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England/Wales cross border frequently asked questions

Wherever you live in the UK, generally you can use the NHS.

However, the NHS is organised differently in each of the 4 countries – Wales, England, Scotland and Northern Ireland.

To make it easier for people living near the England-Wales border to understand how they can use local services, the governments and NHS bodies on either side of the border have made some simple agreements, including a ‘cross border protocol’. This sets out ways to allow patients to see a GP over the border. Through the GP you are able to get other services in a fair and predictable way.

If your question is not answered here or you need more information you should ask your local health board or NHS Trust (external link).

Each area of Wales also has a community health council, which is there to help the local community and individuals use and comment on health services.

There are similar frequently asked questions for English residents on the NHS England website.

  • Can I have a GP in England?

    Yes, you can. This may depend on where you live and the location of GP practices. If you do, the assumption is that you will be mainly using the English NHS. If you need hospital treatment, you will be seen and treated at an English hospital and within the English system of patient choice.

    If you have a GP in England, you need to know which clinical commissioning group you belong to.

  • If I have a GP in England, can I still have free prescriptions?

    NHS prescriptions are free of charge if you have:

    • a GP who is based in Wales
    • a prescription dispensed by a pharmacist who is based in Wales.

    If you live in Wales and have a GP in England, you may still be able to get prescriptions free of charge by having an exemption card. You can apply for exemption cards from the following address:

    NHS Shared Services
    NHS prescription card exemption
    Cwmbran House
    Mamhilad Park Estate
    Mamhilad
    Pontypool
    NP4 0YP

    If you have an NHS prescription dispensed in England, you will be charged at the rate set by the Department of Health in England.

    If you have been sent by your local health board to a hospital in England, and are given an English prescription, you will have to pay the current rate set by the Department of Health, even if you take it to a Welsh pharmacy. However, provided you are a Welsh resident, you may claim this fee back from the NHS Shared Services as long as you have proof of payment.

  • If I have a GP in England, what screening services am I entitled to?

    If you live in Wales, you are entitled to all national population screening programmes that are managed and delivered by Public Health Wales. The majority of screening programmes are based on residency, so if you live in Wales the screening services you receive will normally be those for Welsh residents. Having an English GP does not change this. However, there are some screening programmes that are based on your GP registration, these would therefore be arranged based on your registration with an English GP. You will be invited to attend screening appointments by the organisation who carries out the screening. If you have any questions about your entitlement to specific screening programmes, you should speak to your GP.

  • Can I access out of hours services across the border if I live much closer to them, even if I am registered with a GP in Wales?

    If you are registered with a GP in Wales, you should access the out of hours service provided by your local health board in Wales. However, if you wish to go to a nearby out of hours primary care centre in England, you can ask your own out of hours service if an appointment could be made for you.

  • Can I make use of English drop-in centres?

    Arrangements vary, but you would normally been seen and assessed. If you have a GP in Wales and need further treatment you should be referred back to the Welsh Health Service for that treatment.

  • Can I have treatment in England when I have a GP in Wales?

    If you have a GP in Wales you will normally receive your treatment from the Welsh NHS, and your local health board is responsible for your care. Generally, you will be sent to a Welsh hospital. However, in parts of Wales local health boards have agreements that patients can receive treatment in English hospitals where that is easier.

    All the health boards work together through the Welsh Health Specialised Services Committee (WHSSC) to sort out treatment in England for certain highly specialised services.

    If you, as a patient, feel that there is a strong medical reason why your treatment should be provided across the border, you should approach your GP and the local health board, explaining the reasons.

  • Can I have treatment quicker if I go to an English hospital?

    If you have a GP in Wales and are sent to an English hospital, you will have the same maximum Welsh waiting times. This applies wherever you are seen or treated.

  • What happens if I am receiving treatment for a mental health problem in England?

    If you have a GP in England, you will generally receive mental health services in England. This is the same for both primary and secondary services. If you wish to be seen in Wales you should contact the local health board that covers where you live.

