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Medical repatriation to the UK - road ambulance


Catalpa

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A friend who is currently in a French hospital will probably need to be taken back to the UK, perhaps later this week.

The insurance company are slow in reaching a funding decision for various reasons, none of which are relevant here. Regardless of whether the insurance company pay or if the person is self-funding, how does it work?

- Has anyone here been repatriated by ambulance?

- Did you arrange it direct with a company?

- Did you go straight home or did the ambulance deliver you to a hospital in the UK?

- If a hospital, how was this arranged? Via the GP or did the ambulance service deliver you to hospital?

The person concerned is on oxygen and needs monitoring on the 7-ish hour journey home so travelling in the back of a private car isn't a goer because of a) monitoring and b) the need for oxygen

I'm thinking the UK GP needs to be involved in advance as presumably s/he can either arrange a relevant hospital bed or at least provide prescriptions for oxygen to be available on arrival at home before an assessment the following day (say) by the GP.

I realise this isn't a very clear post but I'm trying to help someone who is being told by the French hospital that they must go back to the UK by ambulance and that they must go from FR hospital to UK hospital. If the need for oxygen is the 'only' factor here, admission to a UK hospital might not be necessary. And though the French hospital is assuming delivery direct to a hospital, that may be a cultural thing as that's the likely process which would be followed in France whereas the UK, admission to hospital for an ailment that can be managed at home isn't so likely.

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Catalpa, I wish I had current information on this sort of scenario.

From knowledge gathered way back, I think your friend might well find that GPs nowadays have to request, nay BEG, for a hospital bed for their patients.

Ever since the "bums on beds", "throughput" (whatever the euphemism) came into being, hospital beds are allocated on a basis of need and, if a GP requests a bed, they have to make a good case of why they need one.  That is to say, they have to describe their patient's condition and make it imperative that a bed is needed.  In your friend's case, I don't think a GP can argue for a bed until they see him or her.

You do not say whether your friend is UK or France resident.  That might well have a bearing on their transport to the UK.  If they have a UK GP already, they might stand a better chance of help.

Otherwise, if they have travel or any sort of medical insurance, they might be able to access that.

As you have said, your question is vague and I must admit that my answer is also vague.  If I knew more, I might be able to think of a likely scenario.  BTW, whilst I haven't been working in the NHS for some 30 years, I HAVE had experience of working within it, in various capacities, including in management, for some 20 odd years.

Give us more info, Catalpa, if it would not transgress privacy.

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Hi Mint, hope you are well and thank you for your response.

Definitely UK resident - no issue at all there, it's purely a holiday home here and they usually only stay for a week or two at most at a time.

They do have travel insurance but it is whether this specific problem will be covered.

If the insurance company covers the repatriation then they will have experience in everything I outlined above and no doubt sort everything out for the patient so effectively it will be easy peasy. However, if it has to be a self-funded and therefore self-arranged repatriation, I'd like to be able to give friend a bit of a guide as to what is possible and how it is best achieved.

It's a very specific situation and it may be that no one here has any experience or advice to give at all but any advice that is available is likely to be worthwhile as I do trust CF's contributors. [8-|]

Well... most of them. [;-)]

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Normally these things should be taken in hand by the Aide Sociale of the Hospital as far as contacting an ambulance is concerned. Obviously I can't comment on the financial side as I don't know enough.

In the case of transport home (within France) this is often arranged by the nurse in charge on the ward, but in a more complicated case such as this there is a Hospital Social worker who should be asked to help.

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Catalpa, I was going to add that if Daft Doctor sees your post, he is likely to have better and more recent knowledge than I am able to offer.

I mentioned the travel insurance because Cooperlola had in the past given a graphic example of a friend of hers who needed the sort of careful nursing that your friend needs on a repatriation exercise.

It might be that your friend can, at the first instance, establish with their insurance people what they are able to do for your friend.

Then I would suggest that a conversation via the telephone with the GP would help to establish what can be offered or done.

In the worst case scenario and your friend gets home but no further immediate medical intervention can be accessed, he or she can at least contact the social services where they live and I really do not think that social services can refuse to step in.  ESPECIALLY, if your friend presents as an emergency or at least a case of some seriousness need.

Don't know if any of that is of help, Catalpa.  But I hope with all my heart that something can be sorted for your friend.

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I'd say present herself to A&E rather than social services if the person has a medical problem and needs treatment, rather than social services. They only have a duty of care if the person is medically stable but unable to manage basic daily living activities..and I mean basic in terms of not being able to wash, get on and off the toilet and feed themselves.
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[quote user="Catalpa"]They do have travel insurance but it is whether this specific problem will be covered.

[/quote]

When I was repatriated home - and it was to my own front door, the final part by UK ambulance - the Travel Insurance co decided a small aircraft was the answer. Seeing as I had broken my leg in 4 places, had been operated on and plastered in St Malo hospital, it was they who decided that I would be more safely (and quickly) returned home by air. They refused outright to let me go by car as they said it would be too long and too complicated.

So I had my own nurse (lovely chap called Mark) who accompanied me from my hospital bed via ambulance to Dinard airport, on the small 2 engined plane to a small Lincolnshire airport, ambulance home and right into my sitting room.

He filled in all the necessary forms and my GP called the next day. From then I was monitored by Lincoln County Hospital.

My insurance was just standard Euro Tunnel cover, nothing special and they paid for everything, even my electric blue crutches. I believe there was a tiny excess but cannot remember how much.

It would not surprise me if your friend's insurance company make the same decision in the circumstances.

Edit : My OH accompanied me all the way home, ambulance, aircraft, ambulance. The Insurance also paid for him to stay in a hotel in St Malo whilst I was in Hospital as, technically, our holiday had ended and so had our travel cover.

Sue

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Hi Catalpa,

Most travel insurance policies includes repatriation so that should be your friends first port of call. If so the insurance company will task a British medical repatriation company to deal with and they will decide if repatriation by road or air ambulance is more appropriate and liaise directly with the hospital concerned. Usually the process involves the repatriation company sending out a doctor and or nurse to accompany the patient home or to a suitable hospital in the UK.

As you can imagine this happens on a daily basis with tens of thousands of Brits abroad at any one time, so the insurance companies are totally geared up to handling this type of situation.

Last but not least, very important the insurance company is notified and brought in as soon as possible to avoid invalidating the policy through failure to notify adequately in advance and no arrangements should be made without the agreement of the insurance company, if you want them to pay the bills!

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12 years ago after a road traffic accident in France, where I cracked a number of ribs, I spent 7 days in a hospital in France. We were covered by a basic travel insurance policy. The Doctors at the hospital (down in the South of France) considered it unwise to travel home to UK by road and so the insurance company arranged for a nurse to come over and return with us from Bordeaux. We waited a couple of days at an hotel near Bordeaux airport while the nurse was arranged. We were then taken first class BA flight to Gatwick, put up in a transit hotel overnight and transferred to Manchester airport the following morning. A people carrier awaited us there and the nurse accompanied us to our front door which was about an hour away from Manchester airport. An excellent service.
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Thank you to everyone who tried to respond to my very fuzzy questions! [:D]

The situation appears to have been resolved - the insurance company have instructed a repatriation ambulance service and they have plans in place for arrival back in the UK for assessment, etc.

Sorry I couldn't have been more clear - I was trying to inform myself so as to best help our friend if the insurance company continued to delay a decision - but it wasn't correct for me to go into more detail.

But all is arranged and should now go well.

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