Travelling to Europe for planned healthcare – the S2 scheme

You can receive planned care, funded by the NHS, in an EU country and Switzerland under the S2 scheme.

The continuation of the S2 scheme is part of the EU exit withdrawal agreement. The scheme is managed on a UK-wide basis by the NHS Business Services Authority (NHSBSA).

In the future, you may also be able to receive planned treatment under the S2 scheme in states belonging to the European Economic Area (EEA). This includes Norway, Iceland and Liechtenstein. Negotiations with these countries are ongoing right now.

Read more about the S2 route and access application forms.

The S2 scheme

The S2 scheme allows Scottish patients, in certain circumstances, to travel for state-funded treatment in an EU country or Switzerland.

Permission to use the scheme is normally at the discretion of your local health board. It's based on their assessment of your condition and circumstances. However, if there's an undue delay in your treatment at home, the health board may allow you to travel for treatment if all other conditions are met.

The S2 scheme only applies to state funded treatment in the UK, EU and Switzerland. It can't be used to access private treatment.

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

Prior authorisation from your local health board is always required. Applications sent after treatment abroad won't be considered.

Applying to use the S2 scheme

It's important to discuss your plans with your GP before making any decisions to travel abroad for medical treatments. Your GP may be able to tell you the options available or will refer you to a clinician in the health board area where you live. Here you can discuss your options and confirm:

• the treatments that the health board is prepared to arrange funding for to allow you to receive state treatment in an EU country or Switzerland
• 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 health board will then decide whether or not to approve your application. This is based on the following criteria:

• you live in Scotland and are entitled to treatment on the NHS
• the NHS would normally provide the treatment to someone in your situation
• a clinical assessment has been carried out that confirms your need for treatment
• a clinician confirms that the NHS can't provide your treatment in a justifiable timescale due to undue delays
• the requested treatment is available under the treating country's state healthcare scheme
• the requested treatment is not experimental or part of a drug trial
• the requested treatment is not emergency treatment
• you have satisfied the nationality criteria when applying for an S2 treatment in Switzerland

Authorisation

If the health board agrees funding to allow you to receive state treatment in an EU country or Switzerland, NHSBSA will issue an S2 form directly to your home address. You must then take the completed form with you to the EU or Swiss hospital that has agreed to provide your treatment.

Payment

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 country you'll be treated in.

There are some 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 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 your local health 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.

Maternity care/giving birth outside the UK

If you're going to an EU country or Switzerland to give birth, the process is different. You'll need:

• a European Health Insurance Card (EHIC) or UK Global Heath Insurance Card (GHIC) for routine medical care
• an S2 form to cover the birth
• travel insurance - this is always recommended as the EHIC or GHIC may not cover you for every situation

To get an S2 you need to download and complete the giving birth abroad application form. You will also need to provide either:

• a Maternity Certificate (MATB1) or
• a letter from your GP or midwife in Scotland showing your expected date of delivery

The MATB1 allows pregnant women to claim Statutory Maternity Pay from their employers or Maternity Allowance from Jobcentre Plus. The certificate confirms the pregnancy and the expected week of delivery.

You should email your completed application form and supporting documents to nhsbsa.ohsapplications@nhs.net.

You should email supporting documents as a PDF attachment.

Further information

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 health board’s decision regarding your application to travel for state treatment in an EU country or Switzerland 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 health board