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S2 (E112) Mandated Treatment

Travel for Planned Treatment under Trade and Cooperation Agreement (TCA) between the European Union and the UK of Great Britain and Northern Ireland (Article SSC.18), known as the S2 or E112 route. This is where an individual seeks access to state-funded treatment in another European Economic Area (EEA) country. It is not suitable for treatment outside Northern Ireland in another part of the UK.

The EU countries are: Austria, Belgium, Bulgaria, Croatia, Republic of Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Ireland*, Italy, Latvia, Lithuania, Luxembourg, Malta, Netherlands, Poland, Portugal, Romania, Slovakia, Slovenia, Spain and Sweden.

Note this scheme does not necessarily cover planned treatment in Norway, Liechtenstein, Iceland or Switzerland. Please contact england.europeanhealthcare@ before you apply for treatment in these countries to check eligibility.

Where you have been assessed as requiring treatment which is not available locally, or is not available within a medically/clinically appropriate time period you may apply for treatment in another EEA country. Please note that this arrangement applies only to treatment in a state provider (i.e. not private) within the EU but outside the UK.


In choosing to access healthcare in another Member State, the home patient is effectively stepping outside of the Health and Social Care (HSC) system and using their rights under S2 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 SPPG, 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 SPPG 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 patient does not pay for eligible treatment costs (apart from any required co-payment costs which would be charged to a person insured within that system, which the patient must pay).

Applications for Maternity S2 funding must be made directly to the NHS Business Services Authority (NHSBSA) not HSC – for further information go to:

The SPPG will consider applications for state-funded treatment in another European Economic Area (EEA) country where:

  1. The treatment is not experimental or part of a drug trial, and
  2. A Northern Ireland Health and Social Care Consultant confirms that the treatment is necessary and recommends that you receive treatment in the other EEA country either on the basis that:
    • The treatment required is not available in the UK; or
    • The treatment is not available in a medically appropriate time period based on an objective clinical assessment of your individual circumstances

In order for the SPPG to support the S2 application you will be required to submit the following supportive information:

  • Clinical confirmation from your HSC/NHS consultant that they are recommending the treatment.
  • If the treatment is available in Northern Ireland, written confirmation from your HSC/NHS consultant that the treatment cannot be provided by the health service within a time that is medically acceptable based upon an objective clinical assessment of your individual circumstances.
  • Written confirmation from the state provider of the agreed treatment(s), proposed dates and estimated costs. Please ensure this is in English or that an English translation is provided.

Important information

  • Applications must be authorised by SPPG before treatment.
  • The treatment must be provided in the state healthcare system of the other country.
  • Applications for maternity S2 funding must be made directly to the NHS Business Services Authority (NHSBSA) and not to this team (visit Department of Health (DoH)website for further information).

You are responsible for providing accurate and complete information to support the decision making process. Incomplete applications will cause delay in processing your request.

Note: The SPPG can only process claims for people ordinarily resident in Northern Ireland and entitled to access health and social care services. Patients will be asked to provide proof of residency and entitlement to health and social care services.

It can take up to 20 working days for a fully completed application form to be processed and a decision made. You will be informed of the outcome of your application once a decision has been reached.

Where an S2 application has been approved the SPPG will:

  • Book flights or ferries.
  • Reimburse other reasonable travelling expenses up to a maximum allowance.
  • Reimburse accommodation expenses up to a maximum allowance.
  • Provide a daily subsistence allowance.
  • Provide assistance towards other transport expenses.

The cost of treatment is paid at national level (i.e. not by the SPPG) through the Overseas Healthcare Team in NHS Business Services Agency (NHSBSA).

Co-payment charges may be reimbursed by the NHSBSA at:

No other costs will be reimbursed.

Travel expense reimbursement for S2 (E112) treatment is not means tested. Expenses in relation to this policy will be payable by the SPPG regardless of the patient’s financial circumstances. The SPPG will not provide cash in advance of travel.

Further information