKVI: MP letter in support of an application’ on what to do when an MP writes to a visa application centre in support of an application.

Suitability

This page gives information on how the suitability rules apply to S2 Healthcare Visitors.

Article 20 of the Withdrawal Agreement with the European Union sets out the circumstances when it may be appropriate to restrict the right of entry or residence of an EU citizen, a family member of an EU citizen or other people protected by the Agreement. There are corresponding arrangements in Article 19 of the EEA EFTA separation agreement and Article 17 of the Swiss citizens’ rights agreement.

Articles 20(1) and 20(2) of the Withdrawal Agreement (and corresponding provision in the other agreements) mean in particular that, in relation to any restriction of the right of entry of residence in the UK of a person protected by the agreements (including those S2 Healthcare Visitors), their conduct (including any criminal convictions relating to it) before the end of the transition period is to be assessed according to the EU public policy, public security and public health test, as set out in the EEA Regulations 2016. Conduct thereafter (including any criminal convictions relating to it) will be considered under the UK criminality threshold (on the ground that it is conducive to the public good). The date the conduct or offence itself occurred should be considered and not the date a conviction or sentence was handed down as a result of that conduct.

Paragraphs HV.2.1 to HV.2.4 of Appendix S2 Healthcare Visitor set out the basis on which an application for an S2 Healthcare Visitor will or may be refused on suitability grounds.

S2 Healthcare Visitor suitability rules: relationship to part 9 of the Immigration Rules

S2 Healthcare Visitors are not subject to ‘Part 9 Grounds for Refusal’. Instead you must apply the suitability requirements in paragraphs HV.2.1 to HV.2.4 of Appendix S2 Healthcare Visitor to the Immigration Rules. These are a single set of requirements that apply to all S2 Healthcare Visitor applications whether for a visit visa, for permission to enter at the border, or for an extension of stay in the UK.

Where an application falls to be refused on suitability grounds, or an entry clearance or permission to enter or stay falls to be cancelled or curtailed, it must be done with reference to the relevant paragraph of Appendix S2 Healthcare Visitor to the Immigration Rules and not under the Part 9: Grounds for Refusal.

Suitability assessment

See: paragraphs HV.2.1 to HV.2.4 of Appendix S2 Healthcare Visitor.

The assessment of suitability must be conducted on a case by case basis and be based on the applicant’s personal conduct and circumstances in the UK and overseas, including whether they have any relevant prior criminal convictions, and whether they have been open and honest in their application.

Applicants (aged 18 or over) are required to provide information about previous criminal convictions in the UK and overseas and are only required to declare past criminal convictions which appear in their criminal record in accordance with the law of the State of conviction at the time of the application. There is no requirement to declare penalties for offences which are not recorded on their criminal records, for example fixed penalty notices for speeding. A sentence of imprisonment does not include a suspended sentence (unless a court subsequently orders that the sentence or any part of it, of whatever length, is to take effect).

Applicants (aged 18 or over) are also required, as in other immigration applications, to declare whether they have any been involved in any terrorist related activities, war crimes, crimes against humanity or genocide.

Applications are subject to a check against the Ident dataset (where the applicant is aged 10 or over) and the Warnings Index (WI).

Caseworkers can where appropriate consider evidence of criminality that they encounter on the Ident or WI even if that evidence was not declared by the applicant. Where an applicant has knowingly attempted to mislead you by not disclosing information regarding criminality that is subsequently discovered on the Ident or WI, they may fall to be refused under Paragraph HV.2.3 (a).

From information provided by the applicant and obtained from the Ident and WI, UK Visas and Immigration must conduct an initial assessment of suitability, to establish whether the application is to be referred to Immigration Enforcement (IE) for full case by case consideration of the individual’s conduct.

Consideration of mandatory grounds under paragraphs HV.2.1 and HV.2.2

Under paragraph HV.2.1 an application must be refused on suitability grounds if, at the date of decision, the applicant is subject to either:

• a deportation order

• a decision to make a deportation order

• an exclusion order

• an exclusion decision

Where the order or decision was made based on conduct committed on or before 11pm GMT on 31 December 2020, you must be satisfied that the order or decision is justified on grounds of public policy, public security or public health grounds in accordance with the EEA Regulations 2016 as set out in paragraph HV.2.2.

