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S2 Application Form Guidance

S2 Application Form

General information and guidance for completing an S2 (E112) Application Form for treatment outside Northern Ireland in an EEA country.

This guidance has two sections:

 

Section 1 – GENERAL

In choosing to access healthcare in an EEA member state, the home patient is effectively stepping outside of the Health and Social Care (HSC) system and using their rights under Trade and Cooperation Agreement (TCA) between the European Union and the UK of Great Britain and Northern Ireland, known as the S2 route, to seek healthcare elsewhere.

At this point, the patient is taking individual responsibility for ensuring that the service they obtain is appropriate and safe within the laws of the country of treatment (not under UK legislation). The HSC, under this legislation, will not be formally commissioning services from providers abroad and therefore will not be liable for the outcome of the treatment provided.

Although the HSC may approve your treatment abroad, the country you want to go to is not obliged to accept you as a patient for treatment. If you are refused treatment in an EEA member state, they will have to explain their decision to refuse treatment.

You cannot expect to receive treatment in preference to a patient already within the country’s state healthcare system. This means you may have to observe local waiting times or the country’s guidance on particular treatments.

The S2 Form is for UK (Northern Ireland) residents, who are requesting treatment in an EU (Non-UK) country.

Do not use this form if you have a UK issued S1 and live in another EU (Non-UK) country. There is a separate form and guidance for this.

Find out more on the NHS Website searching for ‘Healthcare abroad’ at: https://nhs.uk/

 

S2 application route (PLANNED treatments) key points:

Find out more on the NHS Website searching for ‘Healthcare abroad’ at: https://nhs.uk/

 

S2 form issue

S2 forms will only be issued for a treatment period of up to 3 months at a time. Extensions / continuation applications can be made and will be assessed on a case by case basis.

S2s will not normally be approved more than 3 months in advance of the treatment date, to ensure that the eligibility evidence is current.

An S2 form can only cover one treatment provider. If you need treatment at more than one treatment provider then you will need separate S2 forms to be approved for each provider.

If the patient is asked to pay a co-payment charge, this will be in accordance with local residence requirements of the member state and is normal practice. The NHSBSA will be able to advise if the patient is eligible for a refund from them (this is not the responsibility of Health & Social Care Board in Northern Ireland). All other eligible treatment costs should be covered by the S2 form.

 

Treatments available on the NHS (NHS Entitlement)

If a patient is unsure whether a treatment would be available to them in Northern Ireland, they can contact the HSCB Commissioner directly for further advice before applying for funding.

 

Section 2 – Help to complete the application form sections

Part 1: S2 Funding Route

 

Part 2: Patient Details

Please complete all necessary information including your permanent address of residence in Northern Ireland.  You may be asked for further documentation to proof residency, eg passport or driver licence, a household bill and bank details.

Only provide an alternative address if for some reason you are not currently living at your permanent Northern Ireland residence.

 

Part 3: Treating Clinician / Provider Details

Please provide details of the location where the treatment is to be provided and the treating clinician.

Please do not record the details of the hospitals or clinicians that have been treating you under the NHS in Northern Ireland.

 

Part 4: Treatment Details

Record the diagnosis and treatment plan for the S2 funding application, supported by eligibility evidence, for the medical treatments, as follows:

 

Part 5: Supporting relevant information

Detail any further clinical or other documentation that has been submitted with the application.

 

Part 6, 7, 8 and 9: Declarations by the Patient and/or Applicant

Declarations must be read and signed.

 

Part 10: Checklist

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S2 EEA Country - HSC Application Form PDF
S2 EEA Country - HSC Application Form PDF
S2-EEA-HSC-Application-Form.pdf
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PDF of guidance information for completing an S2 (E112) Application Form for treatment outside Northern Ireland in an EEA country.

 

If you require this guidance or the S2 Application form in an alternative format please contact:

National Contact Point
Health and Social Care Board
12-22 Linenhall Street
Belfast BT2 8BS
E: NationalContactPoint@hscni.net
T: +44 (0)28 9536 3152