United Kingdom
Somewhere to have it done, and somewhere to get over it.
Cyprus is an EU country four and a half hours from London. They drive on the left, the plugs are the same three pins as yours, and everyone speaks English. Your hip or knee is replaced by an EU trained consultant in a private hospital, and you spend the fortnight afterwards walking in warm air rather than waiting out another winter at home.
Where things stand
You already know how long the list is.
Trauma and orthopaedics is the longest waiting list in the health service, and has been for years. A large share of the people on it have already waited past the point the standard allows, and in parts of the United Kingdom the longest orthopaedic waits are counted in years rather than months. You will not need us to tell you which part you are in.
Tim Lane, President of the Royal College of Surgeons of England, put it plainly: “Behind every one of these figures is a person whose life is on hold.” That is the part a waiting list cannot show you. A hip that has gone takes the stairs first, then the garden, then the notion of going anywhere at all.
What we do about it
- A consultation with the surgeon who would operate, at no cost and with nothing owed afterwards.
- A written, fully priced proposal within twenty-four hours of it.
- Roughly three weeks from that first conversation to being home again.
- One person beside you for all of it, who you can ring.
If you have been turned away
A number on a chart is not a clinical decision.
Research by Arthritis UK has found that a majority of integrated care boards in England operate a body mass index policy on joint replacement, and that a significant number will refuse or delay surgery on weight alone. The thresholds differ from one area to the next, which tells you what sort of rule it is. Its chief executive has called the practice unfair, and said it flies in the face of the guidelines and the evidence.
We do not operate a threshold. Whether surgery is right for you is decided by the surgeon who would do it, looking at your imaging, your history and your fitness for an anaesthetic. Sometimes the answer is still no. If it is, you will be told why, by the person who reached it.
Not as far as it sounds
An island that already runs the way you do.
There are fewer than a million people on this island, which is to say it works the way a small country works. Nobody stays a stranger for long. By the second day the nurse is asking after your wife, and meaning it. There is a village behind every family here and a long table in the middle of it, and if you sit down at one you will not be let leave hungry.
Four and a half hours in the air from London, and you are sitting down to dinner. That is a good deal closer than the wait you are on.
Small things, which turn out not to be small
What you will not have to think about.
The road and the socket
Cyprus drives on the left and uses the same three pin plug you have at home. You do not need an adapter and you do not need to think twice crossing a road.
The language
English is everywhere here. Around three quarters of people in Cyprus speak it, and it is on the road signs, the menus and in the hospital corridor. Your surgeon, your nurse and your physiotherapist all work in it.
The clock
Two hours ahead of London, all year round, because both countries move their clocks on the same day. You land in time for dinner, not in the middle of the night.
The fortnight after
The surgery is one morning. The recovery is the rest of it.
What decides how a new hip or knee turns out is not the hour in theatre. It is whether you get up and walk, early and often, and keep at it. Pooled trial evidence on early mobilisation after joint replacement shows patients out of hospital sooner, moving better, with no rise in complications.
Which is where the weather stops being a postcard and starts being the point. Cyprus has roughly double the sunshine of Britain and a fraction of the rain. In December, when a British afternoon gives you an hour or two of sun, here it is nearer six. You will want to go outside. In February at home, you will not.
So the rehabilitation is daily, with the same physiotherapist, and the walking happens outdoors because nothing is stopping it. The hotel is minutes from the hospital. The sea is a walk, not a drive.
In February at home you would not go outside. Here you will want to.
What we carry
One person, from the first phone call to the last one.
You are not managing a project. You are having an operation. Everything around it is ours.
- The consultation, and the hospital and surgeon chosen for your case rather than for our convenience.
- One price, agreed in writing before you travel, with nothing added to it afterwards.
- Airport transfers, accommodation, and the run to hospital and back every day of your stay.
- Every appointment booked and every test arranged, so nothing depends on you chasing it.
- Daily rehabilitation with the same physiotherapist, for as long as the programme runs.
- The operation note, the discharge summary and a written aftercare plan, in English, before you fly.
- A named Patient Manager who knows your case and answers the telephone at nine at night.
Northern Ireland
Northern Ireland has a scheme of its own.
If you live in Northern Ireland and you have been on a Health and Social Care Trust waiting list for a year or more, the Waiting List Reimbursement Scheme can repay the cost of private treatment in an EU country, up to what the same treatment would have cost at home. It needs the Department of Health’s approval before you travel, and it does not cover flights or hotels.
