A Patients Tips for the CBHI

Many thanks to the brilliant Sharon Doherty for supplying us with this list of tips for the CBHI and allowing us to use them!

EUROPEAN DIRECTIVE FOR CROSS BORDER HEALTHCARE

This Directive has been in place since 2011!

  • If you are on a waiting list for surgery for too long, in pain, loosing your mobility (and will to live!) and you think that maybe going to another country but think their standards and hospitals won’t be to the same standards as ours think again!! – These Eastern European countries have highly trained staff and their clinics are private so are of a very high standard of equipment. Most of their surgeons have trained or do work in the UK and Ireland, and you can check that out.
  • The first thing I think is to get the support and approval of your GP. I found my GP so helpful and when you need reports/letters signed – he was more helpful than the surgeon I was supposed to be getting.
  • The next thing is to apply to Altnagelvin/your local hospital for any X-rays or scans/tests that another surgeon would need to be looking at.  You have to apply for a form and pay about £10 per copy of X-ray – if you phone Altnagelvin 028 71345171 and ask to be put through to Medical Imaging they will pass you on to the right person.  This can take a few weeks so explain to them why you need them and they might put a hurry on it for you!
  • The Health and Social Care Board in Belfast are in charge of the funding of this. Their website is: www.hscboard.hscni.net/travelfortreatment
  • Christine Grey is the commissioning officer and she is so helpful and friendly – her phone no is: 028 95363059
  • For people in the Republic of Ireland the website is:
  • http://hse.ie/eng/services/list/1/schemes/cbd/acchealthcareabroad/ and the phone no is:
  • HSE Cross Border Directive, St Canice’s Hospital, Dublin Road, Kilkenny Tel: 056 778 4547 or 056 778 4546 or 056 778 4556
  • You need to get an application form first. Check with these offices that you can get the treatment you need under this scheme, how much you are entitled to for it, and what it covers.  Check that they cover the costs of the hotel after you are discharged  if you need follow up treatment eg physiotherapy as a lot of hospitals put the price of the follow up treatments together with the hotel package.
  • I wasn’t entitled to travel money under the one I was applying for – but there is no harm asking about this as well.
  • You have to pay for the treatment yourself then the HSC will refund you the money – so start trying to get money together – or for a loan.  I would remind the Credit Union/building society/bank that you will get a letter of approval from the HSC as soon as they have processed your application and approved it – and that you are getting the money back and this should serve as a guarantee for them if you don’t have enough money in your account.
  • The documents you need for the application form that you need to start gathering are: 3 months pay slips;  a print off of your bank statement showing DAILY SPENDING in the North (or South – wherever you are living). This is to prove you are living where you say you are – they won’t accept just a show of the direct debits that come out of your bank every month.
  • Proof that you are on a waiting list for surgery.  In Altnagelvin if you phone (71345171) and ask to be put through to Waiting Times office – Patricia Hogg – she will look you up and send an email to the HSC confirming this.  Your surgeon’s secretary will not do this so there is no point asking and being messed around wasting a month waiting!!
  • Passport!! I forgot and had to get mine under the one day scheme costing £128.
  • Finding a clinic and surgeon is the next thing. Once you go on the Internet ‘www.Whatclinic.com‘ is very good – it was started by a Dublin man – and once you find a clinic then you can go onto their own website and have a good look. The Eastern European countries are the cheapest – not because they are crap – but because they are still using their own currency not Euros and it’s economic reasons only.  The ex-communist countries have really good medical systems and training.
  • Check the website thoroughly – even though you’ve checked the price of what you need and you see it’s affordable for you – take your time there are so many good clinics out there – no need to rush – this is the one and most important mistake that I made.
  • If someone phones you back within an hour answering your email and promising you they will look after you like a ‘guest’ and their hospital is like a ‘5 star hotel’ – DON’T LISTEN!
  • The reason they got back to you so quickly is that they are NOT THAT BUSY!
  • WHY? Because they aren’t that good at what they do –  in this day and age a good hospital/clinic that is so busy – no one could get back to you at half 8 at night within an hour!
  • Check the photos thoroughly – if they don’t have photos of the wards, hospital rooms, theatres, equipment, patients, – it’s because they are not that modern or great looking and they don’t want to put them out there for all to see! Don’t be fooled by a blurred arty image of a corridor/chair with a close up of a flower pot/picture on a wall – it’s a fudge.
  • Make sure they have plenty of ex-patients on their ‘Testimonials’ page – that they are recent posts, and are from the UK or Ireland.  If they write long detailed positive posts and not short quick comments it’s safe to say they were very impressed and want to get that across to people. When you do make contact with an administrator – make sure you get the contact details of these ex-patients and you do get to either speak to or email them and ask them exactly how their experience was and how their recovery turned out.  If an administrator is slow to give you any ex-patients information or they haven’t any – you can be assured something is up!.
