England/Wales Cross Border Frequently Asked Questions

Wherever you live in the United Kingdom, generally you can use the NHS.

However, the NHS is organised differently in each of the four countries – Wales, England Scotland and Northern Ireland.

To make it easier for people living near the England-Wales border to understand how they can use local services, the Governments and NHS bodies on either side of the border have made some simple agreements, including a ‘cross border protocol’. This sets out ways to allow patients to see a GP over the border. Through the GP you are able to get other services in a fair and predictable way.

If your question is not answered here or you need more information you should ask your Clinical Commissioning Group.

There are similar Frequently Asked Questions for Welsh residents on the Welsh Government website.

Can I have a GP in Wales if I live in England?

Yes you can, but this may depend on where you live and the location of GP practices.  If you do use a Welsh GP, the assumption is that you will be mainly using the Welsh NHS.  If you need hospital treatment you will normally be seen and treated at a Welsh hospital.

Welsh NHS standards and policies will apply to your treatment.  Patient choice and the NHS Constitution do not apply to the NHS in Wales.  If you have a GP in Wales, you will not be able to exercise patient choice as you would in the NHS in England.

If you have a GP in Wales you need to know which Local Health Board you belong to.

If I have a GP in Wales, can I have free prescriptions?

NHS prescriptions are free of charge if you have:

  • a GP who is based in Wales
  • a prescription dispensed by a pharmacist who is based in Wales.

If you live in England and have a GP in Wales, you are able to get prescriptions free of charge as long as the prescription is dispensed by a pharmacist in Wales.

If you choose to have your prescription dispensed in England, you will need to qualify for free prescriptions under the English criteria.

If I have a GP in Wales but live in England, what screening services am I entitled to?

NHS England commissions the national screening programmes for England.  The majority of screening programmes are based on residency, so if you live in England, the screening services you receive will normally be those for English residents. Having a Welsh GP does not change this.  However there are some screening programmes that are based on your GP registration; these would therefore be arranged based on your registration with a Welsh GP.   You will be invited to attend screening appointments by the organisation which carries out the screening.  If you have any questions about your entitlement to specific screening programmes, you should speak to your GP in the first instance.

Can I access out-of-hours services in either England or Wales even if I am registered with a GP in Wales?

Patients access the out-of-hours services that have been arranged for them by the GP that they are registered with.  If you are registered with a GP in Wales you should access the out-of-hours service provided by your Local Health Board in Wales. However, if you wish to go to a nearby out-of-hours primary care centre in England, you can ask your own out-of-hours service if an appointment could be made for you.

Can I make use of English or Welsh drop-in centres?

Arrangements vary, but you would normally be seen and assessed regardless of where your GP practice is. If you have a GP in Wales and need further treatment you should be referred back to the Welsh Health Service for that treatment.

Can I have treatment in Wales when I have a GP in England?

If you live in England and have a GP in England you will normally receive your treatment from the NHS in England, and your Clinical Commissioning Group is responsible for your care. Generally, you will receive your care from an English hospital.  If you as a patient feel that there is a strong medical reason why your treatment should be provided in Wales, you should approach your GP and the Clinical Commissioning Group, explaining the reasons.

If you live in England and have a GP in Wales you will normally receive your treatment from the NHS in Wales and your GP’s Local Health Board is responsible for your care. Generally, you will be sent to a Welsh hospital. However, in parts of Wales, Local Health Boards have agreements that patients can receive treatment in English hospitals where that is easier.

A small number of people live in England and have a GP in England who is part of a Welsh practice. If you are one of these people you will normally receive your treatment from the NHS in Wales and your GP’s Local Health Board is responsible for your care. Generally, you will be sent to a Welsh hospital. However, Local Health Boards will consider requests for you to receive treatment in English hospitals where that is easier.

Can I have treatment quicker if I go to an English hospital?

If you have a GP in Wales and are sent to an English hospital, you will have the same maximum Welsh waiting times. This applies wherever you are seen or treated.

What happens if I am receiving treatment for a mental health problem in Wales?

If you have a GP in Wales you will generally receive mental health services in Wales. This is the same for both primary and secondary services. If you wish to be seen in England you should contact the Clinical Commissioning Group that covers where you live.

If I have a GP in Wales and I wish to make a complaint about the GP, what do I do?

Your first step will normally be to speak to your GP at your GP surgery.  You can speak to them about your concerns or write them a letter or an email.

If you don’t feel comfortable doing that, then you can raise the matter with the relevant health planning body, which will normally be the Local Health Board.