Guidance on making a decision under the public policy, public security or public health test is available in the EEA decisions on grounds of public policy and public security guidance.

Consideration of discretionary grounds under paragraphs HV.2.3 and HV.2.4

Where paragraph HV.2.3 applies at the date of decision, an application must be refused on grounds of suitability where, at the date of decision, you are satisfied that it is proportionate to refuse the application.

When considering whether to refuse on the basis of paragraph HV.2.3 (a) (false and misleading information or documents), you must examine whether the deception is material to the decision whether or not to grant the applicant entry clearance, permission to enter or stay. This is where the false or misleading information, representation or documentation concerns the applicant’s ability to meet the requirements.

Where false information, representations or documents have been submitted, whether or not to the applicant’s knowledge, which are material to the decision whether or not to grant the applicant entry clearance, permission to enter or stay, you may refuse the application on the basis of paragraph HV.2.3 (a), provided that it is proportionate to do so.

You must not refuse an application on the basis of false or misleading information, representations or documents, or of non-disclosure of material facts, unless you are satisfied that dishonesty or deception is involved. The interpretation of ‘false or misleading’ requires deliberate dishonesty or deception to be used in an application although not necessarily by the applicant. An allegation of dishonesty or deception must not be made unless there is evidence to support the allegation. Relevant evidence of deliberate dishonestly or deception may include, for example, discrepancies in the information provided by the applicant at various times, discrepancies between that information and information available from other sources, such as other government departments, and intelligence reports on the veracity of documents submitted.

You must not decide that an application falls to be refused under paragraph HV.2.3 (a) without first notifying the applicant in writing that you are thinking of refusing the application based on false or misleading information, representations or documents and setting out exactly what the allegation is in this regard, including making clear that it is your view that there has been dishonesty or deception. You must give the applicant a reasonable period (14 calendar days) in which to respond to the notification sent by letter or given in an interview.

A decision to refuse the application under paragraph HV.2.3 (b) (public policy, public security), on conduct that took place before 11pm GMT on 31 December 2020, must be justified on grounds of public policy, public security or public health grounds in accordance with the EEA Regulations 2016. Guidance on making a decision under the public policy, public security or public health test is available in the EEA decisions on grounds of public policy and public security guidance.

A decision to refuse the application under paragraph HV.2.3 (c) (conducive grounds), on conduct that took place after 11pm GMT on 31 December 2020, must be justified on the grounds that the decision is conducive to the public good in accordance with the Suitability grounds for refusal. Guidance on making a decision under the UK criminality threshold is available in the Suitability grounds for refusal guidance.

If one of the orders or decisions specified in paragraph HV.2.3 (d) and (e) (an Islands deportation order or an Islands exclusion decision), as made under the immigration laws of the Bailiwick of Guernsey, the Bailiwick of Jersey or the Isle of Man, applies in respect of the applicant at the date the decision on their application is made, the application may be refused subject to consideration of paragraph HV.2.4.

Where the order or decision specified in paragraph HV.2.3 (d) and (e), was made based on conduct committed before 11pm GMT on 31 December 2020, you must be satisfied that the order or decision is justified on grounds of public policy, public security or public health grounds in accordance with the EEA Regulations 2016 as set out in paragraph HV.2.4. Guidance on making a decision under the public policy, public security or public health test is available in the EEA decisions on grounds of public policy and public security guidance. An order or decision made based on conduct after 11pm GMT on 31 December 2020 is to be considered under the UK criminality threshold (on the ground that it is conducive to the public good).

Cancellation and curtailment

See: paragraph HV.11.1 of Appendix S2 Healthcare Visitor.

Paragraph HV.11.1 provides for a person’s entry clearance, or permission to enter or stay as an S2 Healthcare Visitor to be cancelled or curtailed in specified circumstances. When considering whether to cancel or curtail entry clearance or permission under paragraph HV.11.1, you may cancel or curtail only where you are satisfied it is proportionate to do so.

Paragraph HV.11.1 (a) (public policy grounds) sets out that a decision to cancel entry clearance or permission, for conduct that took place on or before 11pm on 31 December 2020, may only be taken where the decision is justified on grounds of public policy, public security or public health grounds in accordance with the EEA Regulations 2016. Guidance on making a decision under the public policy, public security or public health test is available in the EEA decisions on grounds of public policy and public security guidance.

