Working & treating patients overseas

With increasing mobility and the flexibility of modern technology, questions often arise about the provision of NHS care or advice to patients who are temporarily outside the UK, and whether GPs can themselves provide NHS services while based overseas.  Cambs LMC has summarised below the key considerations, potential pitfalls, and where to go for further information and support.

Giving Advice to Patients Outside the UK

Whether a GP should give advice to a patient abroad depends heavily on context and professional discretion.

Medical Defence Organisations (MDOs) have made clear that neither they nor the Clinical Negligence Scheme for General Practice (CNSGP) would cover a GP in defending any complaint brought in another country. There is also the risk that the local medical regulator could act against a doctor for giving advice or care without being licensed to practise in that jurisdiction.

In addition, it remains uncertain whether CNSGP would provide defence support if an NHS patient located abroad were to initiate legal action in a foreign court against a UK GP.  In essence, this is what travel insurance is for, and it is therefore our view that patients should be signposted to the appropriate local health services while they are abroad.

Practical tip: If a patient contacts the practice for advice while overseas, clinicians should check the patient’s location, document this, and avoid providing remote clinical care unless clearly covered and appropriate.

Providing NHS Services While Based Outside the UK

The GMC and MDOs have acknowledged that a GP can, in certain circumstances, continue to provide NHS care while overseas, as was seen during the pandemic. However, this comes with strict professional and contractual obligations.

A GP working in this way must:

• Be registered with the GMC and hold a licence to practise
• Maintain UK-based MDO cover
• Meet UK appraisal and revalidation requirements
• Remain on the NHS England performers list
• Deliver NHS care to the same standard as if based in the UK
• Be assured that they are accessing records safely and securely, and have appropriate means for contacting patients and directing them to face-to-face care easily

That said, Cambs LMC urges caution. Before entering into any agreement or starting remote NHS work from abroad, GPs should seek written confirmation from their MDO that they are fully indemnified for their specific circumstances.

MDOs have reiterated that CNSGP does not cover defending complaints brought overseas, nor do they. Moreover, foreign medical regulators may take separate action for practising without local registration.

While CNSGP might cover the cost of a claim in some instances, the professional and legal exposure could be substantial.

Cambs LMC advice: Always seek written advice from your MDO before undertaking NHS work or giving medical advice while outside the UK.

Summary

Completing any work or advice for patients abroad, or undertaking NHS care from outside the UK, requires careful professional judgment, robust indemnity, and MDO confirmation.

Cambs LMC is here to support practices in navigating these complex situations and ensuring GPs remain protected, compliant, and confident in their professional boundaries.