{
 "schema": 1,
 "id": "united-kingdom",
 "type": "destination",
 "names": {
  "name": "United Kingdom",
  "aliases": [
   "UK",
   "Britain",
   "Great Britain and Northern Ireland"
  ],
  "said": "In the trade the UK is a source market first: the country the packages in Istanbul, Kraków and Budapest are priced in sterling for. Inbound, it is Harley Street and a private wing inside an NHS hospital."
 },
 "region": [
  "europe-west"
 ],
 "facets": {
  "iso2": "GB",
  "direction": "both",
  "currency": "GBP",
  "languages": [
   "English"
  ],
  "draws": [
   "proton-therapy",
   "executive-health-screening",
   "cabg",
   "bone-marrow-transplant"
  ]
 },
 "text": {
  "what": "A net exporter of patients with a small, profitable import trade. British patients travel for dentistry, hair restoration, cosmetic and bariatric surgery and fertility treatment; foreign patients arrive for complex care in London teaching hospitals and private clinics, some of them paid for by their own governments. The queue is the engine on the outbound side, and it is measured monthly.",
  "story": "The queue first. NHS England's statistical press notice of 10 September 2026 put 7.3 million RTT pathways waiting to start treatment at the end of July 2026, an estimated 6.2 million unique patients, since some people wait on more than one pathway. In 111,379 cases the patient had waited more than 52 weeks and in 235 more than 104. In 65.4% of cases the wait was within 18 weeks, against a standard of 92%; the median wait was 12.0 weeks. That figure is published every month, and it is the single most reliable driver of outbound travel anywhere in this directory.\n\nThe travel itself has been counted once properly. Hanefeld and colleagues, using the UK International Passenger Survey alongside interviews and Freedom of Information returns from NHS foundation trusts, estimated that 63,000 UK residents travelled abroad for treatment in 2010 while around 52,000 patients came to the UK — and that inbound private patients treated in NHS facilities produced close to a quarter of the revenue from 7% of the volume in the data examined. The direction of that balance is the finding: the country that talks about being visited is a country that leaves.\n\n*Trade practice —* the inbound side splits three ways: private hospitals and clinics in London, private patient units inside NHS trusts, and patients whose bills are paid by a foreign government's health office, which is the arrangement Gulf states have long used for citizens referred abroad. No published count of state-sponsored arrivals was read for this record, and none is asserted here.\n\nWhat returns with the outbound patient is documented from the other end. Published UK surgical series describe revision work, infection and reconstruction after cosmetic surgery performed abroad landing on NHS units that were not paid for the original operation — a cost the price comparison never carried.",
  "how": "An outbound patient books directly or through a facilitator, pays a deposit, and is quoted in sterling by a clinic abroad against a comparison column the clinic wrote. NHS entitlement does not follow them: aftercare is a new referral at home, and a complication is an emergency presentation. Inbound, an overseas patient either pays a private provider or is billed by an NHS trust's private patient unit at the trust's own tariff, sometimes under an agreement with a foreign government's health office.",
  "today": "As of the July 2026 data, published 10 September 2026, 7.3 million pathways are waiting and the median wait is 12.0 weeks. The most recent national count of how many British patients that sends abroad remains the 2010 estimate; nothing newer with a stated method was read for this record."