Paragraph HV.11.1 (b) (conductive grounds) sets out that a decision to cancel entry clearance or permission, for conduct that took place after 11pm on 31 December 2020, may be taken where the decision is justified on the grounds that the decision is conducive to the public good in accordance with the Suitability grounds for refusal. Guidance on making a decision under the UK criminality threshold is available in the Suitability grounds for refusal guidance.

When considering whether to cancel entry clearance or permission on the basis of paragraph HV.11.1 (c), (false and misleading information or documents) you must examine whether the deception was material to the decision whether or not to grant the applicant entry clearance or permission to enter or stay. This is where the false or misleading information, representation or documentation concerns the applicant’s ability to meet the requirements.

Where false information, representations or documents have been submitted, whether or not to the applicant’s knowledge, which are material to the decision whether or not to cancel entry clearance or permission, you may cancel entry clearance or permission on the basis of paragraph HV.11.1 (c), provided that it is proportionate to do so.

You must not cancel entry clearance or permission on the basis of false or misleading information, representations or documents, or of non-disclosure of material facts, unless you are satisfied that dishonesty or deception is involved. The interpretation of ‘false or misleading’ requires deliberate dishonesty or deception to be used in an application although not necessarily by the applicant. An allegation of dishonesty or deception must not be made unless there is evidence to support the allegation. Relevant evidence of deliberate dishonestly or deception may include, for example, discrepancies in the information provided by the applicant at various times, discrepancies between that information and information available from other sources, such as other government departments, and intelligence reports on the veracity of documents submitted.

Under paragraph HV.11.1 (d) (change of circumstances), it may be appropriate to consider cancelling entry clearance or permission if there is evidence to show that the visitor’s circumstances or purpose in coming to or seeking to enter in the UK have undergone such a change that no longer meet the requirements of this route. This may for example be that they are no longer intending to undergo S2 authorised scheduled treatment or no longer accompanying or joining a patient undergoing S2 authorised scheduled treatment.

Permission may also be cancelled under paragraph HV.11.1 (e) (breach of conditions) where the conditions of stay under this route have been breached. You must examine whether the permission holder’s actions amount to work, study or accessing public funds. Permission should not be cancelled where the initial caseworker was aware of these actions and deemed it proportionate to grant permission.

In all circumstances where any of the above applies, and where it is proportionate to do so, the S2 Healthcare Visitor visa, entry clearance or permission may be cancelled or curtailed (as appropriate) in addition to refusing any application for permission.

Refusals

This page gives information on refusing applications for S2 Healthcare Visitors. See: paragraph HV.9.1 of Appendix S2 Healthcare Visitor.

You must be satisfied that the applicant meets all the requirements of the S2 Healthcare Visitor rules. An S2 Healthcare Visitor’s reason for seeking entry clearance, permission to enter or stay, must be for the purpose of undergoing S2 authorised healthcare treatment, or to accompany or join a patient undergoing S2 authorised healthcare treatment, and they must be able to provide the required evidence.

You should refuse the application if the applicant does not provide sufficient evidence to satisfy you that they meet the requirements of the S2 Healthcare Visitor rules.

The reasons for refusal must be factual, clear and concise and relevant to the application. On whatever ground you are refusing, curtailing or cancelling entry clearance or permission to enter or stay, you must have evidence to support the reasons why you are not satisfied that the applicant meets the requirements. For example:

• if you are refusing, curtailing or cancelling entry clearance or permission on eligibility grounds – see burden of proof and evidence

• if you are refusing, curtailing or cancelling entry clearance or permission on suitability grounds – see suitability

• if you are refusing, curtailing or cancelling on the ground that the applicant is not, or is no longer, an S2 Healthcare Visitor because they are in breach of the conditions of this route – see conditions

Refusal wording

For S2 Healthcare Visitor entry clearance applications, you should use the S2 Healthcare Visit – ROA – refusal letter template and link this to the Proviso caseworking system because this cohort has a right of administrative review and appeal.

