Wellbeing and Disease Prevention
Holiday and Travel Health
Some links on this page have been colour coded to make it easier to find the information you need:
As the NHS suggests
“If you’re planning to travel outside the UK, you may need to be vaccinated against some of the serious diseases found in other parts of the world. If possible, see your GP practice or a private travel clinic at least 6- 8 weeks before you’re due to travel.”
“Travel vaccinations.” The NHS website. Retrieved 30th January 2024
The NHS provide a short simple summary
You will find links on these pages to information which will help you consider many of the health issues associated with travel and allow you to plan ahead. A good starting point which covers much of the important travel health information is from the National Travel and Network Centre.
From the National Travel and Network Centre
Set up by the Department of Health in 2002 with the broad aim of protecting the health of British travellers. Provides up-to-date and reliable information for the international traveller, travel industry and national government.
- Travel Health Pro NaTHNaC – Home
- NaTHNac NaTHNaC | Launchpad to services
Travel to specific countries
Further information on travel to specific countries:
SPECIFIC COUNTRY INFORMATION
From the National Travel Health Network and Centre
Commissioned by Public Health England
Country information NaTHNaC – Country List
From Fit for Travel
Commissioned by NHS Scotland and Public Health Scotland
Information on how to stay healthy and Safe abroad by county Destinations – Fit for Travel
From Gov UK
Get advice about travelling abroad, including the latest information on coronavirus, safety and security, entry requirements and travel warnings Foreign travel advice – GOV.UK
CORONAVIRUS AND TRAVEL TO OTHER COUNTRIES
From Gov UK
Guidance for British people travelling abroad during the coronavirus pandemic, if they are legally permitted to travel under current UK COVID-19 restrictions Travel advice: coronavirus (COVID-19) – GOV.UK
Frequently asked questions – General travel health
INFORMATION ON VACCINES
From the NHS, Patient info and NICE
Travel and vaccinations
- Travel vaccinations – NHS
- Travel Health and Vaccinations | Patient
- Immunizations – travel | Health topics A to Z | CKS | NICE
From Gov UK
The Green Book: Immunisation against infectious disease – “The Green Book has the latest information on vaccines and vaccination procedures, for vaccine preventable infectious diseases in the UK.” Immunisation against infectious disease – GOV.UK
INFORMATION ON MALARIA MEDICATION
From the NHS, Fit for travel and NICE
Malaria prevention in travellers from the UK
- Malaria – Antimalarials – NHS
- Malaria – Fit for Travel
- Scenario: Malaria prevention in travellers from the UK | Management | Malaria prophylaxis | CKS | NICE
As suggest by Patient info
“There is a possibility of antimalarials that you may buy in the tropics or over the internet, being fake. It is therefore recommended that you obtain your antimalarial treatment from your pharmacist or a travel clinic. Pharmacists can now provide the full range of antimalarial medications, so there’s no need to see your GP or practice nurse for a prescription. Medications to protect against malaria are not funded by the NHS. You will need to buy them, regardless of where you obtain them”. Malaria Prevention – Awareness, Bite Prevention, Chemoprophylaxis, Diagnosis | Patient
general Information on vaccinations and medication
There is more information on vaccinations and medication under
WHERE CAN you GET VACCINATIONS FROM AND WHICH ARE FREE ON THE NHS?
From the NHS
Finding a yellow fever centre
From the National Travel Health Network and Centre (commissioned by Public Health England) “Enter the first 2 characters of your postcode to get an initial list of yellow fever centres and the third character to get a more local list if available Yellow Fever Zone
GENERAL ADVICE
From Fit for Travel
Commissioned by NHS Scotland and Public Health Scotland
General Travel Health Advice Advice – Fit for Travel
From Patient info
Health Advice for Travel Abroad Health Advice for Travel Abroad | Patient
From Gov UK
Travel abroad Browse: Travel abroad – GOV.UK
PREGNANCY PRECAUTIONS
From Fit for Travel
Advice for Pregnant Travellers Pregnant Travellers – Fit for Travel
From the NHS
Travelling in pregnancy Travelling in pregnancy – NHS
Any certificate/ letter requested from your GP practice such as “for fitness to travel after 28 weeks” confirming that you are not at risk of complications and your due date will be charged for and there can be a significant delay in producing such a document as this is outside NHS work. It is always best to check directly with your airliner and travel company if it is actually necessary for such a document. On occasions your midwife may do a letter for you.
