The European Cross Border Healthcare Directive

The European Cross Border Healthcare Directive was linked to free movement of services within the EEA. This option to seek treatment in a State or Private provider in another EEA member State and apply for reimbursement through local Health Boards closed to new applications on 31 December 2020 (EU Exit Implementation Period completion day).

The S2 scheme

The S2 scheme is part of social security co-ordination agreements across Europe and has remained in place as part of the EU exit withdrawal agreement.

S2 – for maternity or giving birth:

There are specific arrangements in place for those seeking S2 coverage for maternity care or for travelling to give birth in Europe or Switzerland – for details see www.nhsinform.scot/care-support-and-rights/health-rights/european-cross-border-healthcare/travelling-to-europe-for-planned-healthcare-the-s2-scheme/ 

S2 – for care other than maternity or giving birth:

All of the following details relate to this part of the S2 arrangements

Under the S2 scheme Scottish residents may, in certain circumstances be able to have state-funded planned treatment in an EU country or Switzerland for services other than those relating to maternity or giving birth.  

It is important to note that:

• Applicants MUST obtain prior authorisation from their Health Board BEFORE going ahead with treatment in Europe or Switzerland.
   
• All applications need to be assessed against a range of nationally set criteria
  
  
• The S2 scheme can't be used to access private treatment.
  
  
• Scottish Health Boards cannot vouch for the quality or safety of healthcare you may choose to use in an EEA country.
  
  
• The NHS is not liable for the outcomes of any healthcare received in a Europe or Switzerland through S2, and the treatment is not covered by the NHS clinical negligence scheme.
  
  
• In some countries a patient covers a % of the costs of their state-provided treatment, and if that applies you will be expected to pay the same co-payment charge as a patient from that country.
  
  
• Where agreement under S2 is given by the UK the treatment costs (other than any co-payment elements) are dealt with directly between governments through a voucher system. This voucher MUST be in place before going ahead with treatment.
  
  
• It is strongly recommended that anyone travelling to Europe or Switzerland with an agreed S2 voucher also has travel insurance with comprehensive medical insurance specifically covering travel for medical treatment.
  
  
• It is strongly recommended that anyone travelling to Europe or Switzerland with an agreed S2 voucher also has a European Health Insurance Card (EHIC) or UK Global Health Insurance Card (GHIC) to cover emergency, state-funded healthcare that may been needed.
  
  
• Travel, accommodation, meals and insurance costs are not covered by S2 or the NHS.

Any resident who goes ahead with planned treatment in Europe or Switzerland without having prior authorisation from their health board AND a formal S2 voucher to hand over in Europe or Switzerland is going ahead outwith the S2 scheme and will be directly liable for treatment costs.

The nationally set eligibility criteria within S2 include (but are not limited to) the following baseline confirmations 

• you are ordinarily resident here and have entitlement to treatment on the NHS,
  
  
• the requested treatment would normally be provided on the NHS to an individual in your circumstances,
  
  
• the requested treatment is not experimental or part of a drug trial,
  
  
• the requested treatment is not emergency treatment
  
  
• the need for the requested treatment has been identified by a clinician and from a full clinical assessment. 

For any Grampian residents seeking to make an application under S2 the detailed steps and stages are:

Step 1 – Confirmation from the potential provider

You should obtain all of the following details from the provider that you have identified and are seeking to access in Europe or Switzerland:

• The name and location of that provider hospital facility,
• Your name and details (as they have them as a potential patient),
• The treatment they have offered you,
• Confirmation that this treatment in their facilities is already available under their own public (State) healthcare scheme,
• Confirmation that they can and will accept a UK S2,
• The estimated costs (including whether there is any co-payment applicable, and if so the rate of that co-payment)
• The proposed arrangements for aftercare
• The potential dates of treatment (if these have been identified at this stage)

These details should be on the provider’s formal headed paper. 

Step 2 – Sending details to NHS Grampian and starting an application process

A copy of the above confirmation should be sent to gram.safehavengrampian@nhs.scot

If the original document is not written in English a translation should be attached and submitted along with the original.

Once we have this confirmation we can issue a full application form to you.   

Step 3 – Submission of a completed application form 

A completed application should be returned to gram.safehavengrampian@nhs.scot   

All documentation should be sent by e-mail as PDF attachment – please do not include embedded documents.

Step 4 – NHS Grampian’s determination on the application

The application will be considered against all of the eligibility criteria of the S2 scheme and a decision reached on whether the application can be supported or not.  

It can take up to 20 working days for an application to be processed and a decision made, and it may take longer if your application is not complete and additional information is required. 

Step 5 – Issue of the S2 certificate 

If NHS Grampian agrees that the application meets all of the nationally set criteria and can be supported we will contact the national team who will prepare and issue the actual S2 voucher certificate.

The national team will issue this voucher directly to you for you to take with you to the provider in Europe or Switzerland.  

If you go ahead with planned treatment in Europe or Switzerland without having an S2 voucher you will be directly responsible for ALL costs and are not accessing treatment under the S2 arrangement.

Further information on S2

Further information on the S2 scheme can be obtained locally through e-mail to gram.safehavengrampian@nhs.scot 

NHS Inform also includes a section on S2.

 

Published: 28/11/2023 12:28