For refusals at the border or refusals of extensions of stay you should use the following templates on DocGen, refusing in line with the S2 Healthcare Visitor rules:

• Border Force officers should continue to use IS82 templates for refusal of permission to enter but must ensure that the right of appeal is explained in the refusal letter

• UKVI in-country caseworkers should use the 3-part template for decisions on extension applications

You must keep the reasons for refusal factual, clear and concise and relevant to the applicant, the evidence provided. Examples of some of the most common refusal paragraphs, including refusal paragraphs on suitability requirements are provided in Common refusal paragraphs. You should adapt them as necessary to refer to the relevant part of S2 Healthcare Visitor rules at Appendix S2 Healthcare Visitor and they are only a guide. They must not be used verbatim and should be adapted for the specific circumstances of the case.

Personal details

You should fill out the personal details of the S2 Healthcare Visitor application as per the boxes provided.

How the application was considered

You should use the standard wording provided in the template and insert further details, where it is relevant to do so, as the template indicates in brackets.

The decision

You must keep the reasons for refusal clear and concise and relevant to the applicant and the evidence provided.

• as a guide, provide one bullet point for each factor you are not satisfied with, and where applicable, link it back to evidence provided

• do not use emotive phrases or value judgements

• follow a logical structure

• the notice should be no more than 1.5 to 2 pages maximum

Where the applicant falls for an automatic refusal under one of the mandatory suitability grounds (paragraph HV.2.1), they must be refused under the rules and you do not need to consider whether they would have met the eligibility requirements.

You must, however, consider the eligibility requirements in addition to suitability if refusing on discretionary suitability grounds. See guidance on suitability.

Where, in accordance with the guidance on document verification, you are satisfied, in relation to the application and whether or not to the applicant’s knowledge, false or misleading information, representations or documents have been submitted (including false or misleading information submitted to any person to obtain a document used in support of the application); and the information, representation or documentation is material to the decision whether or not to grant the application you must consider whether this was an innocent mistake or whether the applicant has used deception. If it is proportionate to refuse the application on this basis, you must include, as appropriate, wording set out in Common refusal paragraphs to confirm document verification checks have been made and reasons for concluding that deception was used.

Entry via Ireland under Common Travel Area arrangements

Entry via Ireland is considered in a different manner to other routes of entry, and the above process for refusal at the border may not be relevant. Please see the Common Travel Area guidance for more information.

Conditions

This page gives information on conditions applicable to S2 Healthcare Visitors. See: paragraph HV.10.3 of Appendix S2 Healthcare Visitor.

Whilst in the UK as an S2 Healthcare Visitor, the person must not access public funds, undertake work or study and may be required to register with the police in certain circumstances.

Accessing public funds

S2 Healthcare Visitors are not eligible to access public funds during their stay in the UK. Further information on which benefits and services count as public funds can be found in the public funds guidance.

Permitted medical treatment

Visitors can only access treatment in the UK if it is treatment covered by their S2 certificate of entitlement to scheduled treatment. The certificate acts as guarantee that payment is covered by the competent institution responsible for insuring the applicant, usually in their home state.

Prohibited medical treatment

For treatment not covered by an their S2 certificate of entitlement to scheduled treatment, S2 Healthcare Visitors are not eligible for free of charge or any other treatment on the National Health Service (NHS), unless an exemption from charge applies in law, and therefore may be billed for any NHS treatment received in the UK. Further details are in the Department of Health guidance on overseas visitors.

Work or employment

S2 Healthcare Visitors cannot undertake activities that would amount to work in the UK. Activities must not amount to employment or filling a role even on a temporary basis. Where you consider that the information provided means that this is the case, you must refuse the application or cancel permission as appropriate and notify the sponsor management team in case the organisation holds a sponsor licence.

See ‘Recording requirements for UKVI: employers using visitors to undertake work or fill a role’ for information that you must record and details of where to send this information.

Official – sensitive: start of section

The information on this page has been removed as it is restricted for internal Home Office use.

Official – sensitive: end of section

The reasons for refusing entry clearance or permission to enter or stay must be clear and supported by evidence. Refusal on the ground that an applicant is assessed as not being an S2 Healthcare Visitor because they will be undertaking an activity that breaches the conditions of their stay should be supported by information in the application form or from examination of the applicant at the border.

Study

S2 Healthcare Visitors cannot study during their stay in the UK. Where an individual is coming to undertake a period of study, they should apply under the Visitor, Student or Child Student route.