MEDICAL CONDITIONS PRECAUTIONS
From Asthma UK
Travelling with asthma Travel | Asthma UK
OTHER HEALTH PRECAUTIONS
From the NHS
Sunburn
- Sunscreen and sun safety Sunscreen and sun safety – NHS
- Sunburn Sunburn – NHS
- Keeping your baby safe in the sun Keeping your baby safe in the sun – NHS
From Patient info
Sun and sunburn Sunburn | How to Treat Sunburn | Sun Risks | Patient
From the NHS
Heatwaves
Heatwave: how to cope in hot weather Heatwave: how to cope in hot weather – NHS
Further information on reducing your risk of skin cancer
There is much more information under the question “How can I reduce my risk of skin cancer” under
WATER AND LEISURE SAFETY
From ROSPA (The Royal Society for the Prevention of Accidents)
Water and leisure safety Water and leisure safety – RoSPA
OVERVIEW ON HEALTH AND FLYING
From Fit for Travel
Fit for travel provide a very good summary
Air Travel Air Travel – Fit for Travel
SOME HEALTH CONDITIONS (INCLUDING DEEP VEIN THROMBOSIS (CLOT))
From the NHS, Patient info and NICE
Deep vein thrombosis (DVT) – prevention for travellers
- Prevent DVT (deep vein thrombosis) when you travel – NHS
- DVT Prevention | Travel-related Deep Vein Thrombosis | Patient
- Scenario: DVT prevention for travellers | Management | DVT prevention for travellers | CKS | NICE
Jet lag
- Jet lag – NHS
- Jet lag | Avoiding, Managing, Symptoms and Recovery | Patient
- Scenario: Jet lag | Management | Sleep disorders – shift work and jet lag | CKS | NICE
Ears and flying and is it safe to fly with a perforated eardrum?
- Is it safe to fly with a perforated eardrum? – NHS
- Ears and Flying | Blocked Ears Feeling | Preventing Ear Pain | Patient
From the NHS and the British Heart Foundation
Surgery, heart attacks and plaster casts
- When can I fly after surgery? When can I fly after surgery? – NHS
- When can I fly after a heart attack? When can I fly after a heart attack? – NHS
- Can I travel on a plane if I have a plaster cast? Can I travel on a plane if I have a plaster cast? – NHS
- Planning a holiday when you have a heart condition Planning a holiday when you have a heart condition – BHF
are you FIT TO TRAVEL?
From the UK Civil Aviation Authority
Am I fit to fly Health guidelines for air travel | Civil Aviation Authority
From Fit for Travel
Air Travel Air Travel – Fit for Travel
From the NHS
Travelling in pregnancy Travelling in pregnancy – NHS
Any certificate requested from your GP practice “for fitness to travel” for any condition will be charged for and there can be a significant delay in producing such a document as this is outside NHS work. Many conditions do not require GP certificates. It is always best to check directly with your airliner and travel company if it is actually necessary for such a document.
support for flying phobia
With a significant phobia you can self-refer to Buckinghamshire Talking Therapies for cognitive behavioural therapy.
From NHS Buckinghamshire Talking Therapies
One to one support: Cognitive Behavioural Therapy (CBT) One to one support – NHS Buckinghamshire Talking Therapies
From Fit for Travel
Air Travel: See under “Potential in flights health problems” -fear of flying Air Travel – Fit for Travel
A number of organisations also offer private “fear of flying courses” which many patients have found have allowed them to fully overcome their fears including
- Flying with confidence Flying with Confidence | Special assistance | British Airways
- How to cope with fear of flying How to cope with a fear of flying | Virgin
- Fearless flyer Fear of flying course | Fearless Flyer
GP practices do not prescribe diazepam for fear of flying
The reasons for this are around safety and national guidance which is explained in detail below:
From NICE
Diazepam Diazepam | Prescribing information | Generalized anxiety disorder | CKS | NICE
Contraindications and cautions of diazepam
Do not prescribe diazepam to people with: “Phobic or obsessional states, psychosis or schizophrenia, hyperkinesis — paradoxical reactions may occur.”
Fear of flying is defined as a phobia, so the NICE guidance suggests not prescribing diazepam for a phobia such as fear of flying.
From the British National Formulary (BNF)
Diazepam DIAZEPAM | Drug | BNF content published by NICE
Paradoxical effects: “A paradoxical increase in hostility and aggression may be reported by patients taking benzodiazepines.” Such an event would be unsafe in the enclosed space of a plane.
Common Side effects “Alertness decreased… confusion (more common in elderly) … drowsiness”. None of these potential side effects are safe in the plane environment, particularly with the higher risk of deep vein thrombosis (see above for more information on clots), nor are the side effects conducive to looking after children or driving after a plane flight.
