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Isis fighters parade through Sirte, Libya, where they seized control of the passport office in early 2016. Photograph: AFP/Getty Images

Italian investigators believe that a number of Islamic State fighters from Libya have slipped into Europe by infiltrating a scheme designed to give hospital treatment to wounded regular Libyan government soldiers.

A Italian intelligence document seen by the Guardian reveals a complex network in which, from 2015, members of Isis and others linked to jihadi movements have infiltrated Europe pretending to be injured, so as to be treated in clinics and then freed to move elsewhere in Europe and the Middle East.

Elements of Isis are involved in the smuggling of the wounded men from Libya and are using this strategy to travel out of Libya with false passports, the document says.

The Italian intelligence document focuses on a western-backed health project for the rehabilitation and care of injured Libyans, saying it is being run in a doubtful and ambiguous way, even though it is overseen by the UN-recognised government of national accord based in Tripoli. It suggests the Libyan government has been unwittingly paying the travel expenses of Isis members, confusing them with legitimate fighters.

Diplomats and health sector managers have been using a scheme called the Comitato Assistenza Feriti Libici (Centre for the Support of Injured Libyans) to apply for special visas to take wounded soldiers for treatment in Europe.

But Italian intelligence believes an unknown number of Isis fighters have infiltrated the scheme using false passports supplied to them by a criminal network, including corrupt officials. It says it discovered in early 2016 that Isis had seized control of the passport office in Sirte and stolen as many as 2,000 blank documents.

The French government has already claimed in public that Isis has developed a sophisticated capacity to manufacture as many as 200 false passports.

The Italianintelligence document states: Since 15 December 2015, an unknown number of wounded fighters of the Islamic State in Libya have been transported out of the country to an Istanbul hospital to undergo medical treatment.

The bulk of the false wounded come from the Libyan area of Fataeh, where elements of the Islamic State would be holed up, the document states.

From there, the fighters are most commonly sent to Turkish hospitals. It claims in one case the fighters showed fake passports to doctors in Misrata and told them they were wounded in Sirte and Benghazi.

The Isis fighters the intelligence document says would present false passports and, posing as members of the Majlis Shura Thuwar Benghazi (MSTB) report to medical personnel in Misrata.

Misrata is in fact the headquarters of the smuggling of these men from Libya to other countries. Misrata is also the place where the trafficking of false passports takes place when a fake identity is needed to cover the real identity of these men.

The allegations underline the difficulties authorities in Libya and Europe face in determining the motives of militiamen fighting in Libya, and the extent to which their Islamist sympathies extend to support for Isis.

The main countries identified in the document are Turkey, Romania, Serbia and Bosnia, but the injured appear to have also stayed in France, Germany and Switzerland.

An Italian doctor named in the report, Rodolfo Bucci, confirmed to the Guardian he had been contacted by an individual identified in it as part of the smuggling network. I was contacted by some men to coordinate these medical treatments because Im a specialist in Europe in pain treatment therapy. But then I dont know what happened. I dont know if the programme was stopped, he said.

The Italian intelligence document describes the position of the government of Tripoli as highly ambivalent because, although it does not pay for medical care for Isis fighters, it officially facilitates the exit from Libyan territory of elements traced to MSTB, a group in which jihadist militiamen, linked to Daesh [Isis], are directly involved.

In some cases, the intelligence report states, the documents apparently prepared by hospitals arranging for Libyans to leave the country give only superficially described details of injuries or are totally bereft of any details.

Petter Nesser, a senior researcher at the FFI terrorism research group in Norway, said European intelligence agencies were increasingly concerned about Isis fighters from Libya.

There was a feeling that we would have seen more combatants coming out from Libya and it has taken a while until this materialised. Most of the plots in Europe were linked to Syria. But quite recently we are starting to see more plots in Europe linked to Libya.

We know that Daesh is coordinating the infiltration of more operatives and combatants from Libya. The Berlin attacker had ties to Libyan operatives and even Abdelhamid Abaaoud, the Paris attacks ringleader, had ties with Isis agents in Libya.

The Italian intelligence documents are largely based on the exchange of information from the Italian civil and military police, as well as the FBI. The investigation has been passed to antiterrorism police in Italy.

The Italian interior ministry has been contacted for comment.

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Italy fears Isis fighters slip into Europe posing as injured Libyans - The Guardian