You may also ask the local Community Health Council (CHC) which covers your GP’s area to help you. It can provide a free and independent advocacy service to help you or the people acting for you to raise a concern.

If you are not happy with the response to your complaint, you can refer the matter to the Public Services Ombudsman for Wales.

More information on the process can be found in Putting Things Right.

If I receive treatment in a Welsh hospital and I wish to make a complaint about it, what do I do?

Your first step will normally be to raise the matter with the member of staff concerned. If you don’t feel comfortable doing that, then you can raise the matter with the relevant health planning body, which will normally be the Local Health Board.

You may also ask the local Community Health Council (CHC) which covers your GP’s area to help you. It can provide a free and independent advocacy service to help you or the people acting for you to raise a concern.

If you are not happy with the response to your complaint, you can refer the matter to the Public Services Ombudsman for Wales.

More information on the process can be found in Putting Things Right.

Who is responsible for inspecting and monitoring services in Wales?

The Healthcare Inspectorate Wales (HIW) is the independent inspectorate and regulator of all health care in Wales.

HIW regulate and inspect on behalf of Welsh Ministers, NHS services and independent healthcare providers in Wales against a range of standards, policies, guidance and regulations and to highlight areas requiring improvement.

For more information regarding the role of HIW, please see Concerns and complaints about Health Services in Wales.

If I suddenly need emergency treatment, could I be taken to a hospital in Wales?

Yes – you will be taken where the ambulance thinks you need to go. Dependent on your care requirements, it may be arranged for you to be transferred when your treatment episode or emergency treatment has finished.

You can also access emergency treatment at a hospital in Wales if you transport yourself to the hospital.

I have heard of the 111 service. How does that operate in Wales?

NHS 111 is being introduced in England as a free-to-call number for access to urgent care services.  While NHS 111 is currently an England-only service, it is possible to access NHS 111 from some limited areas in Wales near the border.  It is intended that Welsh residents should use NHS 111 if they have a GP in England. If you live in Wales and your GP is in Wales and accidently get connected to 111, the call centre will do its best to help. However it is likely you will be advised to contact your GP, NHS Direct Wales or local out of hours’ service.

Can the NHS move my treatment from a Welsh hospital to an English hospital without my agreement?

Your doctor would discuss any change to your treatment but it is highly unlikely that the location of an ongoing course of treatment would be moved. However, a new treatment could be commenced in a different location.

In what circumstances can I have medication dispensed by a GP?

In Wales, patients are only allowed to have medication dispensed by their GP if the area they live in has been formally identified as a rural area under the NHS (Pharmaceutical Services) Regulations.

It is for Local Health Boards to decide whether an area is rural. They cannot classify an area in England as rural. Therefore, as it stands currently, patients resident in England who are listed with a GP in Wales cannot receive dispensing services from their doctor, though this is under review.

In England, GPs may be able to dispense medication to patients if they meet the criteria set out in the NHS (Pharmaceutical and Local Pharmaceutical Services) Regulations 2013 – England.  The criteria includes, but is not limited to, requirements that the patient would have serious difficulty in obtaining the necessary drugs, medicines or appliances from a pharmacy due to their distance from a pharmacy or communication difficulties.

Who do I contact if I require emergency NHS dental treatment in England?

If you think you need urgent treatment, contact your usual dental practice and ask to be seen as an emergency. If you require out of hours emergency NHS dental treatment or do not have a regular dentist, you can still access urgent care by calling NHS 111.

Can I get help with transport across the border when I need to cross it for treatment?

This depends on your circumstances. There are rules and there is not a single system. You will need to approach the contact centre that deals with the local authority area where you live.

The rules are that:

  • a patient requesting NHS-funded transport will be assessed for eligibility
  • eligibility for non-emergency transport is based on medical need
  • patients in receipt of benefits may be able to reclaim all or some of their travel costs through the hospital travel scheme
  • patients resident in England, registered with a GP in Wales should contact the appropriate contact centre for their GPs region [see below]

patients resident in Wales, registered with a GP in England should contact the Clinical Commissioning Group for where  their GP is located

Your local authority area Contact Centre

  • Isle of Anglesey, Gwynedd, Conwy, Denbighshire, Flintshire, Wrexham – 0845 607 61 81
  • Powys, Ceredigion – 0845 840 12 34
  • Pembrokeshire, Carmarthenshire, Swansea, Neath Port Talbot, Bridgend – 0844 870 00 888
  • Vale of Glamorgan, Cardiff, Rhondda Cynon Taf, Merthyr Tydfil, Caerphilly, Blaenau Gwent, Torfaen, Monmouthshire, Newport – 0800 328 23 32