INFECTIONS FROM OTHER COUNTRIES
From Fit for Travel
Disease Prevention Advice and Malaria Advice – Fit for Travel
From the NHS
- Typhoid fever and how to prevent Typhoid fever – NHS
- Middle East Respiratory syndrome Middle East respiratory syndrome (MERS) – NHS
- Insect bites and stings Prevention Insect bites and stings – Prevention – NHS
From the NHS, Patient info and NICE
Malaria and how to prevent
- Malaria – Prevention – NHS
- Malaria Prevention – Awareness, Bite Prevention, Chemoprophylaxis, Diagnosis | Patient
- Scenario: Malaria prevention in travellers from the UK | Management | Malaria prophylaxis | CKS | NICE
From NICE
Diarrhoea – prevention and advice for travellers Diarrhoea – prevention and advice for travellers | Health topics A to Z | CKS | NICE
As the NHS suggests
“The UK Global Health Insurance Card (GHIC) lets you get necessary state healthcare in EU countries, and some other countries, on the same basis as a resident of that country. This may be free or it may require a payment equivalent to that which a local resident would pay.”
Applying for healthcare cover abroad (GHIC and EHIC) Applying for healthcare cover abroad (GHIC and EHIC) – NHS
You can apply for a UK EHIC or UK GHIC card. However, as the NHS Business Services Authority (NHSBSA) suggest:
“Your UK EHIC or UK GHIC is not a substitute for travel insurance. It may not cover all health costs and never covers repatriation costs. Make sure you have travel insurance as well as an UK EHIC or UK GHIC.”
Apply for UK EHIC or UK GHIC card online
From the NHS Business Services Authority (NHSBSA)
Get healthcare cover for travelling abroad Get healthcare cover for travelling abroad – NHSBSA
Frequently asked questions – Common medication queries
Many medications required for travel abroad you can get from your local pharmacist (including potentially a first aid travel kit). Some medications require a private prescription. Some medications your GP is not able to prescribe. This is all explained further below.
HOW CAN you PREPARE A FIRST AID KIT FOR HOLIDAY TRAVEL?
Your pharmacist can advise you on products that can be purchased over the counter for a first aid kit, such as oral rehydration sachets, anti-diarrhoeal medicines, antiseptics, antihistamines, sunscreen etc.
From the NHS
Find a pharmacy Find a pharmacy – NHS
From Patient info
- Essential first aid items for your home Essential first aid items for your home | Health at home | Patient
- Holiday first aid kit essentials Holiday first aid kit essentials | Travel Health Advice | Patient
HOW CAN I DEAL WITH MOTION SICKNESS?
From NHS choices and Patient info
Motion sickness
From the NHS
- Hyoscine hydrobromide (Kwells and Joy-Rides) Hyoscine hydrobromide: medicine for travel sickness or to reduce excess saliva – NHS
- Cinnarizine Cinnarizine: drowsy antihistamine used for travel sickness and vertigo – NHS
CAN you POSTPONE MENSTRUATION FOR A HOLIDAY?
This is often possible, see advice below:
It is now possible to buy Norethisterone over the counter directly from some pharmacists to delay your period. Some chemists can do this with an online consultation.
From the NHS
How can I delay my period? How can I delay my period? – NHS
From Patient info
Delaying a Period Delaying a Period | Patient
CAN I TAKE MEDICATION ABROAD?
From Fit for Travel
Travelling with Medicines Travelling with Medicines – Fit for Travel
From the NHS
Can I take my medicine abroad? Can I take my medicine abroad? – NHS
HOW LONG CAN REPEAT MEDICATION BE PRESCRIBED FOR A LONG TRIP ABROAD?
The simple answer is 1-3 months but this is explained in more detail:
From the British Medical Association (BMA)
Prescribing in general practice April 2018 bma-prescribing-in-general-practice-april-2018.pdf
Can be downloaded from section on “prescribing in general practice” Prescribing in general practice
From page 10
“The NHS accepts responsibility for supplying ongoing medication for temporary periods abroad of up to three months. If a person is going to be abroad for more than three months then only a sufficient supply of his/her regular medication should be provided to enable them to get to the destination and find an alternative supply. NHS prescriptions must never be obtained by relatives or friends on behalf of patients who are currently abroad, irrespective of such factors as owning a house in the UK or paying UK taxes. Patients are responsible for ensuring that any drugs they take into a country conform to local laws.”
In addition, even if the repeat prescription is for less than 3 months there may be concerns from your GP practice about drugs which require monitoring
From the General Medical Council
Organisation regulating health professions in the UK
Good practice in prescribing and managing medicines and devices Good practice in prescribing and managing medicines and devices – GMC
Repeat prescribing and prescribing with repeats (page 13 section 102)
“When you issue repeat prescriptions or prescribe with repeats, you should make sure that procedures are in place to monitor whether the medicine is still safe and necessary for the patient.”
It is not possible for a GP to monitor whether a medication is still safe and necessary while you are abroad, particularly if you going abroad for a long period. It is far safer the medication is prescribed and monitored by a clinician in the country you are holidaying.
PRIVATE PRESCRIPTIONS: Malaria medication
As suggest by patient info
“There is a possibility of antimalarials that you may buy in the tropics or over the internet, being fake. It is therefore recommended that you obtain your antimalarial treatment from your pharmacist or a travel clinic. Pharmacists can now provide the full range of antimalarial medications, so there’s no need to see your GP or practice nurse for a prescription. Medications to protect against malaria are not funded by the NHS. You will need to buy them, regardless of where you obtain them”. Malaria Prevention – Awareness, Bite Prevention, Chemoprophylaxis, Diagnosis | Patient
Charging for issuing a private prescription
Can GPs charge for issuing a private prescription for some medication taken when abroad?
Yes, in certain circumstances, though for various reasons explained in further questions below your GP practice may decline to prescribe the medication even as a private prescription.
From the British Medical Association (BMA)
Prescribing in general practice April 2018 bma-prescribing-in-general-practice-april-2018.pdf Can be downloaded from section on “prescribing in general practice” Prescribing in general practice
From page 8
“The only occasions when a doctor may charge for a private prescription are: 1. For drugs which are being issued solely in anticipation of the onset of an ailment whilst outside the UK, but for which the patient does not require treatment when the medicine is prescribed. 2. For drugs issued for the prevention of malaria.”
just in case” medication for a holiday
GPs/ clinicians generally do not prescribe “Just in case” medications. Just in case medication for a holiday, as examples, might include antibiotics or oral rehydration sachets in case one is ill abroad.
Why not?
From the General Medical Council
Organisation regulating health professions in the UK
Good practice in prescribing and managing medicines and devices Good practice in prescribing and managing medicines and devices – GMC
From the first paragraph of the guidance (page 1) for clinicians
“You must only prescribe medicine when you have adequate knowledge of your patient’s health. And you must be satisfied that the medicine serves your patient’s need.”
So, when you are abroad a clinician does not have knowledge of your health state at the time, and whether at that point in time you need treatment with just in case medication such as antibiotics. It is far safer for you to see a clinician in the country you are holidaying.
An example
From the Medical Protection Society
Holiday prescribing Holiday prescribing
fear of flying
For fear of flying GP practices recommend attending a fear of flying course which can be accessed directly as covered in the frequently asked question above on “How can you cope with fear of flying”. They do not prescribe diazepam for fear of flying
The reasons for not prescribing diazepam are around safety and national guidance which is explained in detail below:
From NICE
Diazepam Diazepam | Prescribing information | Generalized anxiety disorder | CKS | NICE
Contraindications and cautions of diazepam
Do not prescribe diazepam to people with: “Phobic or obsessional states, psychosis or schizophrenia, hyperkinesis — paradoxical reactions may occur.”
Fear of flying is defined as a phobia, so the NICE guidance suggests not prescribing diazepam for a phobia such as fear of flying.
From the British National Formulary (BNF)
Diazepam DIAZEPAM | Drug | BNF content published by NICE
Paradoxical effects: “A paradoxical increase in hostility and aggression may be reported by patients taking benzodiazepines.” Such an event would be unsafe in the enclosed space of a plane.
Common Side effects “Alertness decreased… confusion (more common in elderly) … drowsiness”. None of these potential side effects are safe in the plane environment, particularly with the higher risk of deep vein thrombosis (see above for more information on clots), nor are the side effects conducive to looking after children or driving after a plane flight.
Frequently asked questions – treatment and living abroad
TRAVELLING FOR TREATMENT OR TO LIVE ABROAD
From the NHS
Advice about healthcare if you’re planning to visit or move to another country.
Healthcare abroad Healthcare abroad – NHS
WHAT SHOULD I CONSIDER IF I AM GOING ABROAD FOR MEDICAL TREATMENT?
From the NHS
Going abroad for treatment Going abroad for treatment – NHS
WHAT SHOULD I CONSIDER IF I AM MOVING ABROAD ON A LONG-TERM BASIS?
From the NHS
Advice about planning your healthcare if you’re going to move or study abroad Planning your healthcare – NHS
From Gov UK
Living abroad Browse: Living abroad – GOV.UK
EU Countries
Visiting the EU, Switzerland, Norway, Iceland or Liechtenstein Visiting the EU, Switzerland, Norway, Iceland or Liechtenstein – GOV.UK
Non-EU countries with reciprocal health arrangements with the UK
UK reciprocal healthcare agreements with non-EU countries UK reciprocal healthcare agreements with non-EU countries – GOV.UK
