Recorded Events

Republic of Ireland Reimbursement Scheme 2022

Date: 26th July 2022
Location: Online
Time: 6:30 pm

Are you currently living in Northern Ireland and on a waiting list for Orthopaedic Surgery?

UPDATE: The DoH has allocated a further £5m to continue to operate the scheme beyond the planned 30 June 2022 deadline. New applications will be accepted from 1 July 2022. These will be processed in chronological order and the scheme will continue until the additional funding has been committed. Further information on the scheme will be provided on this website. (NHS Website)

The Republic of Ireland Reimbursement Scheme, formerly known as the EU Cross Border Directive, provides people living in Northern Ireland and on a waiting list for orthopaedic surgery with the option to travel to Dublin for their surgery.

This webinar hosted by Sports Surgery Clinic focuses on the Republic of Ireland Reimbursement Scheme, covering the application process and how to apply for the ROI Reimbursement Scheme. It also focuses on the costs involved and what patients can expect when travelling to Santry for their orthopaedic surgery.

This event consisted of presentations from members of SSC’s team and was followed by a live Questions and Answers session on the Republic of Ireland Reimbursement Scheme.

Good evening and welcome to our webinar on the ROI Reimbursement Scheme which some of you will know as the Cross-Border scheme. I’m Fiona Roche, I’m the business development manager here at the Sports Surgery Clinic. I have been looking after the ROI Reimbursement scheme with my team for the last 8 years, so we have a lot of knowledge and hopefully we can help you.

SSC is a leading private orthopaedic hospital in Ireland. We look after all joints, all sports medicine injuries, we do replacements of knees, hips, and shoulders, we also do all foot and ankle work, wrist and hand surgery, and spinal surgery. We are situated around ten minutes from Dublin airport and we do have parking here as well. We have 7 theaters and 4 wards. We also have 3 MRI scanners and a dedicated sports medicine department.

How to apply for the ROI Reimbursement Scheme?

To apply for the scheme you need to contact the Health and Social Care Board or it’s called the National Contact Point, you can see here we have all the contact details. You can download the application form on our website and all the details are there as well to apply. The first thing you need to apply is you have to must on an NHS waiting list in Northern Ireland for surgery, so you must have seen a surgeon and they have put you on the NHS waiting list. There are ways around doing this as you could be waiting around a year to see a surgeon, so you could see someone privately as long as they have a waiting list and I am happy to take any calls on that. Once you have your application form filled in, you must have proof that you are on a waiting list for surgery in Northern Ireland (you can get a letter from your GP or the hospital where you are on the waiting list), you need proof of who you are like a passport, you need proof of address like a utility bill and another thing you will need is proof of your bank statement as they want to know where you can fund the money.

On the application form, it will ask you if the hospital is private or public? SSC is in the private sector, They will also ask you the name of the surgeon doing the surgery? If you don’t have anyone in mind you can put down that you haven’t decided yet, it will also ask you how many nights you will be admitted? For hip and knee’s it’s 2-,3 nights, for other things it may be 2 nights, and in some cases, it can be a day case. They will ask you about the diagnosis and tests you might need? Just put down that will all be done at your appointment and it is part of your pre-assessment. The form will also ask if you will need any follow-up care, which will be mostly physiotherapy. They will ask for an estimated price? I will give you the contact details that you can call and we will give you the price. We have set prices for hip and knee surgery. For other procedures, we will need a letter stating the procedure you need so we can ask our surgeons to give us a procedure code to price it for you.

Once the application is submitted it can take 4-6 weeks to get approval. The full amount for surgery is paid a week before admission and refunds take around 3 weeks, it can take longer so just be aware of that.

Approval & Finance

Once you have submitted your application form and you have got approval you can then contact me on Roche, Glenda Thorne, or Janice Molloy to discuss the application process and what to do once you receive approval. Glenda Thorne is who you can contact for finance information and she can then pass your call on to me. I and Janice can help you and can direct you to Glenda for pricing.

