Italy: Hospitalisation Pack

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Information Pack for
British Nationals hospitalised in Italy
Author
British Embassy, Rome
British Consulate-General, Milan
Date
October 2015
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Contents
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Introduction
The assistance we can offer
Our contact details
The Italian Health System
EU Charter of Patients‟ Rights
EHIC
Insurance
Medical reports
Fit to fly certificate
Repatriation
Complaints procedure
Annex A - Provisional replacement certificate request
Annex B - Some useful vocabulary
Annex C - EU Charter of Patients‟ Rights full text
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Introduction
Although the quality of the Italian health care system has been ranked among the top
10 countries in the world by the World Health Organisation, hospitalisation in Italy
can feel like a „foreign experience‟ for some British Nationals.
Care provided in Italy within hospitals is generally advanced and compassionate.
Some people however find the language barrier can cause them distress as Italian
doctors and nurses are not always fluent in English.
This information pack aims to help you understand how the national health system
works in Italy and to give you information about the assistance we can offer during
your hospitalisation.
The assistance we can offer
The Foreign and Commonwealth Office (FCO) is represented overseas by its
Embassies and Consulates. Consular officers provide help and advice to any British
National who gets into difficulty in a foreign country.
If you are hospitalised in Italy we aim to contact you as soon as possible after being
told that you have been admitted to hospital to assess how we can help you.
We aim to provide assistance according to your individual needs. This may include
visiting you if you are particularly at risk.
Before deciding whether a visit is of help to you, we will take into account factors
such as your medical condition, whether you have relatives or friends with you,
whether you have a tour company representative or a shipping agent assisting you
and whether you have medical staff who can communicate to you in English. If we
believe a visit by a Consular official would provide you with valuable support, we will
aim to visit you as soon as possible.
We also have a network of Honorary Consuls, who work mainly on a voluntary basis
and who can offer assistance and visit you in hospital.
We can contact your family or friends in the UK to tell them that you are in hospital
and we can help you consult your insurance company or a medical evacuation
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company, should you require it. We may also be able to help you communicate with
hospital staff in certain situations if they do not speak English.
We do not usually contact or visit people who have travelled specifically for medical
treatment.
In Italy as well as in the European Economic Area or Switzerland you should carry a
European Health Insurance Card (EHIC) which will entitle you to medical treatment.
If you normally live in the UK, you can apply for the EHIC at any point, even after
medical treatment has become necessary or has begun here in Italy (see
www.ehic.org.uk).
We cannot pay your medical bills nor offer translations of medical reports or
diagnoses. We can provide you with a list of translators. We are not medically
trained to evaluate any treatment you have been given.
Our contact details
British Embassy, Rome:
British Consulate-General, Milan:
British Embassy Rome
Via XX Settembre 80/a
00187 Roma
Italy
Tel: (+39) 06 4220 0001
Fax: (+39) 06 4220 2334
https://www.gov.uk/government/world/org
anisations/british-embassy-rome
Our working hours are from 9.00 to 17.00
Monday to Friday (Italian time)
British Consulate-General, Milan
Via San Paolo 7
20121 Milano
Italy
Tel: (+39) 02 72 30 01
Fax: (+39) 02 86465081
https://www.gov.uk/government/world/org
anisations/british-consulate-generalmilan#our-services
Our working hours are from 9.00 to 17.00
Monday to Friday (Italian time)
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The Italian Health System
Italian legislation recognises the right to health as a fundamental human right. In Italy
therefore the health care system (Servizio Sanitario Nazionale (SSN)) provides free
emergency care (Pronto soccorso) for everyone, including non residents, and
universal coverage to all Italian residents almost free of charge: patients are charged
a nominal fee called a “ticket” (which varies in each region).
Should you require emergency treatment in Italy this will be given to you free of
charge as an EU citizen. You will need to provide your European Health Insurance
Card (EHIC). Long term care may entail charges.
SSN is under the central responsibility of the Ministry of Health.
It operates at three different levels:
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National level: The Ministry of Health formulates a healthcare plan every three
years called the PSN (Piano Sanitario Nazionale) which establishes general
healthcare policies.
Regional level: each one of the 21 Italian regions is responsible for the
implementation of the PSN with its own resources and adjusts it to local
needs or policies.
Local level: local health authorities covering specific urban areas within a
region are called ASL (Azienda Sanitaria Locale) and they provide health
care services – e.g. primary medical services, specialist care, and
coordination of all non-emergency admissions to public hospitals.
As with most countries you may find inconsistency in the quality of health care
facilities and services provided. This is mainly evident in hospital facilities and
management rather than in the quality of medical treatment. Italian medical staff are
extremely well trained.
