Whilst serving personnel are transferred under Defence Medical Services (DMS), family members will need to take measures to ensure a smooth transition and continuity of treatment from your overseas health care provider(s) to one in the UK.
To help with your health care planning we have compiled some guidance, which includes a healthcare planning checklist, and information on registering with a GP and transferring orthodontic treatment – it is always easier to make all arrangements before you leave!
Health care planning checklist
Make a list of health services used
Consider which health related services you access and how to make a move to the same service in the UK. You may need to obtain updated copies of your medical records from the various organizations and institutions to take back to the UK. This may include:
- GP or Primary Care provider
- School medical records
- Immunisation records
- Optician prescription
- Dental records including any treatment plans that have, or continue to be provided.
- Secondary or hospital records including physiotherapy
Check treatments and medication is available in your new location
Before you move, check that any treatment, medication or therapies that you currently receive are available at your new location. In UK healthcare provision can vary from one health authority to another; what is available in one area, may not be on offer in another location. The NHS now operates under a new system of Integrated Care Boards, you will be able to request information about treatments available in your new ICB on the NHS website Find your local ICB (www.nhs.uk)
Obtain sufficient medical supplies
If you receive regular medication, ensure you have enough supplies to cater for your move back to UK. It is also worth checking that the medication you have been prescribed is available in UK, and be aware that it may be manufactured under a different name.
Obtain paper medical records
Although digital medical records are now the norm, it is important that you obtain as much information on paper as possible, a summary of your care record, copies of x-rays, test results, medication records etc. In the event that your digital record does not transfer, you will have all the information any new health practitioner will require to continue treatment.
Registering with a GP practice in the UK
Recently updated NHS Policy has focused on improving the conditions for re-registering with a GP Practice upon return to England. Registration can be undertaken remotely and up to one month prior to return to the UK, thus allowing a smoother and more planned transition.
If you wish to register with a practice where you have previously been a patient:
You can apply to register with your previous GP practice in England up to 1 month before your return date. You may also make this application up to 3 months after your return (however, we would encourage you to register with a GP provider as soon as practicable within this timeframe to ensure you are registered with a GP, in case you come to need their support).
This practice must register you, even if its patient list is closed, if you make the application within that timeframe, unless reasonable grounds apply (e.g. if you are going to live at an address in the UK which is outside of the practice area, and the practice is not currently accepting patients from out of their area). If you have not applied to register with a practice within 3 months of your return to the UK, then no obligation to re-register you will apply if the list is full.
If you need to register with a new GP practice:
You can apply to register with a new GP practice up to 1 month before your return date. You may also make this application up to 3 months after your return
The practice must register you if they have an open patient list, except where reasonable grounds apply (e.g. if the place where you are going to live in the UK is outside of the practice area, and the practice is not currently accepting patients from out of their area). You may wish to contact the practice before making an application to check if they have an open patient list. If they have a closed list, the practice may register you if one of your immediate family members 5 is already a registered patient. If one of your immediate family members is not already a registered patient, you may wish to contact other practices in that area to check if they an open patient list instead.
How to register with a GP surgery (www.nhs.uk) >
What you will need
Confirmation that you are seeking registration under the GP contract provisions for crown servants and their relevant family members returning from overseas postings
A printed, completed and signed GMS1 application form (www.gov.uk) for each applicant. This should be scanned if sent by email. You should enter your ‘home address’ as the address where you have moved to or expect to be resident in the UK for 3 months or longer when you come to the UK. For any temporary registration (www.nhs.uk) (in the case of a temporary home) you will need to complete a GMS3 for
Your anticipated date of arrival in the UK (if still overseas when applying)
Proof of your family member’s status as a current or former service person on, or previously on, the overseas posting on which you are or were accompanying them and from which you are now returning to the UK. This proof should be provided on request by your, or your family member’s, employer (please provide as much notice for this request as possible)
Points to Note:
It is important to provide as much notice to any GP practice that you are applying to as much notice as possible, particularly if you think you may require a GP appointment soon after returning to the UK.
If a GP practice accepts a temporary application, it is responsible for your treatment for up to 3 months from the date of your arrival in the UK (including if your actual arrival date is earlier than your anticipated arrival date), or, if later, the date on which it accepts the application. If you subsequently decide to stay in England for longer than 3 months, you will need to apply to permanently register with that practice, or another practice.
Other things to consider
Defence Medical Services
Some RAF bases allow family members to register with the DMS Medical Centre on base.
To find out if this is the case for you, visit the RAF’s station index and click on the name of the relevant station, followed by the ‘Facilities’ tab. Under the Health and Welfare section, there will be information about the Medical Centre and who is eligible to use it.
If you are still unsure, contact the Medical Centre or HIVE on base who will be able to advise and direct you as appropriate. The majority of Armed Forces families will access and receive their healthcare through the NHS in exactly the same way as the rest of the population.
There is currently a shortage of NHS dentists in the UK and we are aware that service families may struggle to access NHS treatment. Please see our information on finding an NHS dentist and alternative options for provision.
If you are in receipt of healthcare for a condition diagnosed whilst you were overseas
Families often spend a significant period of time overseas with two years usually being the average tour length. Sometimes a family member may receive an initial diagnosis of a health condition whilst they are abroad, using what may be a very different healthcare system and treatment offer. We offer some important advice on how to best manage a move back to UK and a transfer to the NHS so that continuity of care can be maintained if at all possible.
Be proactive – Do your research – Manage your expectations
Inform Career management – Make sure the serving family member informs CM of any health conditions that may require increased planning in terms of relocation. You may need more time to prepare to come back to UK in certain circumstances.