 },
 "geo": {
  "lat": 51.5072,
  "lon": -0.1276,
  "precision": "country",
  "source": "s:natural-earth"
 },
 "metrics": {
  "wait_days_home": 84,
  "note": "The median RTT wait at the end of July 2026 was 12.0 weeks, which is the 84 days carried here; 7.3 million pathways were waiting, an estimated 6.2 million unique patients, with 111,379 waiting over 52 weeks and 65.4% within 18 weeks against a 92% standard. Figures include NHS England's estimates for three trusts and one independent provider that did not submit.",
  "as_of": "2026-07",
  "source": "s:nhs-rtt-july-2026",
  "url": "https://www.england.nhs.uk/statistics/statistical-work-areas/rtt-waiting-times/"
 },
 "kin": [
  {
   "to": "turkiye",
   "as": "Where most British outbound hair, dental and bariatric traffic goes, priced in sterling.",
   "rel": "contrast"
  },
  {
   "to": "poland",
   "as": "The dental corridor whose price list carries a column labelled average UK price.",
   "rel": "contrast"
  },
  {
   "to": "hungary",
   "as": "The older dental destination for the same patients.",
   "rel": "contrast"
  },
  {
   "to": "spain",
   "as": "Where 9% of its foreign-resident fertility cycles were run in 2022.",
   "rel": "contrast"
  },
  {
   "to": "ireland",
   "as": "The other mostly outbound country in this region, with a different queue and a different scheme.",
   "rel": "contrast"
  },
  {
   "to": "uk-nhs-treatment-abroad",
   "as": "What the NHS will and will not fund when a patient goes.",
   "rel": "governed-by"
  },
  {
   "to": "hfea",
   "as": "The regulator that licenses every UK fertility clinic and publishes each one's results — the comparison a patient abroad loses.",
   "rel": "accredited-by"
  },
  {
   "to": "revision-at-home",
   "as": "The operation the NHS performs and did not price.",
   "rel": "risk"
  },
  {
   "to": "oecd-waiting-times",
   "as": "The series that puts this queue beside other countries'.",
   "rel": "measured-by"
  },
  {
   "to": "is-it-cheaper",
   "as": "The question a 12-week median wait answers differently for each patient.",
   "rel": "story"
  }
 ],
 "links": [
  {
   "label": "NHS England — referral to treatment waiting times",
   "url": "https://www.england.nhs.uk/statistics/statistical-work-areas/rtt-waiting-times/"
  },
  {
   "label": "Medical Tourism: A Cost or Benefit to the NHS? (PLOS ONE, 2013)",
   "url": "https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0070406"
  }
 ],
 "sources": [
  "s:nhs-rtt-july-2026",
  "s:hanefeld-2013-nhs",
  "s:whiteman-nhs-burden-2025",
  "s:ahari-breast-unit-2024",
  "s:nhs-cosmetic-surgery-abroad",
  "s:sef-registro-2022",
  "s:natural-earth"
 ],
 "provenance": {
  "default": {
   "tier": "cited"
  },
  "fields": {
   "text.story": {
    "tier": "cited",
    "source": "s:nhs-rtt-july-2026",
    "note": "waiting figures and the 2010 estimate are read off their own publications; the paragraph on state-sponsored arrivals is marked trade practice and carries no number"
   },
   "text.how": {
    "tier": "tradition",
    "note": "how the two sides work in practice; the entitlement point is general and is not advice"
   },
   "metrics": {
    "tier": "cited",
    "source": "s:nhs-rtt-july-2026"
   },
   "geo": {
    "tier": "harvested",
    "source": "s:natural-earth"
   }
  }
 },
 "x_commons_files": [
  "File:Harley Street London.jpg"
 ],
 "needs_verification": false,
 "confidence": "high",
 "updated": "2026-09-16",
 "blurb": "A net exporter of patients with a small, profitable import trade.",
 "region_terms": [
  {
   "key": "europe-west",
   "name": "Western Europe",
   "note": "Germany, France, Belgium, the Netherlands, Ireland, the UK, Switzerland, Austria"
  }
 ],
 "kin_out": [
  {
   "to": "turkiye",
   "type": "destination",
   "name": "Türkiye",
   "as": "Where most British outbound hair, dental and bariatric traffic goes, priced in sterling.",
   "rel": "contrast"
  },
  {
   "to": "poland",
   "type": "destination",
   "name": "Poland",
   "as": "The dental corridor whose price list carries a column labelled average UK price.",
   "rel": "contrast"
  },
  {
   "to": "hungary",
   "type": "destination",
   "name": "Hungary",
   "as": "The older dental destination for the same patients.",
   "rel": "contrast"
  },
  {
   "to": "spain",
   "type": "destination",
   "name": "Spain",
   "as": "Where 9% of its foreign-resident fertility cycles were run in 2022.",
   "rel": "contrast"
  },
  {
   "to": "ireland",
   "type": "destination",
   "name": "Ireland",
   "as": "The other mostly outbound country in this region, with a different queue and a different scheme.",
   "rel": "contrast"
  },
  {
   "to": "uk-nhs-treatment-abroad",
   "type": "rule",
   "name": "NHS funding for treatment abroad",
   "as": "What the NHS will and will not fund when a patient goes.",
   "rel": "governed-by"
  },
  {
   "to": "hfea",
   "type": "org",
   "name": "Human Fertilisation and Embryology Authority",
   "as": "The regulator that licenses every UK fertility clinic and publishes each one's results — the comparison a patient abroad loses.",
   "rel": "accredited-by"
  },
  {
   "to": "revision-at-home",
   "type": "risk",
   "name": "Revision at home",
   "as": "The operation the NHS performs and did not price.",
   "rel": "risk"
  },
  {
   "to": "oecd-waiting-times",
   "type": "dataset",
   "name": "OECD waiting times for elective surgery",
   "as": "The series that puts this queue beside other countries'.",
   "rel": "measured-by"
  },
  {
   "to": "is-it-cheaper",
   "type": "story",
   "name": "Is it cheaper",
   "as": "The question a 12-week median wait answers differently for each patient.",
   "rel": "story"
  }
 ],
 "source_list": [
  {
   "id": "s:nhs-rtt-july-2026",
   "kind": "gov",
   "title": "Statistical Press Notice — NHS referral to treatment (RTT) waiting times data, July 2026",
   "publisher": "NHS England",
   "url": "https://www.england.nhs.uk/statistics/wp-content/uploads/sites/2/2026/09/Jul26-RTT-statistical-press-notice-PDF-578K-97ylx5.pdf",
   "accessed": "2026-09-16",
   "note": "published Thursday 10 September 2026. 7.3 million RTT pathways waiting to start treatment at the end of July 2026, an estimated 6.2 million unique patients; 111,379 waiting over 52 weeks, 9,095 over 65 weeks, 235 over 104 weeks; 65.4% waiting up to 18 weeks against a 92% standard; median wait 12.0 weeks. Figures include estimates for three trusts and one independent provider that did not submit."
