Getting NHS treatment abroad

FAQs RE OVERSEAS TREATMENT ON NHS

Recently, the EU in Brussels has decreed that UK patients have the right, in certain circumstances, to tap into and be treated in other EU countries – with most costs paid by our NHS.  A Department of Health Spokesperson said:

“The Government remains committed to ensuring that, where UK patients choose to travel abroad for care, the NHS retains the ability to decide what care it will fund.

So, how can I get medical treatment abroad paid for by NHS?

There are two ways:
a) where a commissioning body decides to commission care abroad for its patients
b) a patient makes a request to go abroad for care.

What is current situation re NHS funded treatment in the EU?

Due to judgements in the European Court of Justice, there are currently two possible routes for patients who
wish to go abroad for treatment within the EU – one through the E112 form, and one through the ‘Article 49’
route (named after the relevant article of the EU Treaty).  The Government is lobbying in Europe to try and get
this situation simplified, as it can be complicated

I understand that the NHS has previously funded treatment in the EU – what happened?

Er – bit ambiguous.  The Dept. Health’s Press office sent us the following :

Feedback was positive in the ‘live’ project and patient take-up rates have exceeded expectation.                                         Due to low uptake, the scheme finished on 31 March 2005

If you can make head or tail of this – I can’t!

So why go abroad?

The Department of Health admits “there is high quality, cost effective, spare capacity readily available in northern Europe for the NHS to purchase within the specified air travel time”.

The WHO (World Health Organisation) has statistics that prove that many EU countries have better post-cancer survival rates than the UK – therefore it would seem sensible to take advantage of European centres’ treatment where feasible.

Which countries does the scheme cover?

Sensibly, because of potential problems with travel, the Department of Health policy is only to purchase spare capacity within the EU/ European Economic Area.  This means probably within three hours plane travel, or a day by train i.e. those printed in dark blue or green, on map above, and Switzerland.

I have had treatment when abroad.  Can I claim for cost retrospectively?

No.  The NHS does not operate a reimbursement system.  Patients wishing to receive treatment abroad at the
expense of the NHS will need to arrange this BEFORE treatment starts.                                                                                          Patients who fund their hospital treatment privately will not be separately reimbursed.

Won’t the EHIC (European Health Insurance Card) card cover treatment abroad?

No, as it name says, it is for Insurance for emergencies, not pre-arranged medical treatment.

Will I have to wait a long time for an appointment/to start treatment?

Highly unlikely.  As many French GPs and centres operate a system where patients pay for treatment, and then claim this back, they tend to turn up for appointments so there is no over-booking!  Also, most EU countries have more doctors and consultants per head of population, so there are no long waiting lists.  Most people we interviewed for the FAQ list said that once they had seen a consultant, if they were referred on to someone else, or had tests, they would see them that day or the next, and the tests were usually carried out that day, with results available almost immediately.

How will I understand the doctors and nurses?

Most centres provide English speaking staff, and often these staff will have done part of their training in the USA, Canada, etc. so speak excellent English.  If being treated at a medical spa these now offer ‘wellness’ treatments to tourists as well as medical treatment, so staff have to speak English.  For certain treatments, such as mud packs, massage, etc. you may have staff who aren’t required to speak another language, as the treatment is international!

If I stay overnight, what will accommodation be like?

Just like a four-star hotel.

• Most medical centres abroad offer single en-suite rooms (hence MRSA,  etc. is rare), although occasionally you might have to share a bedroom.
• Asked about mixed wards, a Finnish friend said they had them in Finland.  What she really meant is that as everyone has a single bedroom, the wards accommodated men and women!
• Some French centres are noted for the wine they serve with meals! And everyone remarks on cleanliness.

What happens if there is a problem?

Biggest problem with treatment abroad seems to be after-care, if something goes wrong.  However, these problems are often what happens when patients go abroad for cosmetic treatment arranged by themselves, not when referred by your GP.  If you go abroad on a scheme funded by the NHS they will have taken into account after-care, and you will generally find it is excellent.

