CENTRAL EUROPEAN PRACTICE (CEP)
The Central European Practice (CEP) is an administrative medical practice. We support those living in EJSU areas who fall under the care of local healthcare providers and do not have direct access to a UK Medical Centre.
Welcome to the CEP…….
WO2 Pete Thomson
Deputy Practice Manager
Cpl Jamie Dickinson
Healthcare Coordinator Brunssum
Healthcare Coordinator Ramstein
Healthcare Coordinator Bavaria
CEP eConsult –
Contact the practice with
your admin or clinical query
CEP Attend anywhere –
We recommend that patients ensure that they are up to date with all routine vaccinations and any additional requirements for you assigned country appropriate to their age and any other medical conditions prior to arrival in post. Dependants are able to gain the necessary vaccinations at a Service Families Practice when registering as a temporary patient free of charge. Further information about this service can be found in DPHC Guidance Note 26/17 dated Aug 17 (please contact the CEP if unable to obtain a copy). If no Service Families Practice is nearby please arrange your vaccinations via your local Primary Health Care Provider and claim the costs back via the MOD (see prescription and medical costs section).
Once in post, Service Personnel will be informed by the CEP of any vaccinations required as per Military Medical Guidelines. Service Personnel must inform the CEP of any vaccinations they receive whilst in their host nation.
Parents should note that the childhood vaccination schedule for your host nation may differ to that of the UK, in some cases vaccinations may not be available in your host nation and vice versa. The MOD will pay for any top up vaccinations to the UK schedule but will not authorise or fund travel to the UK to have vaccinations done. Further information on vaccination schedules can be found via the European Centre for Disease Control at http://vaccine-schedule.ecdc.europa.eu/Pages/Scheduler.aspx
Once you have received a referral for physiotherapy from the Host nation GP, Healix should be informed and will provide you with a note of authorisation or link you to a provider with whom they have an invoicing relationship so that you can proceed with treatment.
Please ensure you have obtained an authorisation letter prior to commencing physiotherapy treatment so that you do not become liable for the bill.
Healix will undertake a clinical review of the indication for therapy and then sessions will be authorised. Typically, this will be reviewed after 5 sessions and a report from the treating therapist is required to authorise further sessions. The CEP will also be involved if there is any concern about a lack of progression or occupational implications for military personnel.
For military personnel, occupational health is a factor and commonly the CEP will offer a UK regional rehabilitation Unit referral and involve a GP to ensure the serviceperson is appropriately graded.
The CEP and Healix will ensure, where practical, your healthcare is safe, effective and relevant. Secondary Health Care will be benchmarked to NHS England standards and NICE guidelines. This may not be achievable in some overseas locations and when treating some conditions and Occupational Health circumstances dictate as such return to UK may be required. Healix will liaise with the military medical authority regarding an individual’s situation. The military medical authority is the Senior Medical Officer EJSU a senior military GP and if necessary, the chain of command will also be involved as it may require authorisation for any travel and subsistence costs.
Whilst patients will be routinely referred to a Secondary Health Care provider in country, they also retain the right to be referred to an NHS facility in the UK.
Travel – GHIC
All CEP patients should obtain an GHIC card to cover travel through Europe and during transit to and from the UK.
Application for the GHIC card can be made directly at https://services.nhsbsa.nhs.uk/cra/where-will-you-live or calling 0044 (0) 300 330 1350. The GHIC cards are free of charge, you can apply or renew a card via the official GHIC online application form. Beware of unofficial websites, which may charge if you apply through them. The card is not an alternative to travel insurance if you go on holiday or engage in certain activities (See Section 3.3). It will not cover any private medical healthcare or costs, such as mountain rescue in ski resorts, being flown back to the UK, or lost or stolen property. Therefore, it is important to have both an GHIC and a valid private travel insurance policy. Some insurers now insist that you hold an GHIC and may waive the insurance policy excess if you have one.
Parents of newborn children in country should contact the GHIC overseas healthcare team on 0044(0)191 218 1999 who will arrange for the child to be covered by GHIC.
You should use your BFPO address when applying or amending GHIC card details as this clarifies entitlement.
GHIC or existing EHIC card is only valid while in an EU country, GHIC is not valid in Turkey, Norway, Iceland, Liechtenstein and Switzerland. The GHIC may become valid in more countries in the future it is always good to check before travel.
Woman’s Health – Cervical Screening
Qualifying patients are encouraged to have Cervical Screening conducted in the UK prior to taking up post. When in host nation patients can choose to have a test done there and ensure that the result is passed to the CEP for inclusion in the patient NHS record.
COVID Immunisation CEP – Update Jan 22
*Your vaccination records* The details of any immunisation undertaken in the HN (including type, batch number and date of expiry) should be sent to your practice so we can update your NHS and Defence records.
Anyone who is eligible and wishes to start or complete a primary course of COVID vaccine may take up the host nation offer or contact the practice to establish the best option for your course.
Third primary doses
A very small number of people in the UK MoD population require a third primary dose of vaccine due to having a condition or taking medicines that affect the immune response. This third dose used an mRNA vaccine. If you are in this group you should note that you should be expecting to obtain a booster (4th dose) three months from your third dose.
