Eligibility of non-UK residents to receive donated organs
NHS Blood and Transplant (NHSBT) has a statutory responsibility to ensure the integrity of organ donation in the United Kingdom – specifically, that organs donated for transplant are matched and allocated in a fair way, based on the clinical need of the patient and in accordance with the law.
Organs donated from deceased donors in the UK are given freely and without condition. It is illegal to sell organs for transplantation in the UK.
Entitlement to a donated organ is governed by criteria set out in the Department of Health Directions issued by the Secretary of State for Health under section 17 of the National Health Service Act 1977 (now section 8 of the NHS Act 2006).
The Directions place patients into two categories – Group 1 and Group 2.
Group 1 patients
Group 1 includes:
- persons ordinarily resident in the UK who qualify for NHS treatment under the NHS Act and must be treated the same as UK nationals resident in the in the UK, members of the armed forces serving abroad and other Crown servants who are serving abroad;
- persons entitled under reciprocal health agreements to medical treatment in the UK - Regulation (EEC) No 1408/71 (ie. EEA and Swiss nationals and certain other people lawfully resident in an EU Member State); and
- persons entitled under bilateral reciprocal health agreements.
Please go to the Department of Health website for further details.
Therefore, someone who is ordinarily resident but not necessarily a UK citizen, or somebody entitled under reciprocal arrangements, can receive treatment in the UK as a Group 1 patient.
Group 2 patients
These are patients that do not fall within the categories of persons listed in Group 1.
Legal Position
The transplantation of donated organs into non-UK EU residents who qualify for NHS treatment is guided by European law, which effectively regards such patients as having equal access to the NHS. Article 3 of Regulation 1408/71 provides for equality of treatment, therefore healthcare should be provided in the UK to European Economic Area (EEA) nationals on the same basis as it would be to a UK national.
Nationals of countries in the EEA are entitled to register as Group 1 if accepted by a consultant as suitable for treatment. It is the responsibility of the consultant registering each patient for transplant to confirm eligibility and NHSBTand/or the transplant centre is then responsible for ensuring organs are correctly allocated based on the eligibility information supplied.
A citizen of an EU Member State can ask for authorisation from their health authorities to go to another Member State for planned state-sector treatment.
The decision about whether to authorise a referral is a clinical one made by the referring Member State, taking into account factors such as whether undue delay applies or whether it is a specialist treatment that the home state cannot supply. The referring Member State covers the cost of the referral.
All Group 1 patients have equal entitlement to donated organs and treatment funded either by the NHS or their Member State, if in the EEA, or their home country under reciprocal agreements.
Some Group 1 patients may choose to fund their treatment privately. However , this does not confer any additional entitlement or speed of access to available organs.
Group 2 patients are not entitled to NHS funded treatment. Group 2 patients’ treatment may be funded by their government or independently.
Latest news
An independent report to clarify the rules on organ transplants for NHS patients and non-UK EU residents was commissioned by the Health Secretary in March 2009.
The report, entitled Allocation of organs to non-UK EU residents, was published on 31st July 2009, and recommends that organs from deceased donors should only be transplanted into patients who are entitled to transplants on the NHS. These are the patients in Group 1. Patients in group 2 would not be eligible for transplant with organs from deceased donors in the UK.
The Department of Health, which has broadly accepted the report’s recommendations, is currently considering the implications for each of them and has established an implementation group consisting of representatives from the transplant community, NHS Blood and Transplant, commissioners and others to consider each recommendation and to advise on implementation.
Department of Health officials are responsible for putting implementation proposals to Ministers.
The Department of Health website has further details.
9 December 2009
