EU impact on UK health services

Patients' rights to cross-border care to become UK law

In May 2013 England and Scotland consulted on the implementation of an European Union (EU) directive that will give EU patients the rights to access care in another EU state and seek reimbursement to the level of the cost that would have been incurred in their own member state.

Throughout its passage through the EU institutions the RCN stressed the need to ensure the continuity of care and equitable access but respect national health systems' priorities. The European Union approved the legislation in March 2011, and the new EU Directive on Cross-Border Health Care took effect in the UK from October 2013.

Background to the proposals

The European Commission issued a legislative proposal on 2 July 2008 aimed at clarifying and extending the rights of patients to access health care in other EU countries. The proposal covered three main areas:

  • common principles in all EU health systems
  • a specific framework for cross-border care
  • European co-operation on health services.

The final directive

The agreed EU legislation clarifies patients’ rights to seek health care in another European country and either have the costs reimbursed by the NHS or paid directly to the provider. It outlines when patients would need to get prior authorisation, what information member states should provide and confirms that reimbursement would only be to the level of costs for similar care in the NHS. 

The final directive "encourages" co-operation between EU countries on the use of e-health, health technology assessment, rare diseases and recognition of prescriptions, rather than making it mandatory, as the Commission had originally wanted. 


The RCN responded in May 2013 to a Department of Health (DH) England Consultation and an NHS Scotland consultation on implementing the directive in the UK. You can read the RCN's response to the DH England consultation entitled EU directive on patients' rights to healthcare in other European countries (PDF 96.8 KB) on the consultations section of the RCN website.