  },
  {
   "id": "s:hanefeld-2013-nhs",
   "kind": "paper",
   "title": "Medical Tourism: A Cost or Benefit to the NHS?",
   "publisher": "PLOS ONE 2013;8(10):e70406 (Hanefeld J, Horsfall D, Lunt N, Smith R), London School of Hygiene and Tropical Medicine and University of York",
   "url": "https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0070406",
   "accessed": "2026-09-16",
   "note": "mixed methods: UK International Passenger Survey, 77 returning patients, 63 policymakers and industry interviews, 28 Freedom of Information requests to NHS foundation trusts. An estimated 63,000 UK residents travelled abroad for treatment in 2010 against around 52,000 patients treated in the UK; inbound private patients in NHS facilities yielded close to a quarter of revenue from 7% of volume in the data examined."
  },
  {
   "id": "s:whiteman-nhs-burden-2025",
   "kind": "paper",
   "title": "The rising NHS burden from cosmetic surgery procedures performed abroad and non-surgical procedures performed in the United Kingdom",
   "publisher": "Journal of Plastic, Reconstructive and Aesthetic Surgery 2025;102:39-41 (Whiteman E, Romain K, Welman T, et al.)",
   "url": "https://pubmed.ncbi.nlm.nih.gov/39892185/",
   "accessed": "2026-09-16"
  },
  {
   "id": "s:ahari-breast-unit-2024",
   "kind": "paper",
   "title": "The impact of cosmetic tourism across one year on an NHS breast surgery unit",
   "publisher": "Journal of Plastic, Reconstructive and Aesthetic Surgery 2024;99:462-467 (Ahari D, Zaccariah ZR, Preston M, Highton L), Wythenshawe Hospital",
   "url": "https://pubmed.ncbi.nlm.nih.gov/39476527/",
   "accessed": "2026-09-16"
  },
  {
   "id": "s:nhs-cosmetic-surgery-abroad",
   "kind": "org",
   "title": "Cosmetic surgery abroad",
   "publisher": "NHS (England)",
   "url": "https://www.nhs.uk/tests-and-treatments/cosmetic-procedures/advice/cosmetic-surgery-abroad/",
   "accessed": "2026-09-16",
   "note": "read for aftercare responsibility, flying intervals and the statement on travel insurance"
  },
  {
   "id": "s:sef-registro-2022",
   "kind": "dataset",
   "title": "Registro Nacional de Actividad 2022 — Registro SEF, Técnicas de Reproducción Asistida (FIV/ICSI and IA)",
   "publisher": "Sociedad Española de Fertilidad for the Spanish Ministry of Health; the official national ART registry",
   "url": "https://www.registrosef.com/public/docs/sef2022_IAFIV.pdf",
   "accessed": "2026-09-16",
   "note": "section 3.20: 27,564 fresh and frozen cycles in 2022 were for patients resident in other countries — France 39.0%, Italy 20.6%, the United Kingdom 9.0%, Germany 6.4%, Morocco 0.6%, Portugal 0.3%, other 18.3%, country not recorded 5.7%. Of those cycles 52.3% used donated eggs. The reason for coming was not recorded in 90.8% of them; where it was, 1.6% named a technique unlawful at home and 1.1% a patient who did not meet the legal conditions at home."