State education for children

Admission to local authority maintained schools is not an immigration matter. The Department for Education has policy responsibility for admissions to schools in England. Admissions policy elsewhere in the UK is a matter for the devolved administrations of Scotland, Wales and Northern Ireland. Responsibility for deciding whether to admit a child to an individual local authority-maintained school rests with the school’s admission authority, which is the local authority in the case of a community or voluntary controlled school, and is the school’s governing body in the case of voluntary aided or foundation school.

Police registration

In some cases, S2 Healthcare Visitors may be required to register with the police during their stay in the UK. Part 10 of the Immigration Rules sets out the specific categories of applicants over the age of 16 who may be required to register with the police. Further details are available in the guidance on police registration.

Related content

Refer or defer an entry clearance case Transfer or refer an entry clearance case

Related external links

List of registered medical practitioners

Administrative review and appeals

This page gives information on the appeal rights of S2 Healthcare Visitors.

Anyone who makes a valid application for entry clearance or permission to enter or stay and is refused will be able to challenge the decision by administrative review and/or by appeal.

Administrative review is available where an applicant is refused on eligibility grounds.

An appeal is available where an applicant is refused or where their permission is cancelled.

Administrative review

Where the application is refused on eligibility grounds and the applicant believes that the original caseworker has made an error or not followed the published guidance, or where they have new information or evidence in support of their application, they can apply for an administrative review of the decision.

A different caseworker in an independent team will conduct a full reconsideration of the decision, taking into account any new evidence or information submitted, and decide whether the original decision was either:

• correct and should be maintained

• incorrect and should be withdrawn and a new decision made Further guidance is available in the administrative review guidance.

Right of appeal

Anyone who makes a valid application will have a right of appeal against a decision to refuse their application on eligibility or suitability grounds.

They may appeal on grounds that the decision:

• breaches any right they have under the Withdrawal Agreement, the EEA EFTA separation agreement or the Swiss citizens’ rights agreement

• was not in accordance with the Immigration Rule under which it was made Further guidance is available in the rights of appeal guidance.

Recording requirements and other procedures

This page gives information on the recording requirements for S2 Healthcare Visitor decisions and other procedures.

UKVI and Border Force: intentions – borderline decisions

Where you have residual doubts, you must record full details of their stated intentions, especially those given verbally, either on:

• Proviso

• CID

• a written account of the interview

UKVI: MP letter in support of an application

If an MP writes directly to the visa application centre in support of an application, you should send an acknowledgement stating that when the application is assessed, the MP’s letter will be taken into account together with all other available evidence.

UKVI: employers using S2 Healthcare Visitors to undertake work or fill a role

Where you have concerns that specific companies in the UK are utilising S2 Healthcare Visitors to undertake work or fill a role, and circumventing the points- based system employment routes, you must record this in the notes section on Proviso and refer it to the Sponsor Management team.

UKVI: child not travelling or residing with their parent or guardian

You must enter the following details on Proviso or CID to record this:

• name, address and landline telephone number of the parent or carer in the child’s home country

• the host in the UK

• the person accompanying the child

UKVI: parental consent and responsibility for care in home country

You must record the following details about accompanying adults:

• names and passport number - this is necessary for the child’s visa

• address in the home country

• any address in the UK or abroad

• employment details

• their relationship to the child, their parent or guardian and their host in the UK

UKVI: child visiting to stay with a host family

Proviso/CID details must be updated to show that satisfactory care arrangements are met and to include the name, address and telephone number of the intended family or carer, as well as the parents contact details.

Failure to make sure this information is readily available may result in a lengthy delay for the child at the border.

Endorsements and LTE/LTR codes

This page gives information on what endorsements and permission to enter or permission to remain codes must be used for S2 Healthcare Visitors.

Entry clearance as an S2 Healthcare Visitor will be granted on a vignette. For European Economic Area (EEA) and Swiss citizens who made their application using an identity card, the vignette should be issued on a ‘Form for Affixing a Visa’ (FAV). For all other nationals, the vignette should be issued in the relevant passport.

Successful applicants for permission to stay should be issued a UK residence permit which states ‘S2 Healthcare Visitor’ on it. For European Economic Area (EEA) and Swiss citizens who made their application using an identity card, the UK residence permit should be issued on a ‘Form for Affixing a Visa’ (FAV). For all other nationals, the UK residence permit should be issued in the relevant passport.

