Healthcare abroad

Information if you are thinking about healthcare abroad.

The website for information about healthcare abroad

For information about NHS funding and healthcare abroad, in other European countries, including emergency care, your options for planned treatment abroad, or if you are moving abroad please go to NHS Choices

Before you plan to have treatment in another European country

Discuss the treatment with your UK doctor or dentist
If you are thinking about planning any sort of medical or dental treatment outside the UK, it will be important to discuss the issues with your doctor or dentist. Only treatments which are medically necessary can be funded by the NHS (you may need to provide supporting clinical evidence that the treatment is necessary). You will need to be fully informed about the details of treatments abroad, when you can travel, and any after-care or follow-up treatment you might need back in the UK.

Get in touch with NHS Medway to find out about funding and authorisation:
As you will see from the NHS Choices website, there are:

• Different routes to arranging treatment in the EEA countries (S2 (formerly E112) or Article 56 (formerly Article 49))

• Some types of treatment for which you need prior authorisation from your PCT before treatment abroad can be funded (now called special services)

• Some treatments which will not be funded.

Before making plans, you will want to be sure about:

• Whether the treatment you want can be funded
• What level of funding would be available for each treatment
• Whether you need to pay for your treatment up front and then be reimbursed
• How much you will be reimbursed

Countries where you can ask to be treated under EU requirement

Non-EU Member States

• Norway

• Iceland

• Liechtenstein

• Switzerland (S2 (formerly E112 route) only)

Funding restrictions
The following restrictions apply:

• Costs will only be reimbursed up to the level that would be funded for the same treatment provided locally in the UK.
• The cost of treatments that NHS Medway does not routinely fund in the UK will not be met (e.g. policies relating to restrictions on which services or treatments will be funded by the NHS in the UK will also apply when accessing treatment abroad).
• Costs will not be provided for items that may be billed as extras such as upgraded rooms, meals, transport, TV, translation and other such additional costs not normally incurred in the UK (unless costs could legitimately be claimed and reimbursed in the UK, e.g. in some instances transport).

Clinical Quality
It is important that individuals understand that when they organise their own treatment abroad NHS Medway cannot vouch for the quality of overseas providers that the UK does not regulate. Neither S2 nor Article 56 authorisations will make NHS Medway liable for the clinical or criminal negligence of practitioners or clinicians in the proposed provider country. Any liability of the treating organisation would have to be established in accordance with the legislation of the provider state.

You must satisfy yourself of the quality and outcomes of the service you are seeking to use, including making your own enquiries about the level of insurance held by the proposed providers and the level of any liability within the country where the treatment is to be provided. If you arrange and receive treatment outside of the UK you are not covered by the NHS Clinical Negligence Scheme for Trusts (CNST). You are advised to look into and if available take out insurance to cover all aspects of your journey and treatment.

Grounds for refusing prior authorisation
NHS Medway will consider each application carefully. Authorisation may not be given for a treatment for a number of reasons including:

• It has determined that the service you are requesting is not one that would be provided by the NHS, in the circumstances of the patient’s case
• The treatment is experimental
• It is considered that there is a proven or well-evidenced clinical risk to the patient or to wider public health if the patient travels abroad
• It is considered that there are inadequate aftercare or follow-up arrangements in place for the treatment in question
• There is evidence that the provider is unsuitable because it has evidence of its previous negligent or fraudulent actions

A new streamlined process
PCTs in Kent, Surrey and Sussex are working together to streamline the process for:

• Providing information to patients about planned treatment abroad
• Authorising treatment when necessary
• Reimbursing costs as appropriate

Until the new process is ready, applications for prior authorisation (S2 formerly E112) or Article 56 (formerly Article 49) and reimbursement of costs will be handled by the PCT’s Individual Funding Request Team (details above)

Treatments which need prior authorization (special services)
Care for which you require authorisation prior to treatment being undertaken is termed as “special services” and includes:

• A service that involves a stay in hospital accommodation for at least one night
• Medical treatment that involves general anaesthesia, epidural anaesthesia or intravenously administered sedation
• Dental treatment that involves general anaesthesia or intravenously administered sedation
• A service whose provision involves the use of specialised or cost-intensive medical infrastructure or medical equipment