Interventions & Sanctions Directorate Midlands OVM Forum

1. Interventions & Sanctions Directorate Midlands OVM Forum 1 February 2017

2. Immigration Enforcement Interventions and Sanctions Directorate - Aims We are responsible for removing incentives that draw people to the UK illegally; fostering compliance and encouraging others to leave before their right to live in the UK has expired; and expanding Immigration Enforcement’s reach, making it increasingly difficult for illegal migrants to remain in the UK. Our aim is to:

3. ISD – Legislative Measures ISD has implemented a wide range of legislative measures to make it increasingly harder for illegal migrants to remain in the UK and to remove incentives for migrants to come to the UK illegally.

4. ISD – Partnership Working ISD builds collaborative partnerships that allow partners to make informed decisions on provision of services and provide a rich source of intelligence for Home Office teams. HMRC Denial and curtailment of tax and child benefits Identify and encourage employer compliance Illegal Working Denial and curtailment of means tested benefits Identification of chargeable patients ISD Health DWP Taxi licensing authorities Denial and curtailment of taxi licences Denial and curtailment of access to services Local Authorities Private sector services Location of absconder families Education Refusal of private sector services and products (e.g. Construction and financial services)

5. ISD – Community Engagement NHS Up-skilling trusts in identifying chargeable patients Premium immigration checking services ISD is introducing chargeable (at full cost recovery) services for public and private sector partners such as TfL, NHS trusts and Local Authorities to bolster the core free services the HO already provides.  The first embedded officers under this new model are joining partner organisations from September 2016 onwards. The next steps will be the rollout of a new real-time premium services telephone checking service and targeted training packages. Local Partnership Managers (LPMs) engage with local partners to: • raise awareness of ISD’s activities and ‘compliance environment’ measures, • identify and develop solutions to local and national issues, • target threat and intelligence-led engagement where it will have the greatest impact. Taxis Denial and curtailment of local licensing authority taxi licences Construction Reduce illegal working opportunities Local Authorities Denial and curtailment of access to services. Promoting right to rent and licensing measures.

6. Impact of the compliance environment 2,000tax credits andchild benefitsstopped, preventing £14.8m Losses between Sep14 and Aug16 22,000 Reduce illegal migrant population Compliance More Voluntary returns Deterrent v 2,600 civil penalties imposed and nearly Driving licences revokedbetween Sep14 and Aug16 £12.5m debt collected in 2015/16 6 £99m saved by financial sector avoiding fraud through data-sharing between Dec11 and Mar 16

7. Health - What have we done so far… Significant capacity has been invested to support a cultural change in the NHS where a patient’s immigration status is routinely considered to inform decisions about whether to charge for treatment. Much of this activity has been framed to support the Department of Health to deliver its Cost Recovery Programme, which aims to raise £500m from overseas patients by 2017.

8. For example: • Interventions and Sanctions Directorate and Immigration & Border Policy Directorate both sit on the Department of Health Cost Recovery Programme Board. • Through the 2014 Immigration Act, policy colleagues tightened the definition of ‘ordinary resident and, with UKVI, introduced the Immigration Health Surcharge to make sure those who come legally to the UK make a contribution to their health care costs. • ISD’s Local Partnership Managers have developed relationships with Foundation Trusts and devolved NHS Bodies, supporting these organisations and Overseas Visitor Managers through immigration awareness training and to put in place systems to identify chargeable patients.

9. For example: • We have run a series of hospital-based pilots, embedding officers to increase chargeable patient identification and improve NHS staff confidence in identifying chargeable patients. For example an ISD pilot identified circa £90,000 of savings through denial of fertility treatment – this work has informed the latest Department of Health legislation. • We have reduced the NHS Debt Threshold so that NHS debts in excess of £500 and outstanding for a minimum of two months should be reported to the Home Office and result in a refusal for further leave to enter or remain in the country. We’ve also automated the debtor referral process and use that debtor information to inform in country applications and upstream visa decision-making.

10. Where are we heading… We want to continue to drive changes to include denial of elective treatment to those with no right to be here, make sure other treatments are paid for 100% upfront, and move from reporting debt to intelligence on NHS useage to inform upstream and in-country decision-making. We also want to drive forward wider strategic change – including supporting DH in delivering real impacts from legislative change (charging for primary care). And need to ensure the strategy delivers not just DH savings but maximises immigration outcomes and further strengthens the compliance environment.

11. Nationwide action in 2016/17 to continue to reduce access to free NHS services by illegal migrants and increase compliance: Ongoing Programmes Reviewing the NHS debtor process to ensure we have the right business rules in place to feed cases into the business. Produce an e-learning pack for BF, UKVI and IE with a view to improving officers and caseworkers ability to identify NHS abuse. Ensuring that Electronic Travel Authorities (ETA) are cross referenced to Home Office systems to pick up NHS debtors. Establish a premium real time telephone based checking service primarily aimed at NHS Trusts.

12. Nationwide action in 2016/17 to continue to reduce access to free NHS services by illegal migrants and increase compliance: Potential Future Programmes Explore the development of a strategy for driving forward the Home Office’s health strategy in Wales and Scotland. Explore whether Verification Plus, DAST, Evidence & Enquiry and LPM’s engagement with NHS Trusts, and subsequent tasking of ICE teams, could be streamlined. Development of a national strategy for engaging with NHS Mental Health Trusts and Community Trusts with a particular focus on delivering voluntary returns training.  Development of a strategy for dealing with bed blocking cases.

13. Denial of elective treatments and 100% charging upfront: Ongoing Programmes: A programme of work aimed at denying fertility treatment to illegal migrants and those not entitled to free NHS treatments. Potential Future Programmes: Explore whether a programme of work could be taken forward which aims to deny the following treatments to illegal migrants and those not entitled to free NHS services -  cosmetic surgery, gastric bands, renal, cardiology, oncology , physiotherapy/rehab or transplant services. Thoughts: Our current processes of receiving intelligence from the NHS on illegal migrants is based on non payment of NHS debt. If we help the NHS move from invoicing patients to 100% charging upfront, how do we obtain our intelligence?

14. Any questions?