Request

I am writing to request a summary of the use of UK-issued S1 and S2 forms, as well as EHIC, GHIC, or equivalent forms, by EU Member States from 2004 to 2023. This overview aims to provide a comprehensive statistical picture of reciprocal healthcare between the UK and other EU member states.

In addition to the general overview, my primary focus is on the reciprocal healthcare relationship between Poland and the UK from 2004 to 2023. Specifically, I seek information on:

The number of requests from the Polish national health care system in the form of E125 PL invoices during this period. The use of NHS services by Polish citizens based on EHIC within the same timeframe

On 23 July you clarified:

Specifically, I am seeking detailed information regarding the number of courses of treatment that have been provided utilizing these forms. This includes data on the frequency, purpose, and context of these treatments, as well as any trends or changes observed over the specified period. This summary will help to understand the extent and nature of healthcare services accessed under these agreements.

Response

Question 1

I am writing to request a summary of the use of UK-issued S1 and S2 forms, as well as EHIC, GHIC, or equivalent forms, by EU Member States from 2004 to 2023.

Specifically, I am seeking detailed information regarding the number of courses of treatment that have been provided utilizing these forms. This includes data on the frequency, purpose, and context of these treatments, as well as any trends or changes observed over the specified period. This summary will help to understand the extent and nature of healthcare services accessed under these agreements.

A copy of the information is attached

Caveats

• The data provided shows the number of claims the UK has received from the EU Member States (MS) for the healthcare treatment provided by them in the period of 2004-2023. EEA countries and Switzerland are also included.

• One claim may include more than one course of treatment. Also, one course of treatment may be split across multiple claims.

• The data presented under EHIC include UK EHIC, UK GHIC and the older equivalent forms E111 and E128.

• We have included data under PRC (Provisional Replacement Certificate). This is because PRCs serve as a replacement for UK EHIC/GHIC. The data presented under PRC include PRC and the older equivalent form S045.

• The data presented under S1 include S1 and the older equivalent forms E106, E109, E120, E121 and S072.

• The data presented under S2 include S2 and the older equivalent forms E112 and S010.

• The data presented under S2 is further categorised into ‘Maternity’, which are S2 entitlements issued for giving birth abroad and ‘Other – Not Specified’, which represent S2 entitlements issued for planned treatment. However, there are several S2 entitlements which are listed under specific treatment categories, where this has been provided by the Member State.

• The data presented includes two types of claims UK receives from Member States. These are ‘Actual’ and ‘Average’ cost country claims.

o Average Cost Country Claim - for individuals who reside in the Member state on permanent basis, but the UK remains competent for their healthcare. These individuals hold a UK issued registered S1 entitlement. The healthcare costs for the individual are charged to the UK starting from the month the entitlement starts.

o Actual Cost Country Claim - for individuals who: o accessed medically necessary treatment during a temporary stay in another MS by presenting a UK GHIC, UK EHIC, or through a PRC. o had a S1 or S2 entitlement, for which healthcare costs were charged to the UK in monetary value for each individual treatment accessed in the Member State.

• The data shows the required entitlement types, and the number of claims made using this entitlement each year by the Member States. This may assist in the analysis of trends and changes; however, we are unable to provide any further details in relation to this part of the question.

• We are only able to provide the general purpose of the forms as we do not hold reportable details of the individual treatments provided by the Member States.

o S1 is an entitlement issued by one country to confirm responsibility for an individual’s healthcare costs whilst they reside in another country (Member State). The S1 entitles the individual to the same health cover as a resident of that country. The issuing country remains responsible for these costs.

o S2 is an entitlement issued by the UK and entitles the individual to healthcare cover for planned treatment or to give birth abroad (in another Member State). The S2 entitles the individual to receive the treatment stated on the S2 in the Member State. The healthcare cover will be provided on the same basis as a resident of that country.

o UK GHIC/UK EHIC will allow the individual to access medically necessary healthcare treatment whilst temporarily vising other Member States. The healthcare treatment will be provided on the same basis as a resident of that country. For example, emergency treatment or visits to A&E.

o PRC will entitle the individual to the same level of cover as a UK GHIC or UK EHIC, even if the individual does not have their card with them. The PRC can be used to prove the individual’s entitlement to medically necessary healthcare cover if the individual travelled abroad without their UK GHIC/UK EHIC. The healthcare treatment will be provided on the same basis as a resident of that country.

Question 2

In addition to the general overview, my primary focus is on the reciprocal healthcare relationship between Poland and the UK from 2004 to 2023. Specifically, I seek information on:

a. The number of requests from the Polish national health care system in the form of E125 PL invoices during this period. b. The use of NHS services by Polish citizens based on EHIC within the same timeframe A copy of the information is attached. The data includes claim forms received from Poland for individual instances of treatment.

Caveats

• The data has been recorded from October 2008. The table includes the treatments for 2007 as this was not reported to us until after that date.

• We have included data under PRC. This is because PRC serves as replacement for UK EHIC/GHIC, and we can identify PRC separately for this question

Publishing this response

Please note that this information will be published on our Freedom of Information disclosure log at:

https://opendata.nhsbsa.net/dataset/foi-02095