NHS West Sussex Health & wellbeing for life

For information about NHS funding and healthcare abroad, including

• emergency care
• your options for planned treatment abroad
• moving abroad

visit the NHS Choices website: www.nhs.uk/nhsengland/healthcareabroad.

If you are thinking about any sort of planned medical or dental treatment outside the UK, please discuss this fully with your GP, hospital consultant or dentist.

It is important to make sure you have the information you need to make the right choices.

You will need to be fully informed about your European healthcare provider and the details of the treatment you are planning to have.

You may also need to consider:

• when you will be able to travel safely
• how your medical notes will be exchanged between teams
• arrangements for after-care or follow-up treatment either abroad or at home
• how you would deal with any complaint or problem should something go wrong following your treatment abroad.

As the NHS Choices website explains, there are two different routes to arranging treatment in the EEA countries:

• S2 route, formerly called E112
• Article 56 route, formerly called Article 49.

We (NHS West Sussex – also known as a primary care trust or PCT) can help you decide which would be the better route for you. Our contact details and application forms are available on the right-hand side of this page.

All treatment under the S2 route requires PCT approval before treatment can commence.

If you choose the Article 56 route there are some types of treatment (called special services) for which you need to apply for prior authorisation from your PCT before undergoing treatment.

Only treatments which are necessary to treat or diagnose a medical condition can be funded by the NHS, and you may be asked to provide evidence that your treatment is necessary.

Only treatments which are the same as or equivalent to those which would be provided by the NHS, in the circumstances of the individual patient’s case, can be funded.

The amount you can be reimbursed is limited to the amount it would have cost the NHS to provide your treatment.

The cost of ‘extras’ such as upgraded rooms, meals, TV, translation, etc., which would not be incurred in respect of treatment provided by the NHS, cannot be met. If your healthcare abroad is arranged through a specialist travel agency, or other third party, none of their costs can be reimbursed.

People who are entitled to assistance with travel costs in the UK under the Healthcare Travel Costs Scheme may be eligible for help with travel to Europe.

Before making any medical or travel arrangements you will want to be sure about:

• whether the treatment you want can be funded
• whether you will have to pay the European healthcare provider
• how much you can be reimbursed.
   

Under the Article 56 route, prior authorisation for the reimbursement of costs by the PCT is required if the treatment involves:

1. a service that involves a stay in hospital accommodation for at least one night;
2. medical treatment that involves general anaesthesia, epidural anaesthesia or intravenously administered sedation;
3. dental treatment that involves general anaesthesia, epidural anaesthesia or intravenously administered sedation; or
4. a service whose provision involves the use of specialised or cost-intensive medical infrastructure or equipment.

A “service” means any goods, including drugs, medicines and applications which are used or supplied in connection with the provision of a service, but does not include accommodation other than hospital accommodation.

At present NHS West Sussex has not listed any services for inclusion at (4.) above. However, this may change without notice.
 

NHS West Sussex will consider carefully every application for prior authorisation or reimbursement under the Article 56 route, and request for S2 approval.

Each application will be decided on its individual merits.

If you arrange your own treatment abroad it is important to understand that NHS West Sussex cannot vouch for the quality of overseas providers that the UK does not regulate.

Neither S2 nor Article 56 authorisations will make NHS West Sussex 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.

You are advised to look into and if available take out insurance to cover all aspects of your journey and treatment.
 

• Austria
• Belgium
• Bulgaria
• Cyprus
• Czech Republic
• Denmark
• Estonia
• Finland
• France
• Germany
• Greece
• Hungary
• Iceland
• Ireland
• Italy
• Latvia
• Liechtenstein
• Lithuania
• Luxembourg
• Malta
• Netherlands
• Norway
• Poland
• Portugal
• Romania
• Slovakia
• Slovenia
• Spain
• Sweden
• Switzerland (S2 route only)
   

Primary Care Trusts (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.