I did find someone who complained about being made to wait six hours in a French Accident and Emergency centre.  His wife told me afterwards that this had been on a day when every French family takes to the Autoroutes at the mass start of the holiday season, and there is carnage on the roads.  This is the one day when every ambulance is working flat out, so beware – avoid the major holiday periods!  Or be prepared to wait!

However, like with every hospital or doctor, there may be times when mis-understandings occur, but interviewing many patients, on the whole the satisfaction level is extremely high when they have been treated in Europe.

And if you look up World Health Organisation (WHO) survival statistics, major European countries have a far better outcome than the UK.

So what must I do next?

1. Start with your GP or Consultant.
2. They will either refer you to your NHS Trust (PCT) , or need to receive prior
   authorisation to receive treatment under the E112 scheme.
3. Your applications goes forward – you must be prepared to answer questions, and do some ‘homework’ to ensure that you will be happy at the chosen hospital or centre, that those of your family and friends who want to visit will be able to do so, and you are comfortable with travel arrangements.
4. If approved, you will be contacted to tell you what are arrangements.
5. Check arrangements, ensure who is paying for what, what are procedures for claiming, if the PCT will pay directly, or if you have to pay then claim back, who pays for travel, who pays for medicines and if you have to pay a contribution for food.
6. And go off and enjoy the experience!

What happens in between:

Before requesting an E112 for a patient, Commissioners should read the guidance on patient mobility:
www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_073850
Once the decision has been made that an E112 is needed a request should be sent to the appropriate
address below to authorise the treatment abroad and issue an E112. The request should include the
following:-

1. A UK NHS Consultant’s recommendation that the patient be treated in the other EU country with full detail  of the type of treatment and the proposed provider.
2. It should also show that a full clinical assessment has been carried out to demonstrate that the treatment will meet patient needs
3. Prior to contracting with any hospital, regardless of its location, the NHS needs to determine whether a set of prescribed criteria is met.  These include the quality of the care and follow-up care on offer, available accommodation, time, ease and effect of the modes of travel required from the local UK base and cost.
4. The patients’ diagnoses and medical conditions, fitness and willingness to travel and be treated overseas must also be taken into account in determining who might benefit from this type of treatment.
5. Admission and discharge dates for proposed treatment where this has already been arranged.
6. Agreement that the PCT will fund the cost of the treatment
7. Confirmation that the treatment is available under the other country’s state health insurance scheme (as most likely you will be going for rehabilitation or treatment of drug side effects, this means centres such as La Roche Posay, St. Gervais, Casciana Terme and similar medical spas)
8. Confirmation that the patient is entitled to treatment under the NHS and either their NI no. or NHS no as appropriate.
9. Confirmation that this is not experimental treatment/ drug trial
10. Their NHS no. or National Insurance no.
11. Date of birth, full UK address and dates of travel
12. Address in the country they are going to
13. You should also indicate whether or not you will be returning to the UK

Requests should be sent to:

For residents of England, Wales and Scotland :-
Medical Benefits (E-Forms Team)
DWP
International Pension Centre
Room TC001
Tyneview Park
Whitley Road
Newcastle upon Tyne
NE98 1BA
Tel: 0191 218 1999 (Monday to Friday 8am-5pm)
(Note: Medical Benefits administer the E112 system on behalf of the Department of Health)

For residents of Northern Ireland, E112 requests should be sent to:-
Department of Health, Social Services and Public Safety
General Medical Services Branch
Room D3, Castle Buildings
Stormont
Upper Newtownards Road
Belfast
BT4 3SQ
Tel: 028 9052 2890
Fax: 028 9076 5624

More information:   www.dh.gov.uk/treatment-abroad

What happens if Family/Friends come too?

Most hospitals will give you a list of recommended hotels, B & Bs, Pensions, self-catering etc. near-by.

If you are going to a medical spa, then they can stay with you.

Or ask the local tourist board.  They can not only give you details of accommodation, but also lots of ideas for the family to enjoy themselves whilst you are being treated.  Ask for discount vouchers, which often give free or low-cost entrance to venues (from local swimming pools to tourist attractions), free travel on local transport, free or reduced cost entrance to local attractions, water parks, etc.