NHS Funding
- House of Lords
On 7.8.09 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.
How can I get treatment abroad paid for by NHS?
There are two ways in which patients may go abroad for treatment within the EU
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
Commissioning treatment in the EU
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
Which countries does the scheme cover?
Because of problems with travel, the Department of Health policy is only to purchase spare capacity within the
European Economic Area.
* Department of Health policy statement: Where are NHS patients treated
I have had treatment when abroad. Can I now claim 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.
Doesn’t EHIC (European Health Insurance Card) cover this?
No, the EHIC card covers Insurance for emergencies, NOT paying for planned treatment.
Global links
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
What is a local health commissioner?
In England:primary care Trusts, practice –based commissioners and GP’s
In Wales: local health boards and Health Commission Wales
In Scotland: the NHS board of the patient’s residence
In Northern Ireland: health and social services boards
So what would I need?
Probaly best start is to discuss this either with your GP, or with your Oncology Consultant.
Then, you will need a UK NHS Consultant’s recommendation that the patient be treated in the other EU country with full details of the type of treatment and the proposed provider. It should also show that a full clinical assessment has been carried out to demonstrate that the treatment will meet patient needs;
Admission and discharge dates for proposed treatment where this has already been arranged.
Agreement that the PCT will fund the cost of the treatment;
Confirmation that the treatment is available under the other country’s state health insurance scheme (i.e. if you are going to a medical spa in countries where these have to be approved by the country’s health service, e.g. La Roche Posay, St. Gervais, etc. in France, Casciana Terme in Italy, etc).
Confirmation that the patient is entitled to treatment under the NHS and either their NI no. or NHS no as
appropriate.
Confirmation that this is not experimental treatment/ drug trial
Their NHS no. or National Insurance no.
Date of birth, full UK address and dates of travel;
Address in the country they are going to;
They should also indicate whether or not they will be returning to the UK; and also let us know if they have
already left the UK for another EEA country.
Addresses
For residents of England, Wales and Scotland, E112 requests should be sent to:-
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