    If you have a GP in Wales and have been sent to receive secondary mental health services in England, you will be treated in accordance with the Mental Health (Wales) Measure 2010. The measure deals with mental health services in Wales.

  • If I have a GP in England and I wish to make a complaint about the GP, what do I do?

    Your first step will normally be to speak to your GP at your GP surgery. You can speak to them about your concerns or write them a letter or an email.

    If you don’t feel comfortable doing that, then you can raise the matter with NHS England (external link).

    If you are not happy with the response to your complaint, you can refer the matter to the Parliamentary and Health Service Ombudsman (PHSO) (external link).

    Further information on complaining about a GP in England, is available from the NHS Choices (external link).

  • If I receive treatment in an English hospital and I wish to make a complaint about it, what do I do?

    The Care Quality Commission (CGQ) (external link) is the independent regulator of all health and social care services in England.

    If you have experienced poor care, or know that poor care is being provided somewhere, you can report it to the CQC, anonymously if you wish. You can also tell them if you feel you have received good care.

    If you have a concern about care, the CQC can be contacted on 03000 616161 or email enquiries@cqc.org.uk

  • If I suddenly need emergency treatment, could I be taken to a hospital in England?

    Yes – you will be taken where the ambulance thinks you need to go. Dependent on your care requirements, it may be arranged for you to be transferred when your treatment episode or emergency treatment has finished.

    You can also access emergency treatment at a hospital in England if you transport yourself to the hospital.

  • I have heard of the 111 service. How does that operate in Wales?

    The 111 service is being introduced in England as a non-emergency health service number. It is only possible to access 111 from some limited areas in Wales near the border. It is intended that Welsh residents would only use 111 if they have a GP in England. If you live in Wales and your GP is in Wales and accidently get connected to 111, the call centre will do its best to help. However, it is likely you will be advised to contact your GP, NHS Direct Wales or local out of hours service.

  • Can the NHS move my treatment from an English hospital to a Welsh hospital without my agreement?

    Your doctor would discuss any change to your treatment but it is highly unlikely that the location of an ongoing course of treatment would be moved. However, a new treatment may well be commenced in a different location.

  • In what circumstances can I have a medication dispensed by a GP?

    In Wales, patients are only allowed to have medication dispensed by their GP if the area they live in has been formally identified as a rural area under the NHS (Pharmaceutical Services) Regulations.

    It is for local health boards to decide whether an area is rural. They cannot classify an area in England as rural. Therefore, patients resident in England who are listed with a GP in Wales cannot receive dispensing services from their doctor, though this is under review.

  • Can I get help with transport across the border when I need to cross it for treatment?

    This depends on your circumstances. There are rules and there is not a single system. You will need to approach the contact centre that deals with the local authority area where you live.

    The rules are that:

    • a patient requesting NHS-funded transport will be assessed for eligibility
    • eligibility for non-emergency transport is based on medical need
    • patients in receipt of benefits may be able to reclaim all or some of their travel costs through the hospital travel scheme
    • patients resident in Wales, registered with a GP in England should contact the Clinical Commissioning Group (external link)
    • patients resident in England, registered with a GP in Wales should contact the appropriate contact centre for their GPs region.

    Your local authority area contact centre

    Isle of Anglesey, Gwynedd, Conwy, Denbighshire, Flintshire, Wrexham - 0845 607 61 81

    Powys, Ceredigion - 0845 840 12 34

    Pembrokeshire, Carmarthenshire, Swansea, Neath Port Talbot, Bridgend - 0844 870 00 888

    Vale of Glamorgan, Cardiff, Rhondda Cynon Taf, Merthyr Tydfil, Caerphilly, Blaenau Gwent, Torfaen, Monmouthshire, Newport - 0800 328 23 32

  • Who do I contact if I require emergency NHS dental treatment?

    If you require in-hours emergency NHS dental treatment, you should contact the dental practice where you receive your regular NHS dental care. If you require out of hours emergency NHS dental treatment, you should contact your local health board for details of the level and location of the services available.

    Local health boards also provide emergency care/access sessions for those patients who do not have regular access to NHS dental services.