Holidays and travel

The Blue Badge Scheme allows people with severe walking difficulties or sight impairments to park closer to their destination. It is recognised throughout Europe. The concessions provided vary from country to country however, and may not be the same as in the UK. Further information about the individual country’s parking concessions is available on the Department for Transport website www.dft.gov.uk.

You can apply for the Blue Badge Scheme by contacting your local council in the first instance.

If you currently use a Blue Badge it may be worth taking it with you if you are travelling to Europe by car or intend to hire a car while away. No concessions currently exist in countries outside Europe.

If you are travelling within the United Kingdom, information on accessible public transport is available from the local council specific to the area you are in and where you are travelling to.Outwith the United Kingdom, a travel agent will be able to give you further information.

Many organisations provide holiday accommodation for adults and children with a serious illness in the UK. Some organisations also provide financial help to enable people with a serious illness to have a break with their families. You can find out more information by asking your doctor or nurse.

You can get information from your travel company (including airlines, ferry companies and coach tour operators) on how to arrange:

• Early boarding
• Special diets
• Booking a wheelchair
• Accessible facilities and equipment
• Providing oxygen (there may be a charge for this)

Most travel companies (including airlines, ferry companies and coach tour operators)have a medical officer, who can help you decide whether it’s safe and practical for you to travel. They can be contacted before your journey and can help you at all stages of planning and during your actual journey. You can also discuss your plans with people who are involved in your care.

When you book your holiday and travel, it’s important to give clear and detailed information about any disability to the travel agency, so that this can be taken into account. If possible, it is helpful to carry a full summary of your medical condition, preferably translated into the language of the country to which you are travelling.

If you have any kind of disability due to your illness/injury or its treatment, there are many services available to help you. The Disabled Living Foundation can give you practical advice about equipment for independent living.

Travel can be very expensive to arrange for someone who is ill or disabled. Potential costs can include:

• Transport to and from the airport or other travel provider
• The ticket
• Expenses for an escort
• Payment for the number of seats needed to give room for a stretcher (or a reclining first-class seat if this is cheaper or recommended)
• The costs of transporting any equipment that may need to be taken with the person.

It can be very difficult for people who are seriously ill to get travel insurance. The information below aims to help you get the travel insurance you need.

Although your doctor may feel that you are well enough to travel, you may find it difficult to get travel insurance. This is because some insurance companies think that a person who is seriously ill is more likely to need to make a claim on their insurance. This is not always the case, although if you have an advanced illness you may be more likely to fall ill while you’re on holiday and need to make a claim.

Different insurance companies use different factors (criteria) to decide whether or not they will give insurance to people with a serious illness. You may need to phone a few different companies before you find one that will give insurance cover for your particular situation. Some companies charge extra to cover people with certain illnesses, so you might find that the premium is higher than you would normally pay. Some companies say that you must pay a particular amount towards the cost of any treatment that you need. This is known as an excess, and may range from £50 to a few thousand pounds, so it is worth shopping around.

People who have an advanced illness, or are currently having treatment, are less likely to be able to get travel insurance – as are people who have had a blood transfusion in the last three to six months. Companies are often reluctant to insure patients for travel to countries where healthcare is expensive, for example, the USA and Canada, or for trips that involve long flights, such as to Australia or New Zealand.

People with colostomies or ileostomies can get special insurance by contacting Ileostomy and Internal Pouch Support Group.

There may be other potential costs of falling ill. Accommodation or living expenses, for example, or the cost of bringing travel companions back to the UK. Some companies will insist that accompanying family and friends are insured under the same policy.

• Checklist – things for people with a serious illness to consider before travel
• Are you fit to travel safely? Discuss your fitness to travel with your GP, as airlines and insurance companies may request proof of this.
• Do any special arrangements need to be made for travelling?
• Will you need an escort?
• Will special equipment need to be provided?
• Have you let the airline/ferry company/car hire company etc. know about any special needs that you have?
• Have you packed your Blue Badge?
• Do you need particular vaccinations for the area you are travelling to?
• Have you got enough medicines/medical supplies for the whole time away?
• Carry all supplies as hand luggage and don’t let go of it.
• Make sure you have your passport and an additional form of proof of UK residence, such as a driver’s licence.
• Take your European Health Insurance Card, if you are visiting European Union countries.
• Take your travel insurance policy and certificate.
• Take any relevant vaccination certificates.
• If you’re flying, book in early and ask for a seat with plenty of legroom.
• Have you got import and export licences for medicines, if these are needed?
• Do you have a medical summary from your doctor to take with you?
• Do you and your escorts have adequate travel insurance?
• If you have a stoma, does your hotel have ensuite facilities? It may help to ask if where you will be staying has facilities to dispose of appliances.
• Take photocopies of all your documentation with you including; passport, drivers license, insurance policies and certificates, doctors letter(s) and medication summary.

If you have a colostomy, ileostomy, urostomy or a tracheostomy, you may have particular issues to think about before you travel.

Your stoma nurse can give you advice and help about your diet while abroad, stoma supplies, insurance, activities like swimming and the effect of high temperatures on the adhesive used to secure the stoma bags.

The Urostomy Association has information on living with a urostomy. The Colostomy Association has travel information for people who’ve had a colostomy.

The National Association of Laryngectomee Clubs can give information to people who’ve had a laryngectomy.

Stoma supplies

Having a stoma should not stop you from travelling, but you may need to plan your trip carefully. It’s important to make sure that you have plenty of stoma supplies and that these are carried in your hand luggage.

If you’re going abroad for a long time, make sure that you take enough stoma supplies with you. It helps to take more than you think you’ll need, in case you have to change your appliance more often than usual. This is especially important if you are going to a hot climate. Some suppliers will deliver abroad. It is helpful to check whether your supplier offers this service.

Stoma bags should be stored in a cool place out of direct sunlight.

Colostomies and ileostomies

If you have a colostomy or ileostomy, it’s important to eat carefully the day before you travel, and avoid spicy food, fizzy drinks, alcohol and foods which cause wind. If you’re flying, the air pressure changes may cause problems with increased wind in the stoma bag. It may help to add an extra flatus filter onto the bag.

Your GP can prescribe anti-diarrhoea tablets and rehydration powders (such as Dioralyte®) for you to take in case you have any diarrhoea while you are away. If the diarrhoea is severe, or continues for more than 48 hours, it’s important to see a doctor.

Insurance and travel certificates

People with colostomies or ileostomies can get special insurance by contacting the Ileostomy and Internal Pouch Association.

A travel certificate can be carried with you when you go abroad. The certificate can be shown to airport security if you are asked about your stoma supplies. Certificates are available in a number of different languages and are available from the Colostomy Association or from your stoma care nurse.

Most insurance companies will ask for a medical certificate or questionnaire to be completed by the patient and/or their GP or hospital consultant. Some may also want a letter from your GP or consultant confirming that you are fit to travel and what the chances are that you may become ill while you are away.

Some companies may ask you to have an assessment by one of their own doctors before they will give you insurance. It’s worth remembering that travel insurance can take some time to arrange. If possible, make sure that your travel insurance has been confirmed before you finalise your holiday booking, just in case you get ill before you travel.

Further information about travel health and vaccinations.

Air Travel

Some people who are ill may be advised not to travel by air under particular circumstances, as oxygen levels and air pressures change at high altitudes.

You may be advised not to fly if you:

• Are breathless.
• Are anaemic (have a low number of red blood cells).
• Are at risk of developing an increased pressure or swelling in the brain (cerebral oedema) due to a brain tumour.
• Have recently had surgery or a medical procedure – as this can introduce gas into the body that may expand to cause pain and stretch your wound. Air travel should be avoided for 10 days after any surgery.
• Have recently had surgery to your chest. Air travel should be avoided for 3–4 weeks after chest surgery.
• Have recently had surgery to your brain.
• Have problems with your ears or sinuses, where pressure changes may make symptoms worse.

