UK Department of Health and Social Care – Letter to Stakeholders.


The following letter has been forwarded by the British Embassy in Lisbon for dissemination.

“Dear Stakeholder/Partner

We are writing to you on behalf of the Department of Health and Social Care. The Department is currently developing a project across several countries in the EU to request that they require continued health cover under the UK’s Reciprocal Healthcare arrangements.

The UK currently funds state healthcare costs for certain eligible groups resident in the EEA and Switzerland through the S1 scheme. Those eligible for the scheme include UK state pensioners, people receiving another qualifying exportable UK benefit, certain UK workers and their family members.

Around 480,000 UK state pensioners live in the EEA/Switzerland. There are 174,000 S1 holders whose healthcare cost the UK £536.8 million in 2021. Currently, there is no requirement for S1 holders in receipt of a UK state pension to verify that they remain eligible and still need their S1 form. This creates a risk that the UK overpays average cost countries for the S1 scheme, so we are expecting significant financial savings without any reduction in services.

Therefore, we are currently exploring a policy to introduce a process where S1 holders are required to confirm every two years that:

  • they still require an S1,
  • are still eligible,
  • and the UK is still the competent state.

We are developing the process to make it as easy as possible for customers to respond. They will have the option to email, call or to use a new online portal that is currently being developed. Furthermore, we are working on much more robust data-sharing processes with other UK Government departments as well as foreign authorities to ensure the need to communicate with the minimum number of customers necessary.

Furthermore, we are fully aware that many customers are in potentially vulnerable situations e.g. the socially isolated, those with mental health conditions and others who may be in care homes. We appreciate that they may find this new process difficult to understand or respond to, so we are working closely with our partners: the British Consular Network in Portugal; the Portuguese authorities and organisation such as yours to ensure those who are in positions of risk will experience the minimal inconvenience should they fail to respond to our communication with them. In the unlikely event there is disruption to their health cover, there is a process in place to reinstate it from the date of cancellation directly with the Portuguese authorities and without the customer having to intervene or take any action whatsoever.

How can you help?

We have identified that one of the main reasons we overpay Member States is because customers sometimes fail to update their contact details with us e.g. if they move back to the UK or move within Portugal itself. Therefore, given that your organisation has a wide reach within Portugal itself, we would be extremely grateful if you could send the following form out to your members asking them to update their contact details with us via the method most convenient for them.

Furthermore, we would also be more than happy to answer any questions or concerns you may have, either by email or via an online face-to-face meeting. Please feel free to reply to us via this email and we will get back in touch with you as soon as possible.

Kind regards

DHSC Cross Border Healthcare Operations Team



If you are an S1 holder living in Portugal, it is important you ensure that the personal information the NHS Business Service Authority (NHSBSA) hold about you is correct and up to date. The NHSBSA is the organisation that manages your continued right to healthcare in Portugal, funded by the UK

You therefore need to confirm your contact details so NHSBSA can check you are entitled to the health cover you receive. Without this confirmation, NHSBSA will not be able to check your details and you may lose your S1 entitlement.

Please contact NHSBSA on within the next 14 days and provide your Name and DOB. Please also include your:

  • email address
  • postal address
  • contact phone number

If it is more convenient, you may also contact us via our contact centre number on +44 191 218 1999.