En-suite bedrooms are rare in Italian hospital. In-patient wards consist of three to six
beds or more. Should you wish for a single room within the hospital you may need to
pay for it or consider a private hospital. Request for a single room will be subject to
hospital availability.
As a patient you will need to bring everything you need with you, including towels,
toiletries, etc. This can be a surprise to some British patients.
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Meals are provided free of charge and are often served during visiting hours, when
members of the family can help those who are not able to feed themselves. Please
note that nursing staff do not usually help with feeding.
There are social workers in almost every hospital who are able to help you. They can
assist patients and families with non medical needs. When a non medical service is
needed (an interpreter) the social worker will find the best available service in the
area (charities or private) and alert them. Social workers can be contacted at the
URP ( Ufficio Relazione con il Pubblico- Customer Services Office) based within the
hospital.
The EU Charter of Patients’ Rights
All patients have the right to the hospital booklet (carta dei servizi) containing details
such as meal schedules, visiting hours, floor plans, doctors‟ names, hospital rules,
and the location of telephones and toilets. The information included may only be in
Italian and you may need to ask for it. It usually includes the fundamental rights of
the patients according to the EU Charter of Patients‟ Rights:
http://www.cittadinanzattiva.it/files/corporate/europa/carta/European_Charter_of_Pati
ents_Rights_england.pdf
The European Charter of Patient‟s Rights was drafted in 2002 by Active Citizenship
Network in collaboration with 12 citizens' organizations from different EU countries .
The Charter embodies 14 fundamental rights with regards to information, consent,
confidentiality and privacy, care and treatment.
EHIC
UK residents travelling in Italy should always carry their EHIC (European Health
Insurance Card). The card is personal and covers you for emergency health care in
public hospitals. If you are at a private hospital (clinica) your EHIC may not be
accepted, unless the private hospital has a special agreement with the ASL (local
health authority).
Please note that EHIC is not a replacement for travel insurance, as it does not cover
all the other expenses linked to your hospitalisation. An EHIC for example does not
cover the cost of medical repatriation, should that be necessary.
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It is important to have both an EHIC and a valid private travel insurance policy. Some
insurers now insist you hold an EHIC, and many will waive the excess if you have
one.
Each member of a travel party must have their own EHIC. Parents and guardians
can apply for those aged under 16.
EHIC is easy to obtain and it is free. Please note that most UK residents are eligible
for an EHIC, but residents of the Channel Islands and the Isle of Man are not.
Please find a link to the NHS website where you will find information on how to apply
for it:
http://www.nhs.uk/NHSEngland/Healthcareabroad/EHIC/Pages/about-the-ehic.aspx
If you require an EHIC during hospitalisation in Italy, and you don‟t have one, you
can make enquiries with the Overseas Healthcare Team.
Please find details below:
Overseas Healthcare Team
Room MO601, Durham House
Washington
Tyne & Wear
NE38 7SF
Tel. 0044 (0) 191 218 1999
Fax. 00 44 (0) 191 225 2131
If you do not have your card with you or if your card has expired, you can apply for a
provisional replacement certificate. Please ask the hospital where you are to fill in
the relevant form (Annex A to this information pack) and fax it to the Overseas
Healthcare Team (fax number on Annex A).
Insurance
By taking out travel insurance and getting a free European Health Insurance Card
(EHIC), you can avoid expensive medical bills if you have an emergency during your
trip.
The EHIC is not an alternative to travel insurance. It will not cover any private
medical healthcare or the cost of things such as mountain rescue in ski resorts,
repatriation to the UK or lost or stolen property.
If you have purchased travel insurance and you have an emergency, you should
contact your insurance immediately. It is important to get your insuarance company
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involved at an early stage. Make sure your insurance is in direct contact with doctors.
We can help you liaise between the insurers and Italian doctors but it is vital they are
cooperating from the earliest opportunity. You may also want to contact your UK GP
as insurers are likely to speak to them as well.
When you purchase travel insurance inform them promptly of any pre-existing
condition. Many claims are not validated because of undisclosed previous
conditions.
Medical reports
Once you are discharged you will receive a letter briefly outlining your diagnosis and
required medication. This will be in Italian. We cannot translate it for you but we can
provide a list of translators.
If you wish to obtain a full medical report (which includes blood test results, CDs of
scans and so on) you will need to make an official request with the hospital – the
hospital staff should be able to tell you how to do this. Please make sure you have
requested it before leaving the hospital and made arrangements for it to be couriered
to you.
Fit to fly certificate
If you are to be discharged and you are planning to travel home, you should check
with your air company if they require a fit to fly certificate. This can be issued by the
hospital stating that you can fly with a charter flight or indicating any specific need
(portable oxygen for example).