It is the Department’s scheme and not ours. We are not connected with it, we are not approved by it, and we will never tell you what you would get back. What we will do is put every document it asks for into your hands, in English, before you fly home.
England, Scotland and Wales
There is no equivalent, and we would rather say so than let you find out later. The EU route that once allowed a British patient to claim back private treatment abroad closed at the end of 2020. The S2 route still exists, but it funds state hospitals only and needs NHS approval in advance.
If anyone tells you the NHS will refund private surgery in Europe, they are either mistaken or selling you something.
Coming home
Aftercare is the real question, so let us answer it now.
What people ask first is what happens if something goes wrong once they are back. It is the right question, and the honest answer starts with something uncomfortable: a GP in Britain is not obliged to take on the follow-up of an operation they did not arrange. So we do not assume anyone will, and we do not build a promise on it.
You go home with the operation note, the discharge summary and a written aftercare plan in English, addressed to whoever picks up your care. You have the name and direct number of the person who looked after you here. And we strongly recommend insurance that covers medical travel and surgical complications. It is your decision rather than a condition of coming with us, and we will set out plainly what it costs you if you travel without it.
What goes home with you
- The operation note and discharge summary in English, for your own doctor.
- A written aftercare plan, including when you are fit to fly and what you are on.
- The surgeon’s name and registration details, in writing.
- A named person to ring if something is wrong, for as long as it takes.
Questions
What people ask us first
How long would I be away?
About fifteen days from landing to flying home. Consultation and pre-operative tests at the start, then surgery, then the rehabilitation, which is the part that decides how the joint turns out. Most of that fortnight is spent working with the same physiotherapist, in the same place, every day.
I have been refused because of my weight.
We hear this constantly, and it is worth understanding what you were actually told. Research by Arthritis UK has found that a majority of integrated care boards in England operate a body mass index policy on joint replacement, and that a significant number will refuse or delay surgery on weight alone, at thresholds that differ from one area to the next. That is a rationing rule, not a clinical finding. Here your suitability is decided by the surgeon who would operate, on your imaging, your history and your fitness for an anaesthetic. Sometimes the answer is still no, and if it is you will be told why rather than told a number.
When am I allowed to fly home?
When your surgeon says so, and it is written down before you leave. There is no agreed rule in Britain on this. A survey of UK hip and knee surgeons found the advice they give patients ranges from fourteen days to six months, with no evidence-based guideline behind any of it. So the honest answer is that one person decides, in your case, knowing your history, and puts his name to it.
What happens if something goes wrong once I am home?
This is the question people ask first, and it deserves a straight answer rather than a reassurance. A GP in Britain is not obliged to take on the follow-up of an operation they did not arrange, so we do not assume they will. You come home with the operation note, the discharge summary and a written aftercare plan in English, addressed to whoever picks up your care. You have the name and direct number of the person who looked after you in Cyprus, and it does not stop working when you land. We also strongly recommend insurance that covers medical travel and surgical complications. It is your decision, not a condition of coming, and we will explain plainly what it costs you if you go without it.
Will the NHS pay any of it back?
If you live in England, Scotland or Wales, no. The EU route that once allowed it closed at the end of 2020, and anyone telling you otherwise is selling something. Northern Ireland is different and has a scheme of its own, which is set out further up this page.
Who is doing the operation?
A consultant orthopaedic surgeon working in a private hospital in Cyprus, practising in English. Cyprus is an EU member state, so medical qualifications are recognised across the Union automatically, and the General Medical Council accepts Cypriot specialist qualifications for registration in Britain. You will have the surgeon’s name and registration number before you commit to anything.
What does it cost?
It depends on the joint, on the approach your surgeon recommends and on what you need around it, so we quote your case rather than publish a figure that would be wrong for half the people reading it. Ask, and you will have it in writing, all in, before you decide anything. One price, fixed before you travel, and it does not rise when you arrive.
Can my husband or wife come with me?
Yes, and most people do. We would rather they did. The accommodation is arranged for two either way, they are welcome at the hospital, and while you are in rehabilitation there is a country to see.
I am nervous about having surgery in another country.
Most people are, and we would be wary of anyone who told you it was a small thing. What usually settles it is detail. Who is operating and where they trained. Which hospital, and what the room looks like. What the first morning after is like. Who is beside you, and who answers the phone at nine at night. Ask us all of it before you decide anything.
Tell us where you are, and we will tell you honestly whether we can help.
A written answer within four working hours, from someone who has read what you sent. No cost, and no expectation that you go anywhere.
Solence Health is a private company in Limassol. We are not connected with the NHS and not approved by it.