In this section
Maintaining high-quality and safe health and social care remains our top priority now that we have left the EU.
We do not envisage any significant disruption to the day-to-day running of the NHS or social care services as a result of the UK leaving the EU. Local care and hospital services will continue to work as normal. This includes A&E care, social care, GP and dentist services.
Clinicians should not write longer NHS prescriptions and people should keep doing what they’ve always done. That means only ordering prescriptions when they are needed, getting medication dispensed in the usual way and continuing to take it in the way it was prescribed.
If you have any concerns about your medicines or your regular prescription, you should talk to your local pharmacist in the first instance.
EU citizens have always been, and will continue to be welcome in Wales. Our EU colleagues play a valuable role in providing health and social care services in Wales and we value each person and the work they do.
EU citizens and their families living in the UK need to apply to the Home Office’s EU Settlement Scheme by 30 June 2021. This will mean they can continue to live and work in Wales following the UK’s departure from the EU.
The Welsh Government has made a package of free support available to help EU citizens to live and work in Wales. To find out more about the help that is available visit the EU Citizens in Wales page.
The Home Office has published the following advice if you are an EU citizen; an organisation employing EU staff; or are recruiting from the EU:
- EU citizens in the UK – Stay Informed, provides information about the citizens’ rights agreement and the Settlement Scheme for EU citizens in the UK.
- A toolkit has been launched to equip employers with tools and information to support EU citizens and their families about the EU Settlement Scheme.
Wales: EU nationals working in health and social care
Approximately 180,000 people are employed in health and social care roles in Wales, with over 98,000 working within the Welsh NHS as of June 2020. In 2020 approximately 8% of staff identified as non-UK nationals, with a higher proportion of EU nationals than non-EU nationals.
In relation to social care and childcare, it is estimated that 6.4% of staff within registered social care services and 4.5% of staff within registered childcare services in Wales are non-UK EU nationals.
We recognise the importance of maintaining mutual recognition of professional qualifications (MRPQ) for the health and social care workforce. This supports the movement of health and social care professionals across Europe.
Now that the UK has left the EU, a ‘standstill period’ of up to two years is in place where existing EU and international qualifications continue to be recognised. As of 1 January 2021, UK-qualified professionals who wish to supply services in the EU should seek recognition for their qualifications using the national rules in the EU Member States. As part of the agreement reached between the UK and the EU, professional regulators will be able to cooperate with their EU equivalents to agree a process for recognising professional qualifications in one another’s territories. This will give regulators the flexibility to negotiate Mutual Recognition Agreements (MRAs) or use existing third country recognition routes to recognise EU qualifications.
Throughout the transition period to 31 December 2020 existing reciprocal healthcare arrangements continued as they did prior to the UK leaving the EU.
These reciprocal healthcare rights include:
- state pensioners have full access to healthcare in the country they retire to
- the free EHIC (European Health Insurance Card) allows people temporarily visiting another EU member state to receive emergency healthcare, and
- posted and frontier workers are able to benefit from local healthcare rights
UK patients are able to exercise the right to planned medical treatment in another EU/EEA country.
People living in the EU who have their healthcare funded by the UK, including pensioners and students, will have their healthcare costs covered by the UK government.
The UK government is currently looking at the future arrangements for reciprocal healthcare. We are working with the UK government to ensure the interests of Wales are properly understood and represented.
S1 certificate to 31 December 2020
Under current rules, an S1 certificate helps you and your dependents to be covered for healthcare when you are living in the UK.
If you are living in Wales on 31 December 2020, your S1 will still be valid in Wales after that date.
You can continue to apply for an S1 certificate during the transition period until 31 December 2020.
You may be eligible for an S1 certificate, if you:
- have worked and paid contributions in EU countries, Norway, Iceland, Liechtenstein or Switzerland
- receive certain benefits, such as a pension, from EU countries, Norway, Iceland, Liechtenstein or Switzerland
You should apply to the health insurance authority in the relevant country, if you are eligible. You must register your S1 in Wales to access NHS care in the same way as someone who is ordinarily resident.