All those over 16 who are more than 3 months from their primary course of COVID immunisation are eligible in UK terms for a booster dose of one of the mRNA vaccines (Moderna/Pfizer).
In addition the UK’s Joint Committee on Vaccination and Immunisation (JCVI) has advised that booster vaccinations should be offered to persons aged:
• 12 to 15 who are in a clinical risk group or who are a household contact of someone (of any age) who is immunosuppressed
• 12 to 15 years who are severely immunocompromised and who have had a third primary dose
All adults should now have been offered a COVID booster at a DPHC clinic, in the host nation or in the UK. Please email the practice if you experience any problems with access.
The UK advisors (JCVI) now advise (here) that those aged 12-17 may be offered two doses of the Pfizer BioNTech (Comirnaty) vaccine. Young people over 16 at greater risk of serious illness if they catch COVID-19 will need 2 doses of vaccine, 8 weeks apart and all other young people will be offered 2 doses of vaccine 12 weeks apart.
Many European healthcare systems have been offering two doses of Pfizer at a minimum of a 3 week interval since last Autumn and most children who wish to have taken up this offer already. This is the recommended route of immunisation if the offer is identical to the UK.
UK: Following extensive assessment of the risks and benefits of vaccinations for 5 to 11 year olds, including analysis of clinical trial results and real-world international data, the JCVI has updated its advice for this age group:
In the UK, children aged 5 to 11, who are in a clinical risk group or who are a household contact of someone (of any age) who is immunosuppressed, should be offered a primary course of vaccination. This is with 2 x 10-microgram doses of the Pfizer-BioNTech COVID-19 vaccine (a third of the adult dose), with an interval of 8 weeks between the first and second doses.
Further advice regarding COVID-19 vaccination for other 5 to 11 year olds will be issued in the UK in due course following consideration of additional data relevant to this age group, and on the Omicron variant more broadly.
Host Nation offers
In many other countries across the Europe and Turkey area there is already an offer to the parents of children in the 5-11 age group. The primary course of vaccination for all in this age-group is typically also with 1/3 of the adult dose of Pfizer vaccine, but with a shorter interval between the first and second doses in many places.
Like the UK, other nations found their decisions on child immunisation on extensive assessment of the risks and benefits. In Europe this is by the European Medicines Agency (EMA) and national health authorities. We have seen throughout the pandemic that aspects of the immunisation program and response to COVID differ.
Individual preferences; the host nation offer; and the residency and registration status of your child will all play a part in family decisions on whether to take up an offer in your country of residence.
MoD position: JSP 950, Leaflet 7-1-1 (linked on ModNet here): So long as the HN-provided vaccine is compliant with the EMA/FDA/MHRA conditions of authorisation an individual (or the person with parental responsibility) can accept the offer of a HN vaccine under the principles of informed consent (noting that children aged 16-17 are often competent to give their own consent).
In making your decisions, it is also worth highlighting that MoD staff have no authority to move ahead of the NHS program so the CEP cannot, for instance, offer immunisations in line with another nation’s program.
We understand that differing approaches to immunisation and certification between the UK and other nations creates challenges for those who live or travel between two regions (in particular children who are at school in the UK). This has broadly been resolved for over 12s since the UK decision to offer these children 2 doses.
Please email the practice if the inability to obtain immunisation for 5-11 year olds in the UK affects their ability to travel to you or attend school.
Certification – Children
Fully vaccinated 12 to 15 year olds are now able to access a NHS COVID Pass letter for travel including an internationally recognised 2D barcode. The COVID Pass letter is valid for 30 days and may take 7- 14 working days to be delivered. It can be ordered by calling 119 or 0300 311 22 33 or via the website NHS.UK.
Obtaining QR coded eCertification is often an advantage for those who elect for immunisation in the HN.
Certification – over 16
To download an NHS certificate of vaccination you may create an NHS online logon at https://www.coronavirus-record.service.nhs.uk .
The certificate may then be downloaded at https://covid-status.service.nhsx.nhs.uk/
· This is NOT the App
· Use a personal device with camera access.
· You will be asked to validate the account with a form of British ID
· If asked for a postcode, use the BFPO equivalent postcode BF1 2AG
· You will need to re-download a new code each 30 days.
Medical Claims and Invoices
If you attend a medical appointment and there is a cost included, where possible ask the provider for an invoice. This can then be sent electronically to UKStratCom-DMS-DPHC-EJSU-Fin@mod.gov.uk and the provider will be paid directly. There is no further action required by the SP / patient.
If the appointment has been arranged /approved through Healix and you receive an invoice please forward onto UKStratCom-DMS-DPHC-EJSU-Fin@mod.gov.uk for action.
If you pay for your medical treatment / prescription and need to reclaim costs via JPA, please complete a Fin07 located on this page, this needs to be signed by the SP (this can be electronic) and then send it with proof of payment direct to UKStratCom-DMS-DPHC-EJSU-Fin@mod.gov.uk – a JPA claim code and UIN will then be issued so a claim can be inputted onto JPA by the SP. The authorisation code is to be used in the justification box on JPA no further information is required.
All enquiries regarding medical finance should be sent to UKStratCom-DMS-DPHC-EJSU-Fin@mod.gov.uk