Cross-border health arrangements between England and Wales
The border between Wales and England is approximately 170 miles long, with 50% of the population of Wales living within 25 miles of the border. As a result cross-border movements are a fact of life, including for healthcare. Since devolution, there has been increasing divergence between the healthcare systems of England and Wales. This can cause confusion for patients, particularly those who rely on healthcare facilities on either side of the border from where they live.
During our inquiry, we sought to bring clarity to a number of issues and to examine what services cross-border patients are entitled to receive. We also examined the different funding and commissioning arrangements in England and Wales, and hope that our report sheds light on the arrangements for the funding of cross-border healthcare.
Our inquiry has not been concerned with the merits of the healthcare system in Wales, which is devolved to the Welsh Government, or England. Instead, our report focused on areas where there was need for essential and detailed systems of liaison to be in place to guarantee consistent cross-border co-ordination.
The Committee’s key recommendations and conclusions are:
• We welcome the commitment from the Welsh Government’s Health Minister on patient needs and his commitment not to allow the border to become a barrier. We recognise that Welsh GPs will be mindful of a need to maintain investment and capacity in Wales. Healthcare providers in England and Wales need to maintain close links to ensure that patients receive the treatment they need regardless of their country of residence, particularly given the policy divergence that has emerged as a result of devolution.
• We recommend that the UK Government and the Welsh Government work together to examine how improvements can be made in the electronic transfer of information between Wales and England.
• We recommend that the Department of Health works with its counterparts in the devolved administrations to establish a single Performers List for GPs across the UK.
• We recommend that the Department of Health and the Welsh Government work together with medical practitioners, particularly at a GP level, to ensure that patients are better informed of the differences in healthcare policy between England and Wales. Patients must also be made aware of the impact of choosing a Welsh or English GP and the implications that this might have for later care.
• We recommend that NHS Wales and NHS England work together to improve patient engagement for cross-border services.
• We are concerned that there is a lack of communication regarding changes to healthcare services which could have an impact across the border. We recommend that formal protocols are put in place to ensure consultation between LHBs and CCGs when changes to services impact on populations across the border.