What is included in the surgery price? The hospital stay in semi-private accommodation (it’s not a private room on its own), your first appointment, pre-assessment, and a cardio echo if required, surgeon and anesthetist fee, pre and post-op x-ray for joints, The surgery, two post-operative appointments, and your covid swab.

What is not included?

Any additional consultations with other specialists, so for example if you go to pre-assessment and they find you may have a cardiac issue or issues with your kidney or liver, etc. something that was unexpected and you now need clearance for surgery, you may have to go see a consultant here to give you clearance and you will have to pay that fee. You can do phone consultations which can cost between 60-100 euros and a face-to-face consultation would cost 250 euros. Another thing that would not be included would be any additional investigations not part of the normal pre-assessment appointment for example if you might need an MRI. A private room is not included it is semi-private if you do want a private room Glenda can give you a price for that. It is not guaranteed that we have a private room available.

Surgery

When you are deciding that you want to come to SSC for surgery, some of you may have already decided on a surgeon and some of you won’t. If you have a preference for a surgeon we can pass on your details to that office. At the moment appointments and surgery can be complete in 4-6 weeks. This can vary between surgeons. We do try and book all appointments as the same day as pre-assessment to avoid numerous journeys. Appointments can be made on receipt of approval.

Post-surgery 

The length of stay depends on the surgery you require. It is usually 2-3 nights for joint replacements. There are local hotels that SSC has corporate rates with if you have relatives who need to stay, we use the Carlton Hotel Dublin Airport. If convalescence or any is care required at home on discharge you are still entitled to this and it can be organised. You are also entitled to physiotherapy on discharge but if there are delays in starting you may need to start with some privately.

Another thing on discharge from the hospital is that the Cross Border does not pay for your medication t take home and the GP’s aren’t always able to write you a prescription when you go back so it has been suggested that you get your medication here and then when you go back home you have your prescription and you have all your medication with you. We recommend you don’t leave Dublin without your medication just in case you go home and you can get it from your GP. We will give you a form to visit a local pharmacy. If you have any problems afterward at home please contact the surgeon’s rooms or discharge nurse or wards if you are concerned re your wound or have any other issues. We will bring you back down to see us, don’t worry about contacting us.

Covid Restrictions

You are not to have one person accompany you for appointments. There are still no visitors at this time for inpatients. You require a PCR test 72-48 hours before surgery. You can have your PCR test in Northern Ireland (you don’t have to travel l down) as long as you have a copy of the results on the day of admission. A charge of 150 euros will be deducted from the overall cost.

Frequently asked questions

Do I need insurance?

You don’t need insurance, there is no insurance that can cover you. There is no travel insurance or medical insurance that will cover you coming down here to have your surgery.

What happens if there are complications?

If you have a complication that is not related to the surgery for example your heart or bowl problem, we can admit you into the local hospital here which is normally Beaumont Hospital or the Mater Hospital, they will look after you. EC1 card make sure you have applied for that and you have that as well, that will cover you here if you have any complications, it is very rare that these things happen, it only happens once or twice a year but if it does happen it is good that you are prepared.

If re-admission is within 30 days is there a charge?

There is no charge.

Where to find us?

We are very close to Dublin Airport as you can see on the map.

Hello everyone, I’m Gavin McHugh, Consultant Orthopaedic Surgeon based in the Sports Surgery Clinic in Dublin. Fiona has kindly asked me to say a few words about the cross border initiative based on my perspective of it, I suppose.

My area of expertise is hip and knee, and I mainly do a lot of hip replacementsknee replacementspartial knee replacements and soft tissue knee work, which is arthroscopies and cruciate knee ligaments (ACL Repair).

Within the clinic itself, we have a broad area of expertise that covers all the subspecialties such as the spine, upper limp, shoulder, elbow and hand, then obviously foot and ankle as well. Over the past few years I have been here, a really huge growth of my practice has come from the cross border directive, and I have dealt with a lot of happy customers from the north.