  },
  {
   "id": "s:natural-earth",
   "kind": "dataset",
   "title": "Natural Earth — Admin 0 Countries, 1:110m",
   "publisher": "Natural Earth",
   "url": "https://www.naturalearthdata.com/",
   "license": "Public domain",
   "accessed": "2026-09-16"
  }
 ],
 "tiers": {
  "text.what": {
   "tier": "cited"
  },
  "text.story": {
   "tier": "cited",
   "source": "s:nhs-rtt-july-2026",
   "note": "waiting figures and the 2010 estimate are read off their own publications; the paragraph on state-sponsored arrivals is marked trade practice and carries no number"
  },
  "text.how": {
   "tier": "tradition",
   "note": "how the two sides work in practice; the entitlement point is general and is not advice"
  },
  "text.today": {
   "tier": "cited"
  },
  "geo": {
   "tier": "harvested",
   "source": "s:natural-earth"
  },
  "metrics": {
   "tier": "cited",
   "source": "s:nhs-rtt-july-2026"
  }
 },
 "primary_image": null,
 "tag_facts": [],
 "recognition_facts": [],
 "acclaim": 0,
 "kin_in": [
  {
   "from": "ireland",
   "type": "destination",
   "name": "Ireland",
   "as": "The other mostly outbound country in this region, with a monthly queue of its own and a land border in common.",
   "rel": "contrast"
  },
  {
   "from": "nigeria",
   "type": "destination",
   "name": "Nigeria",
   "as": "The other long-standing destination for Nigerians who can pay, and one that counts them as private patients rather than as travellers.",
   "rel": "destination"
  },
  {
   "from": "poland",
   "type": "destination",
   "name": "Poland",
   "as": "The source market its sterling price column is written for.",
   "rel": "contrast"
  },
  {
   "from": "spain",
   "type": "destination",
   "name": "Spain",
   "as": "9% of the cycles it ran for foreign residents in 2022.",
   "rel": "contrast"
  },
  {
   "from": "turkiye",
   "type": "destination",
   "name": "Türkiye",
   "as": "One of the source markets its packages are priced for, in sterling.",
   "rel": "contrast"
  },
  {
   "from": "abortion-care",
   "type": "procedure",
   "name": "Abortion",
   "as": "Where a provider publishes one price list in two currencies, sterling and euro.",
   "rel": "destination"
  },
  {
   "from": "acl-reconstruction",
   "type": "procedure",
   "name": "Anterior cruciate ligament reconstruction",
   "as": "Where the £7,399 self-pay price on this page is sold, physiotherapy inside it.",
   "rel": "destination"
  },
  {
   "from": "addiction-rehab",
   "type": "procedure",
   "name": "Residential addiction treatment",
   "as": "The source market whose own tariff is the comparison being made.",
   "rel": "destination"
  },
  {
   "from": "dental-crown",
   "type": "procedure",
   "name": "Dental crown",
   "as": "The source market whose band 3 charge of £332.10 is the number these lists are written against.",
   "rel": "destination"
  },
  {
   "from": "full-mouth-restoration",
   "type": "procedure",
   "name": "Full mouth restoration",
   "as": "The source market where one band 3 charge covers a course however many teeth it holds.",
   "rel": "destination"
  },
  {
   "from": "gallbladder-removal",
   "type": "procedure",
   "name": "Gallbladder removal",
   "as": "The source market whose queue makes a foreign price legible.",
   "rel": "destination"
  },
  {
   "from": "hair-transplant-fue",
   "type": "procedure",
   "name": "Follicular unit extraction",
   "as": "A source market whose own clinics publish what they quote, and what their competitors quote.",
   "rel": "destination"
  },
  {
   "from": "hernia-repair",
   "type": "procedure",
   "name": "Hernia repair",
   "as": "The source market whose waiting list makes a foreign price worth reading.",
   "rel": "destination"
  },
  {
   "from": "hip-replacement",
   "type": "procedure",
   "name": "Total hip replacement",
   "as": "Where the self-pay price on this page is sold, and the queue most of its buyers are leaving.",
   "rel": "destination"
  },
  {
   "from": "hysterectomy",
   "type": "procedure",
   "name": "Hysterectomy",
   "as": "The source market whose waiting list is the reason to read a foreign price at all.",
   "rel": "destination"
  },
  {
   "from": "icl",
   "type": "procedure",
   "name": "Implantable collamer lens",
   "as": "Where the implant is priced per eye against the same provider's laser ladder.",
   "rel": "destination"
  },
  {
   "from": "knee-arthroscopy",
   "type": "procedure",
   "name": "Knee arthroscopy",
   "as": "Where the £5,899 self-pay price on this page is sold.",
