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What is the role of the NHS overseas commissioning team?The NHS overseas commissioning team is responsible for contracting with high quality overseas hospitals, negotiating prices, organising patient travel and monitoring quality.  The NHS overseas commissioner has built up a large body of expertise, enabling them to identify top quality European hospitals and manage the process in collaboration with NHS Trusts.  The process used by the overseas commissioners for working with overseas providers has been decided in conjunction with the Clinical Reference Group that represents the Royal Colleges and other professional bodies.  A clinical visiting group of representatives from the Clinical Reference Group assesses all European units prior to them being pre-qualified for contract negotiations.

Do I have to use the NHS overseas commissioner?

Due to the complex nature of the overseas contracting process, and the need to take account of European procurement rules and UK bilateral agreements, the Department of Health strongly recommends that all NHS Trusts use the overseas commissioning arrangements.

What specialities are suitable for overseas referrals?

At present our strong advice is that patients undergoing day case procedures should not normally be sent overseas as this would prove less convenient and represents relatively poor value for money.  Currently mainly orthopaedic patients and some cardiac patients are treated in the EEA.  The overseas commissioner is able to commission a variety of procedures, depending on the needs you identify.

What countries are involved?

To date, NHS patients have been referred for treatment in France, Germany and Belgium.  Although the NHS is now legally entitled to purchase healthcare for patients from outside the EEA, clinical advice has suggested that travel times should be kept to a minimum in order to prevent post-operative complications.  As such, the Department of Health has put forward a suggested 3-hour maximum flight time.  The Department of Health does not envisage patients travelling outside Europe for treatment.

What safeguards are in place to ensure a high quality of care?

Various methods are used to ensure the clinical quality of potential overseas providers. The overseas commissioners co-ordinate both assessments of clinical and logistical data, and clinical scrutiny visits to the hospitals involved. The referring NHS trust must also satisfy itself that the overseas hospital can provide a high quality of care, and is entitled to organise further clinical visits. Overseas hospitals are asked to provide detailed information regarding their clinical outcomes, the facilities available, infection control policy and other key quality issues.  These can then be specified in contractual agreements with the overseas commissioners.

Who deals with pre and post-operative assessments, complications etc?

We generally expect pre and post-operative assessments to be carried out by the overseas consultant at the patients referring trust. Patients will usually have intensive rehabilitation in the overseas hospital. Responsibilities for these issues will be made clear in contractual arrangements. The referring trust will be responsible for ensuring that effective arrangements are in place for the whole of the patients' care pathway.

Is this a viable option?

Direct referral of patients has been piloted and approved as a viable option for treating NHS patients. The price for treating patients in the EEA is comparable with patients being treated in the private sector in the UK.

Where can I find further information?

Guidance for NHS trusts considering referring patients for treatment abroad has been published. The key contacts in the Department of Health responsible for overseas treatment are:

• Download Overseas Treatment for NHS Patients - Guidance for Primary Care and Acute Trusts (PDF, 36K)