Overseas surgery complications costing NHS up to £19,000 per patient

Complications from medical tourism is costing the NHS up to £19,000 per patient to treat, a new study has revealed.

The report, by academics at several Welsh universities, also highlighted examples of increased pressures on general practice as a result of overseas medical procedures.

The researches reviewed studies between 2012 and 2024 that focused on 655 patients treated by the NHS for postoperative complications. Of the 655 patients, 385 were treated following overseas metabolic/bariatric surgeries, 265 for cosmetic surgeries, and five for eye surgeries.

The most common procedures were sleeve gastrectomy, breast surgery enlargement, and ‘tummy tuck’ (abdominoplasty).

Related Article: New regulations to crack down on ‘cowboy’ cosmetic procedures

The report found evidence of costs to the NHS ranging from £1,058 to £19,549 per patient in 2024 prices from 14 of the studies, although the ‘certainty of evidence’ for these costs was ‘very low’.

A case study of patients at one GP practice in Northern Ireland found 47 patients (from a patient population of 11,372) over a seven-year period required follow-up in primary care after having bariatric surgery either outside Northern Ireland or privately. One patient had 28 general practice nurse (GPN) appointments and 15 GP encounters.

No patient deaths were reported in the included studies, but at least 196 patients (53%) experienced moderate to severe surgical complications. Most patients were women (90%), and the average age of patients included in studies was 38 – although the youngest known case was aged just 14.

However, the report’s authors noted that because data on the use, frequency, and consequences for the NHS was ‘incomplete and haphazard’, with some areas of the UK underrepresented in the existing literature, the reported impact on the NHS is likely to be greater.

The report comes after a Nursing in Practice survey last September found almost seven in 10 GPNs had seen patients suffering health problems linked to surgical or cosmetic procedures abroad in the last year.

Responding to the report, Professor Azeem Majeed, a GP and head of the Department of Primary Care and Public Health at Imperial College London, said medical tourism presented a risk to patients of missing out on ‘structured follow-up, continuity of care, and clear routes back to the operating team’ they would typically receive within the NHS.

He told our sister title Pulse: ‘These cases place additional pressure on general practice, both clinically and administratively. Patients typically require longer consultations, coordination with secondary care, and careful risk management, all within already stretched services. In addition, the NHS ends up absorbing the cost and workload of managing complications from procedures that were not planned or delivered within the UK healthcare system.

Related Article: Reports of unregulated procedures taking place in public toilets and hotel rooms

‘This highlights the need for better patient awareness of the risks involved in overseas medical treatment, clearer pathways for managing post-procedure complications, and recognition of the additional burden placed on NHS services — including general practice, emergency departments, and specialist teams.’

Sarah Townley, deputy medical director at the Medical Protection Society (MPS), said: ‘The risk of surgical tourism to patients and the cost to the NHS when secondary interventions are required – often due to packages not including post-operative care – are concerning. It is also important to recognise the difficulties clinicians face when they are asked to manage patients returning home with complications.’

Local medical committees have previously told GP practices they can decline patient requests for routine aftercare in the first two years after private bariatric surgery undertaken abroad.

Last month, nurses urged politicians to strengthen accountability, training standards and reporting mechanisms for non-surgical cosmetic procedures following rising reports of unsafe procedures being completed by unregulated professionals.

In August, the Department of Health and Social Care announced plans to crack down on unsafe cosmetic procedures in England, including that only qualified healthcare professionals such as nurses will be able to perform ‘high-risk’ cosmetic procedures, such as Brazilian Butt Lifts.

Related Article: Nurse prescribers must use in-person consults for non-surgical cosmetic meds from June

Since last June, nursing and midwifery prescribers have been required to consult people in person before issuing prescriptions for non-surgical cosmetic medicines, under new guidance from the nursing regulator. The change came as part of an updated position statement from the NMC on the prescribing of non-surgical cosmetic medicines, including some anti-wrinkle injections and other aesthetic emergency kit items.

A version of this article was first published by our sister title Pulse.