Fewer than 100 NHS patients a year on average receive state-funded treatment abroad despite a waiting list of seven million and rising, data released to <i>The National</i> shows. The possibility of using foreign hospitals to relieve the lengthening waiting lists appears closed off to the NHS, even though other European countries use similar tactics and thousands travel overseas <a href="https://www.thenationalnews.com/world/uk-news/2023/06/01/joint-venture-uk-private-hospitals-taking-more-operations-than-nhs-in-a-first/" target="_blank">for private procedures</a> each year. More than 11,400 people have been waiting for longer than 18 months for NHS treatment, with more than 520 waiting longer than two years. An investigation by <i>The National</i> showed that in the past five years a total of 445 planned procedures have been funded by the NHS for UK patients to be treated abroad. However, as waiting times continue to grow in the UK - currently standing at 7.4million - the NHS has been recouping millions of pounds from EU countries for treating their citizens. In the past five years, the NHS has recouped £20,321,303 from 25 EU countries for treating their citizens, indicating that thousands have been treated in the <a href="https://www.thenationalnews.com/health/2023/05/24/travel-kilometres-or-go-private-gps-compelled-to-offer-nhs-alternatives/" target="_blank">British system</a>. In contrast, the NHS has spent just £7.6 million on funding treatment abroad for UK citizens in the past five years, the majority of which was spent on applications from women to give birth abroad. Under the post-Brexit healthcare agreement, known as the S2 funding route, patients are allowed to undergo planned treatment, such as hip operations, and access maternity care in an EU country through its state healthcare system. EU residents are also entitled to apply for treatment on the NHS. Only UK patients whose wait for treatment on the NHS would count as an “undue delay” have been eligible for treatment abroad. High profile crowd-funding appeals to send patients overseas often highlight child patients. Medical leaders warned children’s waiting lists are growing at double the rate of adult lists. The latest figures show that since last April, the NHS has approved 115 people to have pre-planned procedures abroad. The top three countries where patients were sent were Poland (30), Italy (26) and Germany (15). There was a 64 per cent increase in patients being sent abroad compared to the same period the previous year, where only 70 people gained approval. Patients waiting for operations such as hip and knee replacements and general surgery such as gallbladder removals and hernia repairs continue to face the longest waits in the UK. Latest figures show 816,599 patients waiting for trauma and orthopaedics, 613,655 waiting for ear, nose and throat treatment, and 447,877 waiting for general surgery. Tim Mitchell, vice president and president-elect of the Royal College of Surgeons of England, said the long lists are affecting lives. “It is disappointing but not unexpected to see the NHS waiting list grow to yet another record high in July,” he said. “Despite the huge effort NHS staff are putting in to get patients seen quickly, the situation remains challenging. “The longer patients remain on waiting lists, the longer they aren’t able to get on with their lives. In the most serious cases, patients will be unable to work and will need support to carry out the day-to-day tasks that most of us take for granted. “In my own field of ENT, I see patients who have suffered hearing problems for months on end. This is particularly distressing when some of those patients are children whose development can be seriously impacted without timely treatment.” NHS England did not respond to requests from <i>The National</i> as to why the numbers being sent abroad were so low but directed patients to the S2 route. “NHS services have been under significant pressure but tackling the elective backlog is a top priority for the NHS and hardworking staff have virtually eliminated two year waits, and are making good progress on reducing 18 month waits while the number of those waiting more than a year has also gone down,” an NHS representative told <i>The National</i>. “Eligible patients can use S2 funding to access health care aboard, with information for patients, who are resident in England, and how to apply available on the NHS website, including details on how to complain about or appeal a decision.” Latest figures from the European Commission show that in 2021, a total of 320,500 people in the EU were allowed treatment abroad and the bloc paid out €260 million to various countries. Despite the low numbers of UK patients being funded for pre-planned surgery abroad, the NHS has spent more funding women to give birth abroad. Last year, 472 women gained such financial help, the majority to give birth in Poland (127), followed by Italy (63) and France (30). In the past five years, 4,652 women have been granted funding to give birth in other countries. Last year, the NHS paid £1,055,857 to nations for UK citizens to give birth or have procedures. In the past five years, it has paid out £7,651,371 for the treatment of 5,097 people. On Thursday, thousands of senior doctors in England began a 48-hour walkout to demand better pay and conditions, paralysing hospitals and leaving only emergency care covered. It has led to thousands more operations and appointments being cancelled and health officials say the impact of the latest round of strikes to hit the country's public health system is likely to be the biggest yet, because almost no work can be done at hospitals unless it is supervised by a senior doctor. Senior doctors will only be “on call” for urgent work such as critical cancer care until Saturday morning.