Please note that if you are pregnant you may also need to request this certificate
from your doctor prior to departure, to cover your outward and inbound flights –
check with your airline in good time to find out what is required.
Repatriation
If you wish to return to the UK and you are not fit to fly on a charter flight you will
have to contact a private repatriation company. We can provide you with a list of
companies but be aware they can cost up to €20,000.
Your insurance company might be able to organise the repatriation for you (via air
ambulance for example). However, you may have to pay for it if they haven‟t
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validated your claim. If your claim is validated the insurance company should
organise door to door repatriation.
Complaints procedures
If you are not happy with the care you are receiving and you wish to complain with
regards to medical treatment, you can do this with the Ufficio Relazione con il
Pubblico (URP - Customer Services Office) of the hospital. Usually a complaint can
be filed in person, on the phone or in writing either by letter, email or fax. The main
hospitals also upload templates on their website.
If you want a second opinion on your health condition you can consider visiting a
different hospital or consulting another doctor.
For more serious complaints , it is advisable to seek legal advice and we can provide
a list of English-speaking lawyers based in Italy.
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Annex A
Richiesta di duplicato temporaneo di tessera sanitaria
Provisional Replacement Certificate request
Fax
To
Organisation
Overseas Health Care Team
Pension, Disability and Carers Service, M0135, Durham House,
Washington, NE38 7SF
Fax number
From
Hospital contact details
Date
Pages
00 44 191 225 2131
Name of local Hospital
A chi di competenza
Chiediamo gentilmente il rilascio di un certificate temporaneo al paziente indicato
nella pagina successiva e che il certificato venga inviato alla persona e al numero di
fax indicato qui in alto
To whom it may concern,
Please issue a Provisional Replacement Certificate for the patient named on the following
page, and forward the certificate to the fax number and contact name indicated above.
Many thanks
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DATI DEL PAZIENTE
PATIENT DETAILS
Nome (i)
Name(s)
Cognome (i)
Surname(s)
Data di nascita
D.O.B.
Numero di Previdenza Sociale
National Insurance Number
Indirizzo nel Regno Unito
UK address
Nazionalita‟
Nationality
Data di inizio del trattamento medico
Dates of treatment
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Annex B
Some useful vocabulary
For the Patient (Per il Paziente)
I feel unwell
Non mi sento bene
I feel ill
Mi sento male
I have a headache
Ho mal di testa
I have a stomach ache
Ho mal di stomaco
Can you give me something for the pain?
Puo’ darmi qualcosa per il dolore ?
I have a temperature
Ho la febbre
I feel dizzy
Ho le vertigini
I have been sick
Ho vomitato
I have been stung by a bee/wasp
Sono stato punto da un’ape/una vespa
He/She is allergic to...
Lui/Lei e’ allergico a...
His thumb is swollen
Il suo dito e’ gonfio
I have toothache
Ho mal di denti
It is not serious
Non e ‘ grave
TELLING THE DOCTOR
WHAT THE DOCTOR SAYS
What’s the matter?
Here is a prescription for some tablets
Take one, x times a day, after each meal
Che cosa succede?
Qui c’e’ una ricetta per alcune compresse
Ne prenda una, x volte al giorno, dopo ogni
pasto
E’ la prima volta che Le succede questo?
Le consiglio di andare in ospedale
La farmacia apre alle...
Is this the first time this has happened ?
I advise you go to hospital
The chemist’s opens at...
AT THE CHEMIST’S
I would like some plasters, please
Do you have anything for a cold?
I need a sterile dressing
Can you recommend an insect repellant ?
I have sunburn
Per favore, avrei bisogno di cerotti
Ha qualcosa per il raffreddore ?
Avrei bisogno di garze
Mi puo’ consigliare un repellente per gli insetti?
Ho una scottatura solare
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AT THE HOSPITAL
How do you feel?
What’s wrong?
Where does it hurt ?
Since when ?
How often?
How long does it last ?
What makes it better?
What makes it worse?
Has it happened before?
Did you lose consciousness?
I need to take a blood sample
Come ti senti? / Come si sente?
Qual e’ il suo problema?
Dove Le fa male ?
Da quando ?
Quanto spesso ?
Quanto tempo dura?
Cosa lo fa migliorare?
Cosa lo fa peggiorare?
Le e’ successo in precedenza?
Ha perso coscenza?
Dovrei farle un prelievo del sangue
MEDICAL HISTORY
Have you ever had an operation?
Are you taking any medicines ?
Are you allergic to any medicines?
Do you smoke?
How long have you been smoking?
Do you drink?
Have you ever used drugs?
Ha mai avuto un’ operazione?
Sta prendendo qualche medicina?
