CROSS-border health care is on the agenda as a special Welsh Affairs inquiry rolls into Hereford next month.

In July, the Hereford Times revealed the Wye Valley NHS Trust has to find around £12 million a year to cover the cost of Welsh patients who can’t go home because care packages aren’t in place.

Last year, when the Hereford Times highlighted the “postcode lottery” that pushed NHS patients on the Herefordshire side of the border into NHS Wales for treatment, the row went all the way to parliament.

As a result, the Welsh Affairs Committee inquiry into cross-border health care is  coming to Hereford – and a venue yet to be confirmed – on Monday, November 24.

The committee is looking to take evidence from patients, medical professionals and social care practitioners.

The five years since the committee last examined the issue in 2009 have seen an  increasing divergence between the healthcare systems of England and Wales, which has implications for patients in border areas.

In April last year, NHS Wales and the NHS Commissioning Board (CB) England agreed a Protocol for Cross-border Healthcare Services  but it is not clear how well this has been functioning to date.

The Silk Commission has also made recommendations to improve cross-border health delivery, and the Government is preparing its response.

The Committee is inviting written evidence on some, or all, of the following issues:

* The impact of the increasing policy divergence in the health systems of England and Wales on cross-border healthcare services, and on medical practitioners and patients in border regions in England and Wales.

* The experience of patients in England and Wales who are reliant on the use of healthcare services on the other side of the border.

* The case for greater sharing of resources and facilities between the English and Welsh healthcare systems, for example in relation to procurement and use of high-tech equipment.

* The impact of the Protocol for Cross-border Healthcare Services agreed by NHS Wales and NHS CB England, implemented in April 2013, and whether it is meeting its objectives.

* The Silk Commission Part II recommendations on cross-border health, particularly the proposal to develop individual protocols between each border Local Health Board in Wales and neighbouring NHS Trust in England.

* Any lessons that can be learned from other cross-border health arrangements, such as between England and Scotland or Northern Ireland and the Republic of Ireland.

At any one time, Wye Valley NHS Trust can be caring for up to a dozen patients transferred out of NHS Wales and waiting for struggling health and social services across the border to put care packages in place before they can be discharged.

The trust can claim back the care cost - an annual average of £12 million - through a tariff system that pays per person.

But such claims don’t come back quickly and the trust faces a £15 million deficit of its own without financial support.

The trust acknowledges a number of beds are blocked at Hereford County Hospital as delays in repatriating Welsh patients continue.

Trust chief executive Richard Beeken has written to NHS Wales highlighting the plight of Welsh patients at the hospital.

Some of the Welsh patients have been transferred to community hospitals to improve patient flow through the hospital.

The “postcode lottery” was taken up by MP Jesse Norman and the Aneurin Bevan Health Board (ABHB), which covers much of mid and south Wales, announced policy changes that made it easier for border patients to use the hospital of their choice.

Some 3,500 Herefordshire patients are registered with Welsh GPs.

 The ABHB adopted a policy in September 2012 which attempted to keep these patients in Welsh hospitals wherever possible, effectively denying them their choice to come to hospitals in England.

In June last year, public health minister Anna Soubry ordered a review of access to NHS services for patients on the English side of the border.

The ABHB subsequently resolved to allow English residents registered with a Welsh GP to access hospitals in England without prior approval and work with GPs and health commissioners along the border to improve access in the longer term.