International travel

Travel immunisations that can be given as part of NHS provision include:

• Cholera
• Hepatitis A
• Poliomyelitis
• Smallpox
• Typhoid
• Paratyphoid

Combined Hepatitis A / Hepatitis B

Combined hepatitis A and B should not be routinely used for travel vaccinations because patients, who require the hepatitis B vaccine due to travel purposes e.g. adventure holiday, long stay in a high-risk area etc., should not receive hepatitis B vaccination on the NHS.

• If hepatitis B is required for purposes linked with travel, then hepatitis B should be given as a single vaccination on a private prescription.

Travel immunisations that cannot be given as an NHS service:

Following national guidance from NHS England, vaccines exclusively for the purposes of travel should not be initiated in primary care. Click here for more information. Prescribers in primary care should not initiate the below vaccines. Click the following link for a patient information leaflet to support deprescribing.

• Hepatitis B (single agent) any dose
• Japanese B encephalitis
• Meningitis vaccines
• Rabies
• Tick borne encephalitis
• Tuberculosis
• Yellow Fever

For all other indications, as outlined in Immunisation Against Infectious Disease – The Green Book – the vaccine remains free on the NHS. Therefore, if the immunisation is requested for travel the contractor may charge a patient for:

• Private prescription (an NHS prescription must not be used to provide these vaccines)
• Cost of vaccine
• Administration
• Serology testing, where required
• Certification of vaccination if required

No charge should be made to any NHS patient of the practice for providing advice.

For more information please see:

• NHS Website Overview Travel Vaccinations
• PrescQUIPP Bulletin 196: Travel vaccines (DROP-List)

Under NHS legislation, the NHS ceases to have responsibility for people when they leave the UK. However, to ensure good patient care the following guidance is offered:

• Currently people travelling within Europe should always be advised to carry the European Health Insurance Card (EHIC); giving entitlement to local health care arrangements until the UK leaves the European Union. After this time it is likely to change, see Healthcare when travelling abroad (NHS website) for more information.
• Medication required for a pre-existing condition should be provided in sufficient quantity to cover the journey and to allow the patient to obtain medical attention abroad. If the patient is returning within the timescale of a normal prescription (usually one and no more than three months) then this should be issued, providing it is clinically appropriate.
• A patient who is carrying controlled drugs abroad for less than three months, see Travelling with medicine containing a controlled drug (GOV.UK website), for their own personal use will not need a personal export or import licence. They should, though, carry a letter from the prescribing doctor with the following details:
  • Patient's name, address and date of birth.
  • The outward and return dates of travel.
  • The country the patient is visiting.
  • A list of the drugs the patient will be carrying, including dosages and total amounts.
• GPs should not routinely provide prescriptions for medication which is requested solely in anticipation of the onset of an ailment whilst outside the UK, but for which treatment is not required at the time of prescribing (e.g. travel sickness, diarrhoea). A private prescription may be provided for any prescription-only medicines, e.g. for traveller's diarrhoea or malaria prophylaxis:
  • Refer to Traveller's diarrhoea for further information
  • Refer to Malaria prophylaxis for prescribing information

The NHS accepts responsibility for supplying on-going medication required for pre-existing conditions for temporary periods abroad of up to 3 months. If a person is going to be abroad for more than three months, then all that the patient is entitled to at NHS expense is a sufficient supply of his/her regular medication to get to the destination and find an alternative supply of that medication. See information on the NHS website