E’ allergico a qualche farmaco?
Fuma?
Da quanto tempo fuma?
Beve alcolici?
Hai mai fatto uso di stupefacenti?
DIGESTIVE SYSTEM
diarrhoea
indigestion
jaundice
gallstones
stomach ache
heartburn
ulcers
vomiting
constipation
hemorrhoids
hepatitis
diarrea
indigestione
itterizia
calcoli biliari
mal di stomacco
bruciore di stomaco
ulcere
vomito
stitichezza
emorroidi
epatite
RESPIRATORY SYSTEM
cold
difficulty breathing
flu
raffreddore
difficolta’ a respirare
influenza
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dry cough
chesty cough
phlegm
sore throat
asthma
pneumonia
emphysema
tosse secca
tosse grassa
muco
mal di gola
asma
polmonite
enfisema
CARDIOVASCULAR SYSTEM
chest pain
palpitations
heart attack
shortness of breath
hypertension
stroke
heart rate
heart murmur
dolore al petto
palpitazioni
attacco di cuore / infarto
respiro corto
pressione alta
ictus
frequenza cardiaca
soffio al cuore / soffio cardiaco
NEUROLOGICAL SYSTEM
convulsion
numbness
tremors
epilepsy
fainting spell
paralysis
blurred vision
convulsione
intorpidimento
tremori
epilessia
svenimento
paralisi
visione appannata (visione obnulata)
GYNECOLOGIST
How many times have you been pregnant?
When did you last have a baby ?
Have you ever had a ceasarean section?
Did you have an anaesthetic for the delivery ?
When was your last period ?
Is your period regular?
Do you have a heavy or light flow?
When did the pains start?
Have you lost any blood?
miscarriage
voluntary abortion
labor pains / contractions
condom
the morning-after pill
Quante gravidanze ha avuto ?
Quando ha avuto l’ultimo bambino?
Ha mai avuto un parto cesareo?
Ha avuto un’ anestesia per il parto?
Quando e’ stata l’ultima mestruazione?
Le mestruazioni sono regolari?
Ha un flusso abbondante o leggero?
Quando sono iniziati i dolori?
Ha perso del sangue?
aborto spontaneo
aborto
contrazioni
preservativo
pillola del giorno dopo (contraccezione postcoitale)
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TREATMENT
medication
prescription
dressing
plaster
plaster cast
terapia
ricetta
medicazione
cerotto
gesso
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Annex C
European Charter of Patient’s rights
1-Right to Preventive Measures
Every individual has the right to a proper service in order to prevent illness.
2-Right of Access
Every individual has the right of access to the health services that his or her health
needs require.
The health services must guarantee equal access to everyone, without
discriminating on the basis of financial resources, place of residence, kind of illness
or time of access to services.
3-Right to Information
Every individual has the right to access to all kind of information regarding their state
of health, the health services and how to use them, and all that scientific research
and technological innovation makes available.
4-Right to Consent
Every individual has the right of access to all information that might enable him or
her to actively participate in the decisions regarding his or her health; this information
is a prerequisite for any procedure and treatment, including the participation in
scientific research.
5-Right to Free Choice
Each individual has the right to freely choose from among different treatment
procedures and providers on the basis of adequate information.
6-Right to Privacy and Confidentiality
Every individual has the right to the confidentiality of personal information, including
information regarding his or her state of health and potential diagnostic or
therapeutic procedures, as well as the protection of his or her privacy during the
performance of diagnostic exams, specialist visits, and medical/surgical treatments
in general.
7-Right to Respect of Patients‟ Time
Each individual has the right to receive necessary treatment within a swift and
predetermined period of time. This right applies at each phase of the treatment.
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8-Right to the Observance of Quality Standards
Each individual has the right of access to high quality health services on the basis of
the specification and observance of precise standards.
9-Right to Safety
Each individual has the right to be free from harm caused by the poor functioning of
health services, medical malpractice and errors, and the right of access to health
services and treatments that meet high safety standards.
10-Right to Innovation
Each individual has the right of access to innovative procedures, including diagnostic
procedures, according to international standards and independently of economic or
financial considerations.
11-Right to Avoid Unnecessary Suffering and Pain
Each individual has the right to avoid as much suffering and pain as possible, in
each phase of his or her illness.
12-Right to Personalised Treatment
Each individual has the right to diagnostic or therapeutic programmes tailored as
much as possible to his or her personal needs.
13-Right to Complain
Each individual has the right to complain whenever he or she has suffered a harm
and the right to receive a response or other feedback.
14-Right to Compensation
Each individual has the right to receive sufficient compensation within a reasonably
short time whenever he or she has suffered physical or moral and psychological
harm caused by a health service treatment.
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