The NHSCFA estimates that £824,000 of NHS funding is vulnerable to Reciprocal healthcare fraud. The estimate only encompasses EHIC, GHIC and PRC expenditure, it does not include the S1 scheme, the smaller S2 scheme or other reciprocal healthcare agreements.
Reciprocal healthcare agreements enable UK citizens or residents to access healthcare when abroad, and overseas visitors to do the same in the UK. The documentation you are required to present can vary and medical care can be free or discounted.
To learn more about eligibility and the cover provided through a EHICs and GHICs Applying for healthcare cover abroad (GHIC and EHIC) - NHS
To learn more about provisional replacement certificates Get temporary cover for emergency treatment abroad (Provisional Replacement Certificate) | NHSBSA
To learn more about the S1 scheme Planning your healthcare when living abroad - NHS
To learn more about S2 funding The Planned Treatment (S2 funding) route - NHS
To learn more about other reciprocal healthcare agreements UK reciprocal healthcare agreements with non-EU countries - GOV.UK
The main fraud types in this category are:
- False Fraudulent Application
- False Use
To assist you on how to spot the signs of reciprocal healthcare fraud and how to report this type of fraud please see below.
Think Prevention
- Has a false identity or have false details been used to apply for an GHIC, UK EHIC, PRC, S1 or S2?
- Is the individual claiming for treatments or services entitled to do so?
- Are you using the Official Government or NHS website to apply for your card or certificate?
- Is the genuine document holder in possession (or in the company of an individual presenting it on their behalf)?
- Has the Overseas Visitor Manager (OVM) been notified (Please note an OVM cannot determine the urgency of treatment - only a clinician can decide if care is urgent or immediately necessary)?
Further information
- Applying for a GHIC or UK EHIC card is free, however, certain websites advertise themselves as official handlers of EHIC applications, charging for simply forwarding applications to the NHS without making it clear that this can be done free of charge by the individual. Get healthcare cover for travelling abroad - NHSBSA
- For further information on definitions within this category, please check Overseas patients in the fraud definitions.
How to report fraud
Report any suspicions of fraud or attempted fraud to the NHS Counter Fraud Authority online at https://cfa.nhs.uk/reportfraud or through the NHS Fraud and Corruption Reporting Line 0800 028 4060 (powered by Crimestoppers). All reports are treated in confidence and you have the option to report anonymously. You can also report to your nominated Local Counter Fraud Specialist if you are an NHS employee or contractor.