Knee replacement surgery: going private or abroad

Have arthritis, wear and tear or other joint problems knocked your knee for six? Knee problems tend to become more common as we age. And knee problems don’t just cause pain, they can limit your mobility, reduce the amount of exercise you can do, and affect your work and your social life.

The remedy is to have knee replacement surgery. However, you may have to wait some time for your new knee. There are still long waiting lists for some operations through the NHS, including knee replacements. Statistics published in April 2018 show that there were a total of 3.76 million referred to treatment (RTT) NHS patients waiting for their treatment (including knee surgery) to start. Of these, 2,236 were waiting more than 52 weeks for different types of surgery. So it may be worth looking at other possibilities.

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Paying for a new knee

If you can’t bear to wait months to have a replacement knee operation through the NHS, there is an alternative – you can pay to have the operation carried out privately, here, or abroad. Taking this route could mean that you have your operation far more quickly, and get back to normal life sooner.

However, it comes at a price. Recent figures indicate an average cost of £11,400, although this may go as high as £15,400. (Bear in mind that the amount may have increased since these figures were published). Before you decide to have your knee replacement carried out privately, make sure that you ask for current prices, and ensure that the total includes all extras.

If a relative or friend travels with you to a hospital here or abroad, the cost will be even higher. Take care to check all possible expenses before you book.

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Going abroad for knee replacement treatment

This may sound as though it would be more expensive than having your operation privately in the UK, but it doesn’t have to be. There are two options that can allow you to have your operation partially funded by the NHS.

The S2 route

This option may mean that you can have NHS-funded treatment in a European Economic Area (EEA) or in Switzerland.

There are a number of eligibility criteria that you will have to meet before your S2 application will be approved. Here are some examples:

• You live in England and are entitled to have this treatment via the NHS.
• The treatment you need would normally be provided for you by the NHS.
• The treatment you have asked for is available through the treating country’s state healthcare scheme.
• The treatment you have asked for is not emergency treatment.
• You must have a statement from your clinician, saying why you need this treatment, and giving the time scale in which the treatment should be carried out.

In some countries patients pay 25% of the cost of health treatment provided by the state. If you have health treatment in one of these countries you would also be expected to pay 25% of the cost.

To apply for funding under the S2 route you will need the Funding for Treatment in Europe Application Form.

It would be a good idea to also download the S2 and EU Directive funding routes guidance notes, to help when filling in the Funding Form.

The EU Directive route

You may be able to claim for medical treatment abroad using the EU Directive route.  The difference is that you will have to pay for any treatment you have in one of the other European Economic Area (EEA) countries, and then apply to the NHS to have the cost refunded.

You will usually have to pay the costs of the medical treatment before you have any treatment. You will probably only be entitled to have any funding for treatments the same as, or similar to, those you would be able to have on the NHS. (Unless you can prove that you have exceptional circumstances).

It is important to remember that in some cases you will need to have authorisation from NHS England before having certain treatments abroad. If you are thinking of using the EU Directive route, you can find out more about the process by emailing NHS England at England.europeanhealthcare@nhs.net.

If you are going to apply for reimbursement of your medical costs after you have been treated abroad, or for authorization before you have treatment, you need to complete an application form.

It would also be useful to download the S2 and EU Directive funding routes guidance notes, to help when filling in the Funding Form. 

Make sure that you thoroughly research all the options open to you, and how much each one will cost – you don’t want to be unpleasantly surprised when the bill arrives.

Remember to include travel insurance for yourself and anyone who is travelling with you. Think about extra expenses, such as having to be flown back to the UK for extra treatment. Check on local hotel costs in case you don’t feel well enough to travel home straight away.

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