A growing number of UK patients who travel overseas for elective surgery are returning home with serious postoperative complications that require treatment by the National Health Service (NHS), according to a new review published in BMJ Open. The findings highlight significant risks for patients and unresolved pressures on NHS hospital services.

The study examined complications linked to outward medical tourism—UK residents travelling abroad for non-urgent procedures such as cosmetic and weight-loss surgery—and assessed the resulting impact on NHS care once patients return to the UK.

Rise in Overseas Elective Surgery

Outward medical tourism has increased steadily over the past two decades, driven by shorter waiting times, lower costs, low-cost air travel, and aggressive online marketing by overseas clinics. While some patients may benefit financially or logistically, researchers warn that many underestimate the medical risks and the challenges of post-surgical follow-up.

For the NHS, these journeys often lead to complex clinical situations when patients return with infections, wound breakdown, sepsis, or organ failure—sometimes without adequate documentation of the original procedure.

What the Review Found

Researchers conducted a rapid review of UK-based evidence published between 2007 and 2025, analyzing case reports, case series, surveys, conference abstracts, and grey literature. The review identified 37 studies covering 655 UK patients who required NHS care after developing complications from elective surgery performed abroad.

Key findings include:

Bariatric and cosmetic surgery accounted for nearly all reported cases

Bariatric/metabolic surgery: 385 patients

Cosmetic surgery: 265 patients

Ophthalmic surgery: 5 patients

Approximately 90% of patients were women, with an average age of 38 years

Turkey was the most common destination, linked to over 60% of reported cases

At least 53% of patients experienced severe complications, often requiring surgery, prolonged hospital stays, or intensive treatment

Average hospital stays were:

17 days for bariatric surgery complications

6 days for cosmetic surgery complications

Reported NHS treatment costs ranged from £1,058 to £19,549 per patient (adjusted to 2024 prices)

No studies identified any financial or system-level benefits to the NHS from outward medical tourism.

Serious Burden on NHS Services

The review found that complications from overseas surgery frequently require specialist secondary and tertiary NHS care, placing additional strain on already stretched hospital services. Managing these patients can be particularly challenging when surgical details, implant information, or postoperative plans are missing or unclear.

Long hospital stays and the need for further surgery were the primary drivers of cost, though researchers caution that actual expenses are likely underestimated due to incomplete reporting.

Gaps in Evidence and Policy

While the review provides valuable insight, the authors note significant limitations in the evidence base. Most studies relied on retrospective case reports or small case series, many focused only on emergency admissions, and national-level data were lacking. As a result, the true scale and long-term impact of outward medical tourism on the NHS remain uncertain.

Key evidence gaps include:

The impact on primary care and long-term follow-up

Population-level estimates of NHS burden

Standardized reporting of complications and costs

Call for Better Information and NHS Planning

The authors conclude that clearer NHS policies are needed on postoperative responsibility for complications arising from surgery abroad. They also emphasize the importance of better public information to help patients understand the risks associated with overseas elective procedures.

Improved data collection and reporting, they argue, would support more informed patient decision-making and enable better health service planning—especially as medical tourism continues to grow.

Source: https://www.news-medical.net/news/20260116/UK-patients-seeking-surgery-overseas-are-returning-with-complications-the-NHS-must-treat.aspx