  • If you are impressed and think you want to know further – make sure you ask for a Skype call to the surgeon who will be doing the surgery and write down a list of questions beforehand:  what type of surgery (compared to what you know you would have been getting here), the recovery period, pain management after surgery, how much of a scar will s/he do, what is the follow up work needed – where will you get it; how long will you need to stay after the surgery.
  • The Department in the South of Ireland who are responsible for the Southern patients are happy to help Northern people out in this regard – you can email them with the name of the surgeon who is to do your surgery and they will check her/him out re: qualifications and any restrictions to practice or anything like that:
  •  Catherine Donohoe
    General Manager
    Commercial Unit
    Acute Hospital Services
    HSE Office No. 3
    Kilcreene
    Kilkenny.
    Office Tel:  056 77 85502    Mobile:  087 2668759
  • Their website has lots of useful information as well:
  • http://hse.ie/eng/services/list/1/schemes/cbd/acchealthcareabroad/
  • Make sure that they guarantee you will have: a personal assistant to contact AT ALL TIMES who speaks good English that you have their mobile number to ask anything night or day or they can translate for you with a nurse/other staff member.
  • Check the total cost of the surgery before you go and ask them to send you an itemised invoice that will not change when you get there – make sure and ask them that – that you agree to pay the total on the invoice and NO OTHER COSTS when you get out there. Then you have a total to put on your application form for the HSC and you do not pay any more than that.  If you are not sure about the total when they are asking you to pay – don’t put in your card like I did.  Wait and check it. Any decent clinic will not bring a card machine to your bedside before surgery and put pressure on you.
  • Check that the food will be accommodating to the Irish/UK.  Nutrition is very important for the body when recovering from surgery and if for your dinner your handed boiled dumplings stuffed with fish paste or a ‘salad’ consisting of chopped spiced sausage, cold cabbage and a sliver of lettuce – after 3 days you will be feeling constipated anyway because of the anaesthetic and starving.  As breakfast is the most important part of the day make sure you check that it will also be something you can eat and not luncheon meat, a cold boiled egg and rye bread – our stomach’s are just not used to that.  Fresh fruit, yoghurt, fresh salads, fresh vegetables, chicken, fish, fresh rolls, I would be asking are all those available as that is what we are used to eating and the Eastern European diet doesn’t seem to have a lot of this. Trust me after 5 days of trying to eat like this you will not be feeling well.
  • Make sure and ask if they pay the taxi to take you out and about to visit the town/area you are in if you are staying for rehabilitation after you are discharged.  You will really need a breath of air and they pay the taxi men to do this.
  • Make sure you bring all your own medication with you – even paracetomol just in case.
  • Make sure all medications/crutches/stockings that you will need are included in the agreed price of the surgery so they don’t try and charge you another £100 plus after surgery for these like I was.
  • Check with your GP  before you leave which medications that you have to go off after the surgery – eg pain medication so you can agree a plan of going off it slowly and gradually and you know exactly what to do before you leave and you have them with you.
  • Check that when you are discharged they write out a list of all the medications they have prescribed for you and how many to take in English, what they are, and if there is any injections they show you how to do it.
  • Make sure and ask if you have to stay for a few days after you are discharged from the hospital that you still have a personal assistant to call on in case you need anything and that whatever you need will be taken care of. I got very sick when I was discharged from the hospital in Poland as I wasn’t advised about the morphine I had been taking for the pain so I basically went into detox and it was awful.  What was worse is no one answered the calls or emails for help. I was at KCM clinic in Jelenia Gora, Poland and I would seriously not advise you to go there.
  • If it’s a hip or knee replacement make sure you check before you leave here that they are giving you the crutches to go home with and don’t ask you for payment of them before you go home.  Also check with your airline about booking the front row seat for the way home – on the way out – so you don’t miss out on this you will need extra leg room on the flight home.
  • You will have to manage the airport and flight yourself – it can be long walking through the airport leaving and through the airport at home – don’t be proud ask the hospital to contact the airport and arrange a wheelchair and help for you.  It’s hours waiting to get on a flight, fly home and then get your baggage.  They will do all this for you if you go online and book the ‘Special Services’ required for free.   Do it several days before you are leaving. Ryanair were very helpful in this regard.
  • For someone to come with you it is usually not that more of an expense as they will be only adding a small charge for the double room, flights and food is very inexpensive there.
  • This is only me but if you don’t have a smartphone or Netflix I would be borrowing one as it is cheaper then to contact home through Skype, Viber or Facetime whatever.  Also it’s a long night and if you are ok to watch Eastern European TV go for it – but Netflix always give a free months trial which you can sign off from after the month and I was glad of it to pass the time in the evening.
  • Also check the hospital has working, regular broadband.  Really important to keep in touch with family and friends for support and if you can’t and the broadband keeps going off you feel it.