If you are a citizen of Norway, Iceland, Liechtenstein or Switzerland and living in the UK on 31 December 2020, your S1 will still be valid after that date because of the citizens’ rights agreements with those countries.
Reciprocal healthcare arrangements after 1 January 2021
The agreement reached with the EU means that the majority of reciprocal healthcare arrangements with EU countries will continue.
The European Health Insurance Card (EHIC) will continue to be valid until the expiration date on the card. Thus UK citizens are covered if you have urgent needs arising healthcare when in an EU Member State. Once your EHIC card has expired, it can be replaced with a new Global Health Insurance Card (GHIC) issued by the UK Government. Eligible pensioners, frontier workers and certain other groups – and their family members - will continue to have their healthcare costs covered by the UK should they move to the EU.
People will also be able to access planned healthcare (and maternity treatment) in the EU, when pre-authorised.
All people who are covered by the EU Withdrawal Agreement will also retain the same healthcare rights after 31 December 2020.
UK citizens can use a UK passport to get medically necessary healthcare in Norway (for example, emergency treatment, or to treat a pre-existing condition).
If travelling to Switzerland, Norway, Iceland or Liechtenstein from 1 January 2021, UK travellers should get appropriate travel insurance with healthcare cover before travelling, ensuring that it covers any pre-existing conditions that were previously covered by the European Health Insurance Card (EHIC).
Treatment under the Cross Border Directive has not been continued. The Directive can therefore no longer be used by UK citizens to access healthcare treatment in the EU, other than in limited circumstances where patients may use the Directive route to be reimbursed for treatment which has been received:
- up to one year after 11 pm on 31 December 2020, or
- within the period specified for any prior authorisation approval if this is longer than a year.
The New Global Health Insurance Card (GHIC)
The GHIC will replace the European Health Insurance Card (EHIC) and offer the same cover by giving UK residents’ access to emergency and medically necessary healthcare when travelling in the EU. This includes medically necessary treatment for a pre-existing or chronic condition.
People do not need to apply for a GHIC if they already have an EHIC. Your EHIC remains valid in the EU until it expires.
The new GHIC card is free to obtain from the official GHIC website. The card will normally arrive within 10 days.
All UK travellers to the EU are strongly advised to obtain travel insurance in addition to the GHIC as the GHIC may not cover all costs resulting from medically necessary treatment e.g. repatriation.
Beware of unofficial websites, which may charge if you apply through them. A GHIC is free of charge. To apply for a GHIC visit the official GHIC website.
European Health Insurance Card (EHIC)
Your EHIC will continue to be valid if you’re travelling to an EU country until it expires. Once it has expired, it can be replaced with a new Global Health Insurance Card (GHIC) issued by the UK Government. An EHIC gives you the right to access state-provided urgent needs arising healthcare during a temporary stay in the EU. You can get a provisional replacement certificate (PRC) if you need treatment and do not have a card.
All UK travellers to the EU are strongly advised to obtain travel insurance in addition to the EHIC as the EHIC may not cover all costs resulting from medically necessary treatment e.g. repatriation.
UK people travelling to Switzerland, Norway, Iceland or Liechtenstein from 1 January 2021 are no longer covered by the EHIC, though they can use a UK passport to get medically necessary healthcare in Norway (for example, emergency treatment, or to treat a pre-existing condition). They should ensure that they have appropriate travel insurance with healthcare cover before you travel. Make sure it covers any pre-existing conditions that were previously covered by your European Health Insurance Card (EHIC).You can read advice on buying travel insurance with the right cover.
UK-issued EHICs after 1 January 2021
Some people can apply for a new UK EHIC that they can continue to use after 1 January 2021 in the EU, Norway, Iceland, Liechtenstein and Switzerland. People who can apply for the new card include:
- UK students studying in the EU, Switzerland, Norway, Iceland, or Liechtenstein who are not nationals of these countries
- Some British State Pensioners who live in the EU and their families
Nationals of the EU, Switzerland, Norway, Iceland, or Liechtenstein who are ordinarily resident in the UK
Getting healthcare in Wales after 1 January 2021
EU citizens lawfully living in Wales before 31 December 2020, will be able to use the NHS in Wales and access NHS services free of charge as you can now, provided you have registered and obtained settled or pre-settled status to be able to continue to live in the UK. If you do not register, you may be considered an overseas visitor and may be charged for NHS services. To find out what free support is available when applying for settled and pre-settled status visit the Immigration Advice Service website.