S2 Healthcare Visitor visa endorsement codes

See: Visit endorsement guidance.

The visit endorsement for S2 Healthcare Visitors is Cat C- VISIT.

Endorsements for accompanied children (visa nationals)

If the child is travelling with one adult, you must include the adult’s passport number, initial and surname on the child’s vignette.

If the child is travelling with 2 adults, the endorsement must read ‘only valid if acc. by [passport number of first adult], or [passport number of second adult]’.

Entry codes at the border

See Visit endorsement guidance.

The entry code for S2 Healthcare Visitors who are entering with an S2 Healthcare Visitor visa is Code 3.

If you are landing a B5JSSK national or a European Economic Area (EEA) or Swiss citizen at the staffed primary control point in circumstances where you would endorse a Code 5N, this should be granted verbally, in line with the B5JSSK guidance.

On entry refusal codes at the border

See Visit endorsement guidance.

B5JSSK nationals and EEA and Swiss citizens

Nationals of Australia, Canada, Japan, New Zealand, Singapore, South Korea, and the United States of America (B5JSSK) and EEA and Swiss citizens are able to use ePassport gates to enter the UK. If they do so without holding a valid entry clearance but are in possession of a valid S2 certificate of entitlement to scheduled treatment (or are the accompanying person of someone in possession of an S2 certificate of entitlement to scheduled treatment), they will automatically receive 6 months permission to enter as an S2 Healthcare Visitor and will not receive an endorsement in their passport.

If granting permission to enter as a S2 Healthcare Visitor to a B5JSSK national or EEA/Swiss citizen at the staffed primary control point, you should not endorse the passenger’s travel document with a code 5N but should instead grant permission to enter verbally, in line with the B5JSSK guidance.

