London School of Hygiene & Tropical Medicine

British people travelling abroad for medical treatment are often unaware of the potential health and financial consequences they could face, according to a new report co-authored by experts at the London School of Hygiene & Tropical Medicine.

The authors say at least 63,000 UK residents travel abroad for medical treatment each year, which can, in some cases, have catastrophic effects for individual patients.

However, the study conducted in partnership with the University of York, Royal Holloway University, the University of Birmingham and Sheffield Teaching Hospitals NHS Trust, concludes that many people are embarking on medical tourism without understanding the risks involved.

These include a lack of redress in many countries should things go wrong, and the costs of non-emergency care at home to rectify poor outcomes of treatments received overseas. Many people, the researchers say, are unaware that under current NHS eligibility and commissioning rules, individuals may be personally liable for these costs.

The study looked at the effects on the NHS of British nationals going abroad for services including dentistry, bariatric (weight-loss) surgery, fertility services and cosmetic surgery.

The authors say a sample of patients revealed that while some patients had minor or no problems following treatment abroad, others faced severe health problems which in some cases were exacerbated by an inability to ensure continuity of care or obtain patient records to address patients' needs.

The researchers conclude that GPs need support and training to enable them to advise patients not only on the broad consequences of medical tourism, but also the implications of specific forms of treatments which may present particular concerns. Bariatric surgery and fertility treatment are highlighted as particular areas of concern.

They also recommend that more information and advice is provided to potential medical tourists. This, they say, needs to be packaged and disseminated so it will reach those who may not consult their GP or a specialist website before travelling.

Report co-author Dr Johanna Hanefeld, Lecturer in Health Systems Economics at the London School of Hygiene & Tropical Medicine, said: "The people we interviewed are sometimes far from 'empowered consumers' and are failed by the current system. There is a real need for urgent policy action to address the gap in information that exists for people travelling for treatment."

The medical tourism study 'Implications for the NHS of Inward and Outward Medical Tourism' addressed four interrelated themes: patient decision-making; quality, safety and risk; economic implications; and provider and market development.

The researchers found that decision-making around outward medical travel involves a range of information sources, with the internet and information by informal networks of friends and peers, playing key roles. They conclude that medical tourists often pay more attention to 'soft' information rather than hard clinical information. They also found that there is little effective regulation of information - be it hard or soft - online or overseas.

The research was funded by the National Institute for Health Research Health Services and Delivery Research Programme.

Publication

• Lunt N, Smith RD, Mannion R, Green ST, Exworthy M, Hanefeld J, Horsfall D, Machin L, King H. Implications for the NHS of inward and outward medical tourism: a policy and economic analysis using literature review and mixed-methods approaches. Health Services and Delivery Research. DOI: 10.3310/hsdr02020