   "rel": "destination"
  },
  {
   "from": "lasik",
   "type": "procedure",
   "name": "LASIK",
   "as": "Where the four techniques are priced as a ladder, per eye, aftercare included.",
   "rel": "destination"
  },
  {
   "from": "prostatectomy",
   "type": "procedure",
   "name": "Prostatectomy",
   "as": "The source market whose queue makes a foreign price legible.",
   "rel": "destination"
  },
  {
   "from": "proton-therapy",
   "type": "procedure",
   "name": "Proton beam therapy",
   "as": "Ran a state programme that flew its own patients abroad for eleven years before its centres opened.",
   "rel": "destination"
  },
  {
   "from": "root-canal",
   "type": "procedure",
   "name": "Root canal treatment",
   "as": "The source market whose band 2 charge of £76.60 sits under all of these.",
   "rel": "destination"
  },
  {
   "from": "shoulder-replacement",
   "type": "procedure",
   "name": "Total shoulder replacement",
   "as": "Where the self-pay price on this page is sold.",
   "rel": "destination"
  },
  {
   "from": "sperm-donation",
   "type": "procedure",
   "name": "Sperm donation",
   "as": "The jurisdiction whose capped payment and identity release this record reads off the regulator's own pages.",
   "rel": "place"
  },
  {
   "from": "spinal-fusion",
   "type": "procedure",
   "name": "Spinal fusion",
   "as": "Where the £14,400 cervical fusion on this page is sold, with no inclusion list beside it.",
   "rel": "destination"
  },
  {
   "from": "top-surgery",
   "type": "procedure",
   "name": "Top surgery",
   "as": "Where a private list publishes guide prices and a queue sends people to look at them.",
   "rel": "destination"
  },
  {
   "from": "vaginoplasty",
   "type": "procedure",
   "name": "Vaginoplasty",
   "as": "Where a private list quotes guide prices roughly three times the Bangkok table, and states it cannot quote at all before a consultation.",
   "rel": "destination"
  },
  {
   "from": "revision-at-home",
   "type": "risk",
   "name": "Revision at home",
   "as": "The system that published its own ledgers, which is why this record has numbers at all.",
   "rel": "place"
  },
  {
   "from": "abortion-travel-law",
   "type": "rule",
   "name": "Travelling for a termination",
   "as": "A destination whose statute contains no residence bar.",
   "rel": "destination"
  },
  {
   "from": "donor-anonymity-law",
   "type": "rule",
   "name": "Donor anonymity",
   "as": "The source market that ended anonymity in 2005.",
   "rel": "destination"
  },
  {
   "from": "uk-nhs-treatment-abroad",
   "type": "rule",
   "name": "NHS funding for treatment abroad",
   "as": "The country whose system this is, and one of the largest source markets in Europe.",
   "rel": "destination"
  },
  {
   "from": "hfea",
   "type": "org",
   "name": "Human Fertilisation and Embryology Authority",
   "as": "The jurisdiction it licenses, clinic by clinic, and the border its register stops at.",
   "rel": "place"
  },
  {
   "from": "keith-pollard",
   "type": "person",
   "name": "Keith Pollard",
   "as": "Where the publishing business was registered, and where its sites sold private treatment at home as well as abroad.",
   "rel": "destination"
  },
  {
   "from": "ndm-1-2010",
   "type": "event",
   "name": "NDM-1, 2010",
   "as": "Where the 37 UK isolates were found, and where the travel histories were taken.",
   "rel": "destination"
  },
  {
   "from": "hfea-results",
   "type": "dataset",
   "name": "HFEA fertility treatment results",
   "as": "The jurisdiction the register covers, clinic by clinic.",
   "rel": "destination"
  },
  {
   "from": "oecd-waiting-times",
   "type": "dataset",
   "name": "OECD waiting times for elective surgery",
   "as": "Reports only the census measure, 185 days median for a knee in 2024, so it compares with nobody who reports the other.",
   "rel": "measures"
  },
  {
   "from": "is-it-cheaper",
   "type": "story",
   "name": "Is it cheaper",
   "as": "Where the self-pay list price on this page is published.",
   "rel": "place"
  },
  {
   "from": "the-follow-up-nobody-books",
   "type": "story",
   "name": "The follow-up nobody books",
   "as": "The system that published its own ledgers, which is the only reason this page has numbers.",
   "rel": "destination"
  },
  {
   "from": "waiting-lists",
   "type": "story",
   "name": "The queue is the product",
   "as": "Publishes its queue monthly, which is why it is the one this piece reads first.",
   "rel": "destination"
  }
 ]
}