Common refusal paragraphs

Type of application	Paragraph or paragraphs in S2 Healthcare Visitor rules	Reason for refusal	Suggested wording
All	HV.2.1 and HV.2.2	Suitability	Your application has been refused because you do not meet the suitability requirements of an S2 Healthcare Visitor. You do not meet these requirements because you are subject to a deportation order / a decision to make a deportation order / an exclusion order / an exclusion decision which was made on [dd/mm/yyyy]. This means that you do not qualify as an S2 Healthcare Visitor and your application has been refused under paragraph HV.2.1 of the Immigration Rules, Appendix S2 Healthcare Visitor. Please see the enclosed letter which provides full details of your deportation decision / exclusion direction and any appeal right associated with that decision. You were previously advised on [dd/mm/yyyy] of the details of the decision to make a deportation order / your deportation order / your exclusion order / the exclusion direction / the decision to refuse you admission to the UK and any associated appeal rights. Those rights are not affected by this refusal under the Immigration Rules, Appendix S2 Healthcare Visitor. We are satisfied the order/decision/direction is justified, on the grounds of public policy, public security or public health. This is because [insert reasons].
All	HV.2.3	Suitability	Your application has been refused because you do not meet the suitability requirements as an S2 Healthcare Visitor and your application has been refused under paragraph HV2.3 [(a)/(b)/(c)/(d)/(e)] of the Immigration Rules, Appendix S2 Healthcare Visitor. We have carefully considered the circumstances of your case, including whether we should exercise discretion in your favour. We have also considered whether the decision to refuse your application is proportionate, taking into account your personal circumstances and the impact that refusal would have on you. We are satisfied that refusal is appropriate and proportionate because [insert reasons including what evidence has been considered and why discretion is not being exercised]. Your application as an S2 Healthcare Visitor is therefore refused under rule HV.2.3 [(a)/(b)/(c)/(d)/(e)].
All	HV.2.3 (a)	Suitability – false or misleading information	We are satisfied that you [made false or misleading representations / provided false or misleading information / provided false or misleading documents]. You stated that / submitted [detail]. We are satisfied that this information/ document was false / misleading because [detail]. We are satisfied that you knew the information / document was false / misleading because [insert reasons]. In response, you explained / provided [explain] We have taken this additional information into account when making a decision on your application, but we are satisfied that the information / representation / document was false / misleading in relation to your application and amounted to dishonesty or deception. This is because [provide details]. You have not responded to our notification in writing, or provided any additional information, after being given a reasonable opportunity to do so. Therefore, we have made a decision on the information and evidence available to us. The information / representation(s) / document(s) is / are material to the decision whether or not to grant your application as an S2 Healthcare Visitor because [provide details].
All	HV.2.3 (b)	Suitability – where conduct occurred before the end of the transition period	We are satisfied the refusal of your application is justified, in respect of conduct on or before 11pm on 31 December 2020 on the grounds of public policy, public security or public health. This is because [insert reasons].
All	HV.2.3 (c)	Suitability – where conduct occurred after the end of the transition period	We are satisfied the refusal of your application is justified, in respect of conduct after 11pm on 31 December 2020, on the grounds that the decision is conducive to the public good. This is because [insert reasons].
All	HV.2.3 (d) and (e) and HV.2.4	Suitability	You do not meet these requirements because you are subject to an Islands deportation order / Islands exclusion decision which was made on [dd/mm/yyyy] We are satisfied the order/decision is justified, on the grounds of public policy, public security or public health. This is because [insert reasons].
All	HV.3.1	Applicant does not qualify under ‘the agreements’	To qualify as an S2 Healthcare Visitor you must be eligible under one of the following: Article 32(1)(b) of the Withdrawal Agreement Article 31(1)(b) of the EEA EFTA separation agreement Article 26a(1)(b) of the Swiss citizens’ rights agreement. I have considered the information you have provided but I am not satisfied that the articles set out above apply to you. This is because you / the person you are accompanying / the person you are joining did not apply for authorisation of S2 scheduled healthcare before 11pm GMT on 31 December 2020. Your application for as an S2 Healthcare Visitor has been refused under paragraph HV.3.1 of the Immigration Rules, Appendix S2 Healthcare Visitor.
All	HV.4.1	Applicant has not demonstrated they can support themselves / will be supported for the duration of stay	To qualify as an S2 Healthcare Visitor you must demonstrate that you have access to sufficient funds to support yourself for the duration of your stay in the UK. I have considered the evidence you have provided, but I am not satisfied that you have access to sufficient funds to support yourself in the UK because [explain]. We contacted you on [insert date] to ask you to provide further evidence of your finances. Despite being given a reasonable opportunity to do so, you have not provided this evidence / You provided further evidence on [insert date] but I am not satisfied that this demonstrated you have access to sufficient funds because [explain]. Your application as an S2 Healthcare Visitor has been refused under paragraph HV.4.1. of the Immigration Rules, Appendix S2 Healthcare Visitor.
