From 1 April 2013, NHS England was made responsible for the administration process for patients seeking funding for treatment in the EEA and Switzerland. Previously PCTs administered this process individually. Now NHS England has set up the “European Team” to administer the two routes whereby patients can apply for funding. These are:
- the “S2” (formerly “E112”) route - a direct arrangement between the NHS and the state healthcare provider in the other European country; and
- the so-called “EU Directive route” (where patients pay the costs of treatment abroad and then claim reimbursement from the NHS when they return).
The European Team does not deal with cross-border healthcare issues within the UK or outside the EEA and Switzerland.
The S2 route is funded by agreements between states, but under the EU Directive route, the CCG identified as the responsible commissioner for the patient will be invoiced by NHS England for any costs the European Team has agreed to reimburse. Reimbursement costs will be the lower of the actual cost of treatment or the equivalent cost to the NHS of the providing the same treatment.
CCGs will also need to be aware that changes are on the horizon in October 2013 when new regulations will be published as part of the UK’s obligations to implement EU Law. Under these new regulations CCGs will be required to publish information to inform patients what their entitlements are in respect of cross-border healthcare with the EEA and Switzerland and information on any access criteria or thresholds that apply.
NHS England will update this information in October and we expect the Department of Health will also issue directions to accompany the regulations when they become law.