Going Abroad for Medical Treatment Policy

 

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NHS Post-Operative Support for Self-Funded Bariatric Surgery

The following guidance has been published by the ICB for Northamptonshire which we must follow and abide by. 

There have been several enquiries to the NHS Northamptonshire Integrated Care Board (ICB) regarding patient access to NHS post-operative support for those who have chosen to travel abroad for self-funded bariatric surgery.

NICE recommends a specialist MDT follow up for two years after the surgery, and as a private patient this would not be provided on the NHS as they do not have the automatic right to re-enter the NHS care flow for this.

If you are planning on seeking private treatment abroad, we ask you to be aware and know what happens afterwards  - Going abroad for medical treatment - NHS.

NICE Guideline & Quality Standard 

NICE guidance applies only to services commissioned by the NHS and within the commissioned NHS bariatric service care package (and is good practice for independent sector providers regulated by CQC) so providers of bariatric services outside of the UK are out-with the NICE expected standards.

The NICE guideline is clear that the described post-operative care is part of a single episode of care to be commissioned from and provided by a Tier 4 weight management service. The NICE standards cannot therefore be automatically applied outside of those circumstances.

Likewise, the British Obesity and Metabolic Surgery Society (BOMSS) Guidelines on expected standards of safe clinical practice in post-operative care apply in the UK setting, and like NICE guideline, BOMSS says that the follow-up care should remain with the bariatric centre for the first two years post-op. It would not be considered appropriate or expected for a GP practice to provide or arrange any follow-up care.

NHS commissioning & service specification

This is detailed in NHS England 2016 guidance, Appx 9 for Obesity Surgery, and Appx 8 for Revision Surgery for Complex Obesity. Private Patients may have had their primary obesity surgery outside of NHS contracts at independent/ private providers (in Europe, or within the United Kingdom). We expect complications of treatment that are solely the consequence of a privately funded episode of care to be managed by the private provider and be privately funded. The only exception to this is when a patient is admitted under emergency care, or the complication is life threatening.

Provision of standalone NHS post-surgery care to a patient who has had bariatric surgery abroad is not routinely commissioned.

Patient responsibilities prior to seeking surgery abroad

Government advice, NHS advice and some patient support groups’ advice on Treatment Abroad all advise that patients must be clear about how aftercare will be co-ordinated and provided after the surgery. The patient may be responsible for costs of the aftercare and of possible return trips associated with aftercare. Patients who have paid for bariatric surgery abroad have a responsibility to review and plan for all points in the recommended Treatment Abroad checklist and may choose to buy a standalone package of post-op care through a UK independent sector provider, or other non-UK provider.

The NHS website has been produced for patients to explain this Treatment abroad checklist.