All	HV.4.3	Applicant has not demonstrated they can support themselves or they will be supported for the duration of stay by a third party	To qualify as an S2 Healthcare Visitor you must demonstrate that you have access to sufficient funds to support yourself for the duration of your stay in the UK. You have claimed that you will be supported by another person while you are in the UK. I have considered the evidence you have provided, but I am not satisfied that you will be sufficiently supported by someone else or that you have access to sufficient funds to support yourself in the UK because [explain]. We contacted you on [insert date] to ask you to provide further evidence of your finances or the support available to you from someone else. Despite being given a reasonable opportunity to do so, you have not provided this evidence / You provided further evidence on [insert date] but I am not satisfied that this demonstrated you have access to sufficient funds because [explain]. Your application as an S2 Healthcare Visitor has been refused under paragraph HV.4.1 and HV.4.3. of the Immigration Rules, Appendix S2 Healthcare Visitor.
Patient	HV.6.1	Applicant is a patient and has not provided a valid S2 certificate	You have not provided a valid S2 certificate of entitlement to scheduled treatment (also known as a ‘Portable Document S2’) in support of your application. We contacted you on [insert date] to ask you to provide an S2 certificate of entitlement to scheduled treatment (also known as a ‘Portable Document S2’) which would show you qualify as an S2 Healthcare Visitor. Despite being given a reasonable opportunity to do so, you have not provided this certificate or any other evidence that you will be undergoing S2 authorised scheduled treatment in the UK. Your application as an S2 Healthcare Visitor has been refused under paragraph HV.6.1. of the Immigration Rules, Appendix S2 Healthcare Visitor.
Patient	HV.6.2	Applicant is a patient and has not provided a valid/renewed S2 certificate or a letter from their treatment provider	You have not provided a valid/renewed S2 certificate of entitlement to scheduled treatment (also known as a ‘Portable Document S2’)/a valid S2 certificate of entitlement to scheduled treatment and a letter from the doctor or other health professional providing the treatment in the UK detailing the further treatment required in support of your application. We contacted you on [insert date] to ask you to provide evidence which would show you continue to qualify as an S2 Healthcare Visitor. Despite being given a reasonable opportunity to do so, you have not provided this certificate or any other evidence that you will be continuing to undergo S2 authorised scheduled treatment in the UK. Your application for permission to stay as an S2 Healthcare Visitor has been refused under paragraph HV.6.2. of the Immigration Rules, Appendix S2 Healthcare Visitor.
Accompanying person	HV.7.2 and HV.7.5	Applicant has not demonstrated their relationship with an S2 patient	You have not provided evidence that the person you are accompanying or joining has permission to enter or stay in the UK as an S2 Healthcare Visitor/provided the S2 certificate of entitlement to scheduled treatment (also known as their ‘Portable Document S2’) and the travel document of the person you are accompanying. We contacted you on [insert date] to ask you to provide evidence of your relationship to a person undergoing S2 authorised scheduled treatment. Despite being given a reasonable opportunity to do so, you have not provided this evidence. Your application as an S2 Healthcare Visitor has been refused under paragraph HV.7.2 of the Immigration Rules, Appendix S2 Healthcare Visitor [and HV.7.5 if original documentation was requested but not provided].
Accompanying person	HV.7.3 and HV.7.5	Accompanying person has not demonstrated that they are resident in the EEA/Switzerland	You have not provided evidence that you are resident in an EEA state or Switzerland. We contacted you on [insert date] to ask you to provide evidence that you are resident in the EEA or Switzerland. Despite being given a reasonable opportunity to do so, you have not provided this evidence. Your application as an S2 Healthcare Visitor has been refused under paragraph HV.7.3 [and HV.7.5 if original documentation was requested but not provided] of the Immigration Rules, Appendix S2 Healthcare Visitor.
Accompanying person	HV.7.4	Accompanying person has not provided the patient’s valid/renewed S2 certificate or a letter from their treatment provider	You have not provided valid evidence the person you are accompanying has permission stay in the UK as an S2 Healthcare Visitor/a valid/the person you are accompanying’s renewed S2 certificate of entitlement to scheduled treatment (also known as a ‘Portable Document S2’)/ the person you are accompanying’s valid S2 certificate of entitlement to scheduled treatment and a letter from the doctor or other health professional providing the treatment in the UK detailing the further treatment required by the person in support of your application. We contacted you on [insert date] to ask you to provide evidence which would show you continue to qualify as an S2 Healthcare Visitor. Despite being given a reasonable opportunity to do so, you have not provided this certificate or any other evidence that you will be accompanying a person who is continuing to undergo S2 authorised scheduled treatment in the UK. Your application for permission to stay as an S2 Healthcare Visitor has been refused under paragraph HV.7.4. of the Immigration Rules, Appendix S2 Healthcare Visitor.
Children	HV.8.1, HV.8.2 and HV.8.3	Required parental consent has not been provided	You have not provided the required parental consent to support your application as an S2 Healthcare Visitor. You have not demonstrated that your parent or legal guardian supports your application / living and care arrangements in the UK / travel to, and reception in, the UK. We contacted you / your parent / your legal guardian on [insert date] to ask you / them to provide the required consent. Despite being given a reasonable opportunity to do so, you have not provided evidence that the required consent has been given. Your application as an S2 Healthcare Visitor has been refused under paragraph HV.8.1. [and HV.8.2. where the consent is incomplete or HV.8.3 if written consent was requested but not provided] of the Immigration Rules, Appendix S2 Healthcare Visitor.
All	HV.10.3	Applicant intends to breach the conditions of S2 Healthcare Visitor permission	You have stated that you [insert details of activities they intend to do], but it would appear that this amounts to work / study / accessing public funds which is in breach of the conditions of the S2 Healthcare Visitor route. Therefore, your application has been refused under paragraph HV.10.3 of the Immigration Rules, Appendix S2 Healthcare Visitor.