Holidays in the UK

Many organisations provide holiday accommodation for adults and children with a serious illness in the UK. Some organisations also provide financial help to enable people with a serious illness to have a break with their families. You can find out more information by contacting an organisation appropriate to your illness.

Healthcare while travelling in the UK

If you're a UK citizen travelling in the UK and you become ill, you can be treated free of charge by the nearest GP or NHS hospital.

It can help to have a letter from your hospital doctor with you. The letter should describe your condition, giving details of any medicines you are taking and information on how to deal with any potential medical problems.

It helps to wear a medical alert badge or pendant (from a jewellers or chemist) with emergency contact numbers, especially if you are travelling on your own.

Healthcare abroad - Travelling within the European Economic Area (EEA)

If you’re travelling within the European Economic Area (EEA) or Switzerland, you are entitled to free or reduced-cost emergency medical treatment if you have a European Health Insurance Card (EHIC). The EHIC has replaced the E111 form, which can no longer be used.

The EHIC allows you to be treated on the same basis as a person who is resident in that country. The treatment you are entitled to may not be the same as in the UK. The EHIC can also be used if you need to have on-going treatment while you are abroad, such as regular injections. Every person travelling needs to carry an EHIC. The government recommends that you also buy travel insurance.

Find out how to apply for or renew your EHIC.

Travelling outside the EEA

Some countries outside Europe have an agreement with the UK to provide emergency medical treatment to people from the UK. You will be treated in the same way as a resident of the country you are in, which may differ from what you’d expect from the NHS. Visit the NHS England website for a list of countries, further information about the agreements and information on what is covered. Even in countries where the UK has healthcare agreements, you will need a certain amount of insurance.

In all other countries, including the USA, South America, Africa, most of Asia, and Turkey, you will have to pay the full cost of any healthcare that you have if you become ill. You are strongly advised to take out full medical insurance to cover the cost of any treatment.

The high commission, consulate or embassy of the country you are visiting should be able to give you information on the health care services available.

Claiming costs of treatment

If you need to claim refunds for the cost of healthcare while you are abroad, you need to apply (in person or by post) to the relevant authority in the country you’re visiting. You must enclose the original invoices and documents. If you wait to claim until you have returned to the UK, you should apply to the Pensions and Overseas Benefits Directorate (MED) who will liaise with the authorities of the other countries on your behalf (for contact details see the Health Advice for Travellers booklet). The costs will be refunded from the other country, but this may take a while to arrange.

Contacting relatives if necessary

Keep the names and addresses of friends and relatives with your passport, so that British Consular officials can contact them if their help is needed. If you need to return to the UK quickly, contact British Consular officials. They can usually arrange this for you, but you may need to pay the costs.

Sun protection

Protect your face and neck with a wide-brimmed hat and always wear sunglasses (with a guaranteed ultraviolet light filter) in strong sunlight. Use a high skin protection factor sun cream (SPF 15-30) on any skin exposed to the sun. Follow the instructions on the bottle and reapply as recommended, particularly after swimming.

Wear clothing made of cotton or natural fibres, as these have a closer weave an doffer more protection against the sun. As the sun protection value of different fibres varies, it’s possible that you may need to use some of the other types of protection as well as covering up with clothing.

Never allow your skin to burn.

Stay out of the sun during the hottest part of the day – usually between 11am and 3pm. Try to sit in the shade, even at other times of the day.

Preventing blood clots:

• If you are worried that you may be at risk of developing a blood clot when you travel, it's best to discuss this with the specialist treating you. They can advise you whether you need to have treatment that can help to prevent blood clots.
• Discuss with your doctors whether you should wear special compression socks during your travels.
• All air travellers should drink plenty of non-alcoholic fluids during flights.
• On any type of journey it is helpful to walk around or do leg exercises regularly.