An introduction to the UK health system

28 August 2018

The United Kingdom (UK) is made up of England, Northern Ireland, Scotland and Wales. Well-known for its beautiful country side, rich history (and bad weather), it’s also home to the largest state funded healthcare system in the world - the NHS (National Health System). 

Apart from prescriptions, optical services and dental care, the NHS is free for all UK residents. If you’re not a UK resident however, accessing healthcare in the UK can be a bit more complicated –but don’t worry, this guide will explain how it all works.  

Who can use the NHS?

If you’re living in the UK, any emergency treatment for life-threatening conditions will be free - whether you’re a resident or not. But to use the NHS for general healthcare and non- emergency treatment, you’ll need to be a UK citizen or be what’s known as ‘ordinarily resident’. This is explained in more detail on the NHS website but it generally means you legally live and work in the UK. 

Private Healthcare in the UK

Though the NHS provides a good standard of care, 9 in 10 hospitals in the UK are overcrowded. So it’s not surprising waiