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Brexit: What does it mean for reciprocal healthcare arrangements?

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Brexit: What does it mean for reciprocal healthcare arrangements? is part of a series of briefings produced by the Royal College of Physicians (RCP) outlining key information on topics surrounding Brexit negotiations and beyond.

What this means for patients

In many instances patients need to access treatment in a country in which they are not a citizen. The EU works to facilitate this collaborative care across the member states as required by patients. When treatment is provided in another country, it is reimbursed by the patient’s country of citizenship.

Unless sufficient guarantees are provided, patients will no longer have access to necessary treatment and care outside the UK.

S1 and S2 registration

  • If a citizen is planning to stay in another EU country for an extended period of time, the individual is required to register for an S1 certificate of entitlement to healthcare.
  • If a citizen is planning to travel specifically to obtain medical treatment in another EU state, they have to apply for an S2 certificate of authorisation.

Under both registrations, the UK provides reimbursement for the cost of care.

European Health Insurance Card

The European Health Insurance Card (EHIC) is part of the system of social security cooperation that provides access to healthcare that is ‘medically necessary’ for all EU citizens travelling within the EU and staying in another state temporarily. Its removal will have significant impact on emergency treatment to British citizens travelling in EU states.

RCP recommendations

  • Participation in the S1 and S2 scheme should be continued. If the S1 and S2 scheme ends and access to treatment is not provided, British citizens may be obliged to return to the UK or prevented from travelling to the other 27 EU states for treatment. Caring for these additional patients in the current system would put patient safety at risk.
  • The UK and EU should come to an agreement to ensure that patients living on the island of Ireland are able to access the necessary treatments they require, through continued close collaboration between Northern Ireland and the Republic of Ireland’s healthcare system.