From my point of view, people are coming down a little bit sceptical of what exactly is involved, and I always say to people I have never really seen any catches in the whole process, it has actually been quite seamless, they have done a lot of work on the cross border initiative to make it as easy as possible for patients. From a principle point of view, lots of people have issues in regard to moving away slightly from the NHS. I completely understand that, but from my point of view, I have seen patients that are in a really bad way, and they are looking at waiting lists that are really long, potentially years-long and ultimately, you need to make a call that is right for yourself.  We have a similar process here that lots of patients end up going the other direction, and also, there are lots of waiting lists. That is when I say to patients there has to be a safety net there for people. The NHS is still responsible for your care. So if you’re on a waiting list for surgery and I perform your surgery, if there is a problem down the line, your consultant up north is still bound to look after you and the same works both way here’s. You won’t be left behind on. In terms of what you get,

the care you receive in the sports surgery clinic is state of the art, one of the best in the world, and I am happy to say that.

There are no real catches in the care. I say to everyone this is something we really fought for over the years. The price the clinic pays you is the price you pay for a job. If there are any problems and you may need to stay an additional few nights, there are no issues in regards to this. We want you to do well following your surgery. We want you going home safe and ultimately doing well.

In terms of what I do, the breakdown of the vast majority of patients that I see here is for hip or knee replacements. The time people have developed a lot of pain in the hip, it is time for a hip replacement, and there are various methods of doing so. Knee replacements have slightly more options, such as partial knee replacements rather than just full knee replacements. Quite often, patients tell me they have been told they needed a full knee replacement when often I have only needed to give them partial, which has its advantages such as maintaining the knee that they have half and the recovery process.

One other area where I have really developed an area of interest potentially is having both joints done at the same time, as in both hips together or both knees together. This can sound daunting to patients, but obviously, the huge advantage of this is getting everything over with one operation both operations and one recovery progress. It offers huge advantages to people that may be in a bad or painful way to get back on track again. Its not going to be something for everyone but pretty much every week Ill do one or two patients with both knees or both hips.

Back to do partial knee, it is obviously easier to get both knees done, it’s not an easy thing to go through, but it is a case of getting your life back again in one go. We try to get to combine your pre-assessment and consultation on the same day to make it straightforward for you. It is as seamless as we can make it. I am happy to see everyone and give my opinion. I often laugh when people say when doctors differ, patients suffer, which is not the case. It is important that I am happy to do it and see you beforehand. I look forward to seeing many more patients.

Click here to download the Republic of Ireland Reimbursement Scheme Application Form.

For assistance with completing this form please contact Fiona Roche: +353 1 526 2168 or Glenda Thorne on +353 1 5262071 or Email: info@sportssurgeryclinic.com

The scheme was supposed to finish on the 30th of June and then they extended it by 5 million. Once that is gone they then re-access, we will have to then see what they will do about funding. If you have an application form ready to go I would suggest you put it in as quickly as possible because we are not sure how long that 5 million is going to last.

We did chat with the national contact point about this, what we do suggest, is we normally give 4-5 days’ worth of medication but you do have to purchase that from a chemist on the way home from SSC, we don’t have a dispensing pharmacy here, we have a number of local chemists. We do give you a form to hand in to the chemist so they will know you are a cross-border patient and what to give you. If you need to go back and get another prescription from your GP, a lot of the GP’s cant see you for about a week so now they are suggesting you get your medication down here for longer before you go home, defiantly get the 5 days before you go. Some ones the medication down here inst available up the North and the GP may have to change that, that is okay and we are aware of that it doesn’t not be exactly the same sometimes. You can call me or Janice to discuss if needed.

You will be on crutches for 6 weeks following surgery and then you see the surgeon again, they may put you on one crutch and then gradually you come off that. You can discuss your return to work with your surgeon. Be prepared to be on crutches for 6 weeks after surgery.

If you have any questions at all regarding the Republic of Ireland Reimbursement Scheme, the application process, pricing or any query relating to a potential hospital stay, please do not hesitate to contact 00 353 1 5262117

For more information please email ROI@sportssurgeryclinic.com or call  00 353 1 5262117