TRAVEL ABROAD Under NHS legislation, the NHS ceases to have responsibility for people when they leave the UK. For patients intending to be away from the UK for a period of at least three months, the health board can remove them from the contractor’s list of patients as specified in the NHS General Medical Services Contracts Regulations (Schedule 6, Paragraph 25) 19. However, to ensure good patient care, the following guidance is offered. Following Brexit, healthcare provisions akin to those provided by the European Health Insurance Card (EHIC) will continue. If an EHIC is still in date, it will remain valid for travel to an EU country. If an EHIC has expired, a new UK Global Health Insurance Card (GHIC) should be applied for. Patients should be advised that neither the EHIC nor the new GHIC is a replacement for travel insurance, and that they should have both in place prior to travel. Patients are advised to check specific details on the UK Government website. Guidance for GPs on risk assessment for travellers and appropriate advice is available from the NaTHNaC website41.
Medication required for a pre-existing condition should be provided in sufficient quantity to cover the journey and to allow the patient to obtain medical attention abroad. If the patient is returning within the timescale of a normal prescription (usually one and no more than three months) then this should be issued, providing it is clinically appropriate. Patients carrying certain prescribed medication for their own personal use may require a doctor’s letter or a personal licence41. This will depend on the duration of travel, the type of medicine (e.g. codeine, Sativex®) and the country of travel. More information on the carrying of prescribed controlled drugs abroad for personal use is covered in section 15.3. Patients who require over-the-counter (OTC) medicines should check that the medicine is available OTC in the country of destination42.
For longer visits abroad (e.g. more than three months), the patient should be advised to register with a local doctor in the destination country for continuing medication; this may need to be paid for by the patient. It is wise for the patient to check with the manufacturer that medicines required are available in the country being visited. All Wales Medicines Strategy Group Page 18 of 27 GPs are not required to provide prescriptions for medication that is requested solely in anticipation of the onset of an ailment whilst outside the UK, but for which treatment is not required at the time of prescribing (e.g. travel sickness, diarrhoea). Patients should be advised to purchase these items in the UK prior to travel; advice is available from community pharmacists if required. A private prescription may be provided for any prescription-only medicines if deemed appropriate and necessary, such as ciprofloxacin for traveller’s diarrhoea (for use outside Asia). Patients should be advised about the appropriate use of self-medication and when they would need to seek medical attention abroad. Travellers should consider carrying a personal emergency medical travel kit tailored to their needs and their travel destination (advice on what to include is available from the NaTHNaC website). There are occasions where the traveller may wish to include prescription-only medicine (POM) items including plasma substitutes in their personal emergency medical travel kit. A private prescription is required for the former. 15.1 Immunisation for travel abroad Immunisation against infectious disease (The Green Book)43 gives recommendation