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High satisfaction amongst NHS patients sent to France and Germany for treatment

Posted on 12 August 2002

Very high patient satisfaction has been reported from NHS patients in Southeast England sent to France and Germany for treatment. An evaluation by the York Health Economics Consortium at the University of York of the initiative to send waiting list patients to Europe for treatment, found that almost 80 per cent of patients said they were very satisfied.

Patients reported few language problems in overseas hospitals, either because of staff fluency in English or because of the presence of additional English-speaking staff to help with communication. Patients were generally impressed with the efforts made by the overseas hospitals to provide high quality patient care.

The York Health Economics Consortium Ltd, a contract research company at the University of York, was commissioned to evaluate the management arrangements and patient satisfaction. The report is published today (12 August 2002) by the Department of Health.

Three health authorities sent patients to Europe: East Kent; Portsmouth and the Isle of Wight; and West Sussex and East Surrey Health Authorities. East Kent contracted directly with La Louviere hospital in Lille, while the other two health authorities used three intermediary agencies to arrange care in several German hospitals.

In total 190 patients, (153 orthopaedic and 37 eye surgery) patients were sent abroad. This was less than originally planned. East Kent sent 90, Portsmouth and the Isle of Wight sent 50, and West Sussex and East Surrey sent 44 patients.

"The lower than anticipated numbers reflected concern that patients were suitable and fit enough, which tended to reduce the number recommended for surgery overseas, as selection tended to be conservative," said Dr Peter West, Director of YHEC. "Contracting arrangements in Germany also made it more difficult to arrange for a large number of patients to travel for care in a short time. Finally, in some cases there were delays and difficulties in managers identifying the patients who might travel from local waiting lists."

"Patients experienced some problems with after-care on their return to the NHS and some raised concerns with the type and quality of food in German hospitals," he said. "Some aspects of travel arrangements posed problems because of the specific needs of people with physical mobility or sight problems, compared to the general organisation and timetabling of transport services. These problems included such things as walking along station platforms, and getting on and off trains in a short period of time."

The YHEC report makes a number of recommendations for improved organisation and management and these have been embodied in the most recent guidance to the NHS on sending patients overseas. In particular, YHEC recommended use of a lead commissioner - an NHS body to take prime responsibility for dealing with overseas hospitals, on behalf of other health service bodies. YHEC also recommended that hospitals planning to send patients abroad should take active and early steps to ensure that their own surgeons understood the plans and were committed to helping with the reduction in the waiting list in this way.

Department of Health information about the YHEC report can be found at:

York Health Economics Consortium Ltd Report for the Department of Health

Notes to editors:

  • YHEC Ltd is a research and consulting company owned by and established at the University of York to carry out short-term projects for the NHS and for private sector health care manufacturers and providers.
  • YHEC was not asked in its terms of reference to examine the costs of the initiative or the longer-term clinical outcome.
  • Health authorities were reorganised in April 2002 and so the district health authorities referred to above no longer exist.
  • The YHEC website is at

Contact details

David Garner
Senior Press Officer

Tel: +44 (0)1904 322153