Check what support is available before you leave – Check with your in-country medical team at your support unit for support for any help they may be able to give. They may be able to help you with accessing medical records, x-rays and other useful information to give to your new NHS healthcare provider
Check the local NHS offer – Once you have received your assignment in the UK, make sure that you check your local NHS offer, and the treatment and care that you require is available at your destination location NHS Services. It is possible that treatments that you receive overseas are not available in the UK, or that due to different parameters for diagnosis and care you may not be eligible. There may be a waiting list, or you may be provided with a different type of care in the UK. This is particularly relevant to the USA, where healthcare is based on high cost, high availability, as opposed to UK where the NHS is publicly funded and based on patient need.
Children with SEND diagnosed overseas
In other countries the process of assessing, diagnosing, and supporting children with SEND can vary from one country to another. Some key differences may include:
Terminology – Different countries use varying terms and conditions to describe SEND or disabilities. These terms may encompass a wide range of conditions and may not directly correspond to terminology used in the UK.
Assessment Processes – The methods and procedures for identifying and assessing SEND can look very different overseas: some countries may rely on standardized assessments made by a child paediatrician and others may emphasise clinical or educational evaluations or a combination of both. Time frames for assessment and diagnosis may be shorter, and the parameters for diagnosis may also be quite different. In some countries, diagnosis may be made in one visit to a SEND specialist, or by a child psychologist in a school setting. In the UK diagnosis may take much longer; the child will normally be assessed and observed over a longer period, usually via a multi-agency approach that may involve health, educational and child psychology professionals. In the UK, a measured approach to the diagnosis of SEND is generally taken to allow children to develop and move through milestones, this prevents inaccurate diagnoses closing off areas of support that the child may require as they develop.
Legal Framework – Each country has its own legislation and policies governing SEND, just as we do in the UK. The rights, entitlements, and support available to children with SEND can vary greatly depending on these frameworks.
Support Services – The range and availability of support services, and the eligibility factors to access them vary from one country to another. This includes access to educational support, child therapies such as Speech and Language Therapy, Occupational Therapy, and funding for additional resources. Some services in the UK, particularly child therapy services, have strict eligibility factors, and although you may be receiving these in your overseas location, these may not be available, or your child may not be eligible for these in UK. Your new Local Authority is required to have their SEND Offer available online; this can help you to gain an understanding of what is available to meet your child’s specific needs in your destination location.
With this information in mind, it is essential for serving families to gather as much evidence relating to their child’s circumstances before they move back to the UK:
Plan ahead. Make sure you have all the evidence from any education or healthcare professionals who have been involved with your child’s care to bring back with you, bring paper or digital copies if possible. This may include medical reports, educational observations, and any child therapies they may have been receiving, together with any supporting evidence of the reasons your child is accessing these services.
Contact relevant agencies – Once you know your assignment destination, contact the relevant agencies that you may need to be involved with your child’s care and education once you return to the UK. Make sure they are aware you are a service family; many GP practices are veteran accredited (this includes Service families) and can code your records to indicate this. Early contact is vital and can result in a smoother transition and speedier access to any service or therapy, or placement on a waiting list for that care. This may be a school, GP, or other healthcare professional who can refer you for the relevant support for your child. To help with your health care planning we have compiled some guidance, which includes a healthcare planning checklist and information on registering with a GP – which you can do up to one month before you return to the UK.
Be prepared to repeat observations or assessments – It is reasonably common in the UK for those returning from overseas to be required to repeat observations and assessments already completed overseas. This is, as diagnoses made overseas may not always be accepted in the UK.
Get familiar with local NHS services – It is a good idea to familiarise yourself with the healthcare services available in your area and the types of treatment and child therapies that they have commissioned, you can do this via the NHS website.
Although we understand that moving back to the UK is an extremely busy and challenging time, we know that any prior preparation, collation of evidence and forward planning you can achieve, will make the transition easier once you arrive back in UK.
Use our Returning to the UK Checklist for comprehensive information, guidance, and a full checklist of things to consider as you transition back to the UK.
If you have any questions or concerns, there are people that can help. The HIVE in your new location will be able to help with local information and the Education Advisory Team can provide guidance on education.
Orthodontics and transferring treatment commenced overseas
If you have commenced NHS funded orthodontic treatment overseas, you will need to locate a new orthodontist in the UK. In order to continue treatment in UK you will need to find a suitable orthodontist who is willing to continue treatment under NHS criteria:
SearchRegisters (gdc-uk.org) >
You should also arrange for your original patient records, including study models, radiographs, photographs and notes, to be provided so an NHS orthodontist can confirm they meet NHS criteria. Upon return to the UK, if further treatment is required you will be deemed a transfer case, the orthodontist who continues treatment will complete the course and claim the costs of orthodontic ‘activity’ back from the NHS.
If the orthodontist does not feel the NHS criteria would have been met, or original patient records are not provided, a course of NHS treatment will not be provided.
NHS England Customer Contact Centre
If you have any further queries concerning orthodontic transfers, the NHS England Customer Contact Centre is a useful point of contact for patients requiring information about accessing primary care (GP, dental, optical and pharmacy services). To contact NHS England’s Customer Care Centre call 0300 311 22 33 or email [email protected]
The British Orthodontic Society – Moving & transferring children during treatment also has some useful information too.
If you are moving to Scotland, Wales or Northern Ireland the process may be more complex to navigate if your original approval for access to NHS Orthodontics originated with the NHS Business Authority in England. If this is the case, please contact us at the RAF Families Federation so that we can support you to transfer to the relevant NHS Authority for continuation of your care.