Information on Cross-Border Healthcare for the NHS in England and Wales

To make it easier for people living on or near the England-Wales border to understand how they can use health services, the governments and NHS bodies on either side of the border have made some agreements summarised in a Statement of Values and Principles.

This Statement sets out the arrangements for delivering healthcare between the NHS in England and the NHS in Wales across the England-Wales border. It helps support patients who live on or near the England-Wales border to make sure they receive healthcare without confusion or delay.  Whilst there are some differences between the NHS in England and Wales, the overriding principles of the Statement are that no treatment will be refused or delayed due to uncertainty or ambiguity as to which body is funding the individual’s healthcare treatment. It also ensures that both countries will act in the best interest of patients at all times and are committed to delivering excellent patient care.

Following changes to the healthcare system in England, if you live in England and are registered with a GP practice that is either based in Wales or is registered with the NHS in Wales, then the way you are referred to a consultant will be different to how you have been referred in the past.  NHS England, NHS Wales, Clinical Commissioning Groups (CCG), Welsh Local Health Boards (LHB) and stakeholders have been working together to ensure that the referral process for secondary care healthcare treatment for people living on or near the England-Wales border fair and in line with NHS England law and constitutional rights.

We want to make it easy for people living on or near the border of England and Wales to understand what these changes mean for them. Whilst patients should not experience any changes to care provided by their GP, there are a few changes to onward secondary care that patients need to be aware of:

  • If you live in Wales and are registered with either a Welsh or English GP you will experience no change to your current GP arrangements.
  • If you live in England and are registered with a GP practice that is either based in Wales or registered with the NHS in Wales and you need to be referred for consultant-led care there will be a new referral process.
  • Your GP will arrange for your details to be sent to a central NHS Referral Assessment Service (RAS) – hosted by NHS Shropshire CCG in Shrewsbury.
  • Once your referral is received, a member of the RAS team will contact you to arrange a convenient appointment at the hospital or clinic of your choice. If you prefer, you can still choose to receive your consultant-led treatment and care in a hospital or clinic in Wales instead of England.
  • If you are cared for by the NHS in Wales you will receive high quality care to the same standards and policies as Welsh patients and Welsh referral to treatment times will apply.
  • The RAS is not currently involved in urgent suspected cancer referrals; these are sent directly to the hospital or clinic by your GP.
  • A list of GP practices that are signed up to the RAS in the relevant Welsh LHB is provided.
  • If your GP practice is not signed up to the RAS, then the GP or CCG will be responsible for your referral and finding you an appropriate provider of the service needed. You will not experience any delay in treatment by choosing this option.  However, it is possible that you may have to change your GP practice if you wish to be referred into England for treatment.

To provide further information for patients we have produced FAQs together with patient information leaflets setting out further detail for your relevant CCG or LHB.

Who Pays? Establishing the Responsible Commissioner: This document sets out the circumstances which determine which clinical commissioning group is responsible for paying for a patient’s care within the NHS in England.

Responsible body guidance for the NHS in Wales:  This is the relevant guidance for the NHS in Wales.

GP practices using the RAS

Betsi Cadwaladr University health board

Using RAS

  • Chirk Surgery, Castle Health Centre, Colliery Road, Chirk, Wrexham
  • The Surgery, Sandy Lane, Hanmer, Whitchurch, Wrexham

Not using RAS

  • Alyn Family Doctors, The Health Centre,School Road, Llay, Wrexham
  • Overton Medical Practice, 15 High Street, Overton-On-Dee, Wrexham
  • The Stables Medical Practice, 27 Glynne Way, Hawarden, Deeside
  • The Marches, 83 Main Road, Broughton, Nr Chester, Flintshire
  • Caergwrle Medical Practice, 39 – 41 High Street, Caergwle, Flintshire
  • Crane Medical Centre, Crane Street, Cefn Mawr, Wrexham

Aneurin Bevan health board

Using RAS

  • The Wyre Valley Practice, Smithville Close, St Briavels, Gloucester
  • Vauxhall Practice , Vauxhall Lane, Chepstow, Monmouthshire
  • Town Gate Practice, Chepstow Community Hospital, Tempest Way, Chepstow
  • Castle Gate Medical Practice, Monmouth
  • Dixton Surgery, Dixton Road, Monmouth
  • Wye Dean Practice, Tintern Surgery, The Old Police Station, Tintern

Not using RAS

  • Tudor Gate Surgery, Tudor Street, Abergavenny
  • Mount Pleasant Practice, Chepstow Community Hospital, Tempest Way, Chepstow
  • Old Station Surgery, Brecon Road, Abergavenny
  • Hereford Road Surgery, 6 Hereford Road, Abergavenny

Powys Teaching health board

Not using RAS

  • Montgomery Medical Pract, The Surgery, Well Street, Montgomery
  • Knighton Medical Practice, The Surgery, Wylcwm Street, Knighton
  • Welshpool Medical Practice, Salop Road, Welshpool
  • Llanfyllin Medical Centre, High Street, Llanfyllin
  • Newtown Medical Practice, The Surgery, Park Street, Newtown
  • Hay-on-Wye Medical Practice, Forest Road, Hay-on-Wye

International Borders

For any queries regarding treatment abroad please visit: