Travelling to Europe for planned healthcare – the S2 scheme

If you're thinking about having medical treatment in another European country, it's important to understand how it works.

There are currently 2 potential ways for you to receive planned care in another EU country funded by the NHS:

• the S2 scheme, under EU regulation with the co-ordination of different countries' state healthcare providers - it's administered by NHS Business Services Authority (NHSBSA)
• the European Cross-border Healthcare Directive. Read more about the EU Healthcare Directive

Your local NHS Board can advise you on which option is better for the type of treatment you require as each option works in a different way.

The S2 scheme allows Scottish patients, in certain circumstances, to travel for state-funded treatment in another European Economic Area (EEA) country or Switzerland.

Permission to use the scheme is at the discretion of your NHS Board, based on their assessment of your condition and circumstances, except in cases where there's undue delay, in which case the board may have no option but to authorise it.

Since this is through a direct arrangement between the NHS and the state healthcare provider in another EEA country, the S2 scheme is only valid for state funded treatments.

If your application is approved, your treatment will be provided under the same conditions of care and payment that would apply to residents of the country you'll be treated in.

Prior authorisation from your NHS Board is always required and retrospective applications won't be considered.

It's important to discuss your plans with your GP before making any decisions about travelling abroad for medical treatments. Your GP will tell you the options available or will refer you to a clinician in the NHS Board area where you live to discuss your options and confirm:

• the treatments that the board is prepared to arrange funding for to allow you to receive state treatment in another EEA country
• that you fully understand the conditions that you'll be treated under
• any programme of after-care or follow-up treatment you may need when you return to the UK

Approval process

After approaching your GP to discuss S2 funding, the NHS Board will then decide whether or not to approve your application, based on the following criteria:

• You're a permanent resident in Scotland entitled to NHS treatment.
• An NHS consultant or clinician has recommended in writing that you should be treated in another EEA country and that the treatment will meet your specific needs.
• The NHS Board has determined that the same or equivalent treatment can't be provided by the NHS within a suitable time period.
• The treatment is available under the specified EEA country’s state healthcare system and it's agreed to give you the treatment.
• The cost of going abroad for treatment is justified against NHS responsibilities for spending public money efficiently and fairly.

Authorisation

If the NHS Board agrees funding to allow you to receive state treatment in another EEA country, NHSBSA will issue an S2 form directly to your home address. You must then take the completed form with you to the EEA state hospital that has agreed to provide your treatment.

If your application under the S2 route is approved, your treatment will be provided under the same conditions of care and payment that would apply to residents of the EEA country you'll be treated in.

There are some EEA countries where, like in the UK, healthcare is free at the point of delivery. This means an approved S2 will cover 100% of the costs of your healthcare and you won't have to pay any treatment costs.

In some EEA countries, however, patients cover a percentage of their state healthcare costs. For instance, a patient may need to cover 25% of the costs of their treatment and the state covers the other 75%. This means you could have to pay a percentage of the costs personally (co-payment charge). When receiving treatment under such a healthcare system, you'd be expected to pay the same co-payment charge as a patient from that country.

For example, for an operation that costs £8,000, of which you're expected to pay a standard patient co-payment charge of 25%, you'll pay £2,000. The NHS will pay the remaining £6,000 to the healthcare provider treating you.

Travel and accommodation costs associated with treatment won't be paid for or reimbursed by NHSBSA or the NHS Board.

Reclaiming co-payments

If you've used a co-payment for your treatment, you may be able to claim back some or all of your contribution when you return to Scotland. To apply for a refund of your contribution, you'll need to contact the Overseas Healthcare Team within NHSBSA on 0191 218 1999 or email nhsbsa.ohsapplications@nhs.net.

If you're going to another EEA country specifically to give birth, the process is different. You'll need:

• a European Health Insurance Card (EHIC) for routine medical care
• an S2 form to cover the birth

Travel insurance is also recommended as the EHIC may not cover you for every situation.

To get an S2 you need to write to the Overseas Healthcare Team, explaining why you want care outside the UK and including:

• an MATB1 certificate or a letter from your GP or midwife in Scotland showing your expected date of delivery
• your NHS number or National Insurance number
• your date of birth, your full UK address and dates of travel

You must also indicate whether or not you'll be returning to the UK, as well as if you have already left the UK for another EEA country.

The Maternity Certificate (MATB1) is specifically designed for the purpose of enabling a pregnant woman to claim Statutory Maternity Pay from her employer or Maternity Allowance from Jobcentre Plus. The certificate confirms the pregnancy and the date of the expected week of delivery.

If you need more information on the S2 scheme you should contact NHSBSA, who administer the S2 scheme on behalf of the UK Government. 

Overseas Healthcare Services
NHS Business Services Authority
Bridge House
152 Pilgrim Street
Newcastle upon Tyne
NE1 6SN

Phone: 0191 218 1999

Email: nhsbsa.ohsapplications@nhs.net

Appeals

If you're unhappy with your local NHS Board’s decision regarding your application to travel for state treatment in another EEA country under the S2 scheme, you've the right to appeal. Your local NHS Board will be able to provide you with details of its appeals process.

Find the contact details for your local NHS Board