To be considered ordinarily resident, you must be living in Wales on a lawful and properly settled basis for the time being. You may be asked for evidence of this.
Agreement with Norway, Iceland, Liechtenstein and Switzerland
Under the citizens’ rights agreements with Norway, Iceland, Liechtenstein and Switzerland, citizens of these countries living lawfully in the UK on or before 31 December 2020 will be able to use the NHS as they do now.
These agreements do not cover citizens of these countries who move to the UK after the end of the Transition Period on 31 December 2020. Find out more about the Swiss Citizens’ Rights Agreement on GOV.UK.
Find out more about the EEA EFTA Citizens’ Rights Agreement (Norway, Iceland and Liechtenstein) on GOV.UK
Agreement with Ireland
Irish citizens who live in the UK, and British citizens who live in Ireland, will continue to have healthcare cover in the country they live in after the UK’s departure from the EU on 31 December 2020. This is because of longstanding arrangements under the Common Travel Area and as part of the new reciprocal healthcare arrangements with the EU.
Find out more information on the Common Travel Area between the UK and Ireland on GOV.UK
Studying in Wales
EU, Iceland, Liechtenstein, Norway and Switzerland citizens who began studying at an accredited UK higher education institute in the UK on or before 31 December 2020, may use their EHIC for medically necessary healthcare until the end of their course, irrespective of their nationality. The individual must apply to the EU Settlement Scheme if their course extends beyond 30 June 2021. EU, Iceland, Liechtenstein, Norway and Switzerland citizens whose course of study in the UK began after 1 January 2021 and lasts for more than 6 months, will need to pay the immigration health surcharge as a part of your student visa application. For a shorter course of study EU, Iceland, Liechtenstein, Norway and Switzerland citizens can continue to use their EHIC for medically necessary healthcare.
Find out more information on the Studying in the UK: guidance for EU students on GOV.UK.
Planned Health Care (previously S2)
Planned healthcare arrangements will continue; and eligible pensioners, frontier workers and certain other groups – and their family members - will continue to benefit from reciprocal healthcare arrangements covering their healthcare costs.
Healthcare providers should continue to use the processes already in place to recover these costs from Member States.
With the ending of free movement, EU citizens who move to the UK from 1 January 2021 for more than six months will be subject to immigration control and pay the immigration health surcharge as part of any visa application. However, certain groups, where a Member State continues to cover their healthcare costs in full, will be able to seek reimbursement of the surcharge. Short-term visitors to the UK who are not covered by the new UK-EU agreement on reciprocal healthcare, including former UK residents, may be charged for NHS treatment.
Long-term healthcare coverage for pensioners (previously S1)
After 31 December 2020 individuals who move their habitual residence to a Member State (or to the UK from a Member State) will be able to receive full healthcare coverage whilst in that Member State. However, people who export pensions and other qualifying benefits will no longer be eligible for treatment for free on the NHS if they return to the UK unless they have ongoing exemption under the Withdrawal Agreement or are covered by other exemption under Wales’ National Health Services Charges to Overseas Visitors Regulations 1989 and amending regulations.
Long-term healthcare coverage for workers (previously S1)
As with existing arrangements, some individuals who move their habitual residence to a Member State (or to the UK from a Member State) will be able to receive full healthcare coverage whilst in that Member State. This includes frontier workers, some other cross-border workers (such as mariners) and some posted/’detached’ workers.
The agreement between the UK and the EU provides for the continued free flow of personal data from the EU and EEA EFTA States to the UK, whilst EU data adequacy decisions for the UK are adopted, and for no longer than six months (from 1 January 2021). The UK has, on a transitional basis, deemed the EU and EEA EFTA states to be adequate to allow for data flows from the UK.
Continue to visit the Information Commissioner’s website to find out more about personal data flows between the EU and the UK, and to keep up to date on any changes which will affect you or your organisation.