The overseas referral programme is overseen by NHS England Highly Specialised Commissioning and a Proton Clinical Reference Panel manages the referral pathway. This panel has the necessary knowledge to approve cases that have been referred for consideration of proton beam therapy; ensuring patients have appropriate and equitable access.

Which patients go abroad?

NHS England has prioritised certain types of cancer as being of the highest indication for consideration of referral for proton beam therapy. However, it is important to recognise that an approved diagnosis does not necessarily imply that this is the preferred option. A wide range of factors is taken into account when assessing whether proton beam therapy offers any significant clinical advantage over X-Ray (photon) treatment.

Discussing with your Doctor whether proton beam therapy is the right treatment

All patients for whom proton beam therapy may be appropriate must have a consultation with a Consultant Clinical Oncologist. They have the specialist skills and knowledge necessary to discuss the pros and cons of proton beam therapy, alternative treatments and whether proton beam therapy is the right treatment.

How the referral process works

Before any referral can be made, a full Multi-Disciplinary Team (MDT) discussion must have considered the case and the patient seen by a Consultant Clinical Oncologist. After both of these have been undertaken, a referral can then be made.

The list below demonstrates the referral pathway:

  • Eligible diagnosis
  • Review by Consultant Clinical Oncologist
  • Referral to Proton Clinical Reference Panel
  • Decision from Proton Clinical Reference Panel and which Proton Beam Therapy Centre to refer to
  • Referral to Proton Beam Therapy Centre
  • Agreement from Proton Beam Therapy Centre
  • Liaison between UK and Proton Beam Therapy Centre
  • Liaison between UK Centre and patient
  • Patient travel
  • Treatment: patient usually spend 8-10 weeks abroad
  • Patient returns home
  • Patient continues treatment and/or enters into follow up


The NHS recognises that travel and accommodation costs would significantly exceed costs that would be incurred by travelling for treatment within the UK.

As such, the NHS funds:

  • Proton Beam Therapy Treatment and any procedures necessary for the treatment
  • For paediatric patients: 2 adult carers (1 must be legal guardian)
  • Teenage Young Adult/Adult patients: 1 carer
  • Accommodation
  • Economy return flights
  • Car hire
  • ESTA visa waivers (required for entry into the U.S.A)
  • Travel insurance
  • Travel to and from airport (at public transport costs)

The patient is responsible for covering the costs of sustenance and any activities they wish to undertake whilst abroad.

Further Information

The websites below contain further information which may be of interest:


NHS England. Clinical Commissioning Policy: Funding Policy for travel and accommodation proton overseas programme. April 2013. (Reference: NHS England B01/P(HSS)a0)

NHS England. National Specialised Commissioning Team. Guidance for the Referral of Patients Abroad for NHS Proton Treatment. Version 2.3 July 2011.

Last updated: September 2019