Medical claims under Articles 3 and 
       8 of the European Convention on 
       Human Rights (ECHR) 
        
       Version 8.0 
        
                    
          Page 1 of 37  Published for Home Office staff on 19 October 2020 
        
        
       Contents 
        
       Contents ..................................................................................................................... 2 
       About this guidance .................................................................................................... 4 
        Contacts ................................................................................................................. 4 
        Clearance ............................................................................................................... 4 
        Changes from last version of this guidance ............................................................ 4 
       Purpose of instruction ................................................................................................. 6 
        Background ............................................................................................................ 6 
        Policy intention: medical claims .............................................................................. 7 
        Application in respect of children: medical claims ................................................... 7 
       Relevant legislation and case law .............................................................................. 9 
        International law...................................................................................................... 9 
        Domestic legislation ................................................................................................ 9 
        Important case law .................................................................................................. 9 
        Medical claims as protection cases case law ....................................................... 11 
       Applications on medical grounds .............................................................................. 12 
        Application forms .................................................................................................. 12 
        Applications by letter ............................................................................................. 12 
        Charging: Article 3 only ......................................................................................... 13 
        Charging: Articles 3 and 8 mixed applications ...................................................... 13 
         Implied medical claims ...................................................................................... 13 
         Requesting confirmation ................................................................................... 14 
        Claims indicating Refugee Convention protection needs ...................................... 14 
        Further leave applications ..................................................................................... 15 
        Further submissions following the refusal of asylum............................................. 15 
       Considering medical claims ...................................................................................... 17 
        Article 3: medical cases ........................................................................................ 17 
         Substantive test................................................................................................. 18 
         Procedural obligations ....................................................................................... 18 
          Step 1 ............................................................................................................ 18 
          Step 2 ............................................................................................................ 19 
          Step 3 ............................................................................................................ 19 
         Assessing the risk facing the claimant on return ............................................... 20 
         Availability and accessibility of treatment .......................................................... 20 
       Page 2 of 37   Published for Home Office staff on 19 October 2020 
        
        
         Obtaining medical country of origin information ................................................ 21 
         Obtaining assurances from the receiving state ................................................. 22 
         Other exceptional circumstances ...................................................................... 22 
       Article 8: medical cases ............................................................................................ 23 
       Transplant cases ...................................................................................................... 25 
        Pre-transplant cases ............................................................................................. 25 
        Post-transplant cases ........................................................................................... 26 
         Considering a short period of leave in post-transplant cases ............................ 26 
         Certifying a decision in transplant cases ........................................................... 26 
       Mental health cases ................................................................................................. 28 
        Specific factors to consider in mental health cases .............................................. 28 
        Cultural and social issues ..................................................................................... 28 
        Care and treatment available ................................................................................ 28 
        Suicide and self-harm cases ................................................................................. 29 
       Considering medical evidence ................................................................................. 32 
        Acceptable medical evidence ............................................................................... 32 
        Evidence of post-traumatic stress disorder ........................................................... 33 
        Medico-Legal Reports ........................................................................................... 33 
        Requesting more medical evidence ...................................................................... 33 
       Outcomes and decisions .......................................................................................... 35 
        Refusing leave to remain on medical grounds ...................................................... 35 
        Refusing someone previously granted leave ........................................................ 35 
        Granting leave to remain on medical grounds ...................................................... 35 
         Referring the case before granting .................................................................... 35 
         Granting limited leave to remain........................................................................ 35 
         Length of grant .................................................................................................. 36 
         Conditions ......................................................................................................... 36 
         Dependants ....................................................................................................... 36 
         Dependants who are overseas.......................................................................... 36 
        Granting further periods of limited leave or indefinite leave .................................. 36 
         Further periods of limited leave ......................................................................... 36 
        Granting settlement .............................................................................................. 37 
        Case management notes ...................................................................................... 37 
       Page 3 of 37   Published for Home Office staff on 19 October 2020 
        
        
                 About this guidance 
                  
                 This guidance tells you how to consider applications for leave to remain on medical 
                 grounds where a claimant claims that removing them from the UK would breach their 
                 human rights. A Human Rights claim on medical grounds relies on the following 
                 articles of the European Convention on Human Rights (ECHR):  
                  
                     •   Article 3 – inhuman or degrading treatment  
                     •   Article 8 – respect for private life, including moral and physical integrity  
                  
                 This guidance does not cover Article 8 ECHR claims on private life grounds other 
                 than those based on medical grounds. For guidance on Article 8 private life claims, 
                 see separate guidance on long residence and appendix FM and 276ADE (family 
                 members and private life); this guidance does not cover applications for leave to 
                 enter based on seeking medical treatment.  
                  
                 For criminality cases, this medical claims guidance must be read in conjunction with 
                 the Criminality guidance for Article 8 ECHR cases. 
                  
                 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 
                 email Asylum Policy. 
                  
                 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. 
                  
                 Clearance 
                  
                 Below is information on when this version of the guidance was cleared: 
                  
                        •   version 8.0 
                        •   published for Home Office staff on 19 October 2020 
                  
                 Changes from last version of this guidance 
                  
                 Changes in this version include: 
                         •   amendments for clarification of caselaw in relation to mental health 
                         •   amendments for clarification to considering medical evidence section 
                          
                 Previous changes to this guidance include: 
                        •   updated and re-branded 
                 Page 4 of 37   Published for Home Office staff on 19 October 2020