1. Europe and Health collaboration with
Kent
Date 19th Janury 2009

2. Cross Border Health Care
Current situation
NHS patients are entitled, subject to certain conditions, to receive
reimbursements towards the costs of care received in another EU country
The patient pays upfront - reimbursement is up to the level that the care would
have cost at home
Patients can only receive reimbursements for treatment that their PCT funds

3. Clarifying the rules and introducing measures to
support cross-border provision of healthcare
As well as restating existing rights, the proposals:
Confirm that it is the patient’s home health system that decides what care will
be covered and that the patient must follow the same conditions for
accessing treatment as apply at home
Place strict limits on when prior authorisation systems can be made compulsory
Establish that the quality and safety standards of the country where care is
provided apply
Some issues still unclear e.g. the circumstances in which patients can be
required to seek prior authorisation

4. Major issues for the NHS
Determining what treatment a patient can receive: eligibility criteria, conditions for
access and equity
What makes up a treatment package, does it include transport and hotel costs
Hospital and non-hospital care: a false distinction
Prior authorisation: facilitating informed patient choices
Quality and safety standards
Information
Framework for European Cooperation

5. The Kent experience of
Cross Border Health
Services
Using single patient policy to make decisions on requests form individuals and families
More requests form people in East Kent than West Kent
Opportunities for treatment in Europe not advertised
Thinking about potential markets in close proximity to Kent
Probably less then 1% activity and cost of our health services resources spent in Europe

6. Single patient requests in
NHS West Kent
11 requests since Oct 06 Country requested Types of requests
Spain Egg Donation
2 approved Cyprus Hernia
Poland Surgery
4 refused treatment could have Germany Dental
been provided in the UK reconstruction
Milan Opthalmology
special contact
5 not progressed by patients lenses
Holland Orthopaedics
Variety of countries not in close Bordeaux France cardiology
proximity to home Belgium Ablation

7. Single Patient Requests
NHS Eastern & Coastal
Kent
11 requests since April 08 Range of countries not related to
proximity to home
3 approved Most orthopaedics
1 on going Specialist procedures like bariatric
surgery
7 refused due to lack of prior
authorisation

8. Cross Border Public
Health-lots
• Bien Etre – 2 year project on health and well-being of primary school between
Northernin North France and Dover-ongoing cross border rugby tournaments between
the Kent and French schools completed 2007 funded by European Social Fund
(Interreg)
• “Lets talk”-2 year research project into sexual health attitudes amongst young people
between Northern France and Kent completed 2007 funded by the European Social
Fund (Interreg)
• Collaboration between Romania and Kent sharing practice in health and social care
ongoing
• Collaboration with Kent County Council and Kent University in Brussels
• Planning to join the EU alcohol Forum
• EU funded projects – applications in progress – outcome expected 2009
1.International Literature Review on Self efficacy of young people – Kent and Northern
France
2.Establishment of cross border Society of Public Health & Social Medicine to explore
common health challenges and seek collaborative solutions to the problems – Kent and
Northern France

9. Contact information
Meradin Peachey
Director of Public Health
Eastern& Coastal Kent PCT
Kent County Council
West Kent PCT
Meradin.peachey@kent.gov.uk