Overseas Care & Spend Control
What we are sending abroad, what it costs, and which capabilities would pay for themselves if built at home.
This quarter
$12.2M
+12% vs 2026 Q2 ($10.9M)
Awaiting approval
17
$2.16M if all approved
Approved / in flight
$8.33M
16 cases in progress
Deliverable locally
16
$2.85M of avoidable outflow
Overseas spend by quarter
Committed cost of approved and completed overseas cases.
Where it goes
Committed cost by specialty across the live pipeline.
Top destination: Jackson Memorial Hospital — $3.03M committed.
Escalations
Actions beyond a role's authority become requests here. Approving one executes the original action with the approver's authority.
Nothing escalated to or from the Minister of Health in this session.
Approval queue
Each case carries clinical justification, cost and a local-capability flag. Decisions here update the pipeline, the dashboard and the patient record.
Patient 0208 · Paediatric cardiology
REF-2026-1005 · NIB ••• -40 · Cleveland Clinic Florida, Weston · waiting 27 days · $306k
Could be delivered locallyrequestedPaediatric cardiology not available in-country; case reviewed by Dr. Terrence Cartwright and meets overseas criteria.
Patient 1368 · Orthopaedic reconstruction
REF-2026-1022 · NIB ••• -43 · Cleveland Clinic Florida, Weston · waiting 39 days · $218k
Could be delivered locallyapprovedOrthopaedic reconstruction not available in-country; case reviewed by Dr. Sandra Miller-Knowles and meets overseas criteria.
Patient 2105 · Oncology — radiotherapy
REF-2026-1031 · NIB ••• -68 · Cleveland Clinic Florida, Weston · waiting 24 days · $60k
Could be delivered locallyreviewedOncology — radiotherapy not available in-country; case reviewed by Dr. Sandra Miller-Knowles and meets overseas criteria.
Patient 1005 · Vascular surgery
REF-2026-1035 · NIB ••• -36 · Health City Cayman Islands · waiting 47 days · $161k
Could be delivered locallyrequestedVascular surgery not available in-country; case reviewed by Dr. Terrence Cartwright and meets overseas criteria.
Patient 1992 · Paediatric cardiology
REF-2026-1039 · NIB ••• -44 · Cleveland Clinic Florida, Weston · waiting 47 days · $126k
Could be delivered locallyreviewedPaediatric cardiology not available in-country; case reviewed by Dr. Marissa Deveaux and meets overseas criteria.
Patient 1363 · Orthopaedic reconstruction
REF-2026-1043 · NIB ••• -38 · Cleveland Clinic Florida, Weston · waiting 27 days · $98k
Could be delivered locallyreviewedOrthopaedic reconstruction not available in-country; case reviewed by Dr. Colwyn Rolle and meets overseas criteria.
Patient 1821 · Nephrology / transplant work-up
REF-2026-1046 · NIB ••• -51 · Jackson Memorial Hospital, Miami · waiting 42 days · $163k
Could be delivered locallyapprovedNephrology / transplant work-up not available in-country; case reviewed by Dr. Neville Pinder and meets overseas criteria.
Patient 2314 · Vascular surgery
REF-2026-1047 · NIB ••• -10 · Nicklaus Children's Hospital, Miami · waiting 19 days · $334k
Could be delivered locallyrequestedVascular surgery not available in-country; case reviewed by Dr. Terrence Cartwright and meets overseas criteria.
Patient 0264 · Neurosurgery
REF-2026-1056 · NIB ••• -96 · Health City Cayman Islands · waiting 59 days · $27k
Could be delivered locallyreviewedNeurosurgery not available in-country; case reviewed by Dr. Sandra Miller-Knowles and meets overseas criteria.
Patient 2210 · Vascular surgery
REF-2026-1076 · NIB ••• -84 · Nicklaus Children's Hospital, Miami · waiting 27 days · $253k
Could be delivered locallyrequestedVascular surgery not available in-country; case reviewed by Dr. Marissa Deveaux and meets overseas criteria.
Patient 2017 · Ophthalmology — vitreoretinal
REF-2026-1103 · NIB ••• -69 · Baptist Health, Miami · waiting 1 days · $189k
Could be delivered locallyrequestedOphthalmology — vitreoretinal not available in-country; case reviewed by Dr. Sandra Miller-Knowles and meets overseas criteria.
Patient 0212 · Paediatric cardiology
REF-2026-1119 · NIB ••• -44 · Baptist Health, Miami · waiting 3 days · $148k
Could be delivered locallyrequestedPaediatric cardiology not available in-country; case reviewed by Dr. Marissa Deveaux and meets overseas criteria.
Patient 1109 · Oncology — radiotherapy
REF-2026-1131 · NIB ••• -51 · Jackson Memorial Hospital, Miami · waiting 1 days · $39k
reviewedOncology — radiotherapy not available in-country; case reviewed by Dr. Marissa Deveaux and meets overseas criteria.
Patient 2235 · Orthopaedic reconstruction
REF-2026-1135 · NIB ••• -20 · Jackson Memorial Hospital, Miami · waiting 57 days · $130k
Could be delivered locallyrequestedOrthopaedic reconstruction not available in-country; case reviewed by Dr. Neville Pinder and meets overseas criteria.
Build-at-home candidates
Repeat overseas specialties ranked by committed spend — the policy question behind the pipeline.
| Specialty | Cases | Committed | Flagged deliverable locally |
|---|---|---|---|
| Paediatric cardiology | 12 | $2.25M | 5 cases |
| Orthopaedic reconstruction | 9 | $1.74M | 3 cases |
| Vascular surgery | 10 | $1.53M | 6 cases |
| Neurosurgery | 6 | $1.16M | 3 cases |
| Nephrology / transplant work-up | 5 | $856k | 2 cases |
| Oncology — radiotherapy | 5 | $761k | 2 cases |
| Interventional cardiology | 4 | $647k | — |
| Ophthalmology — vitreoretinal | 3 | $580k | 2 cases |
| Complex obstetrics | 4 | $497k | 1 cases |
| Cardiothoracic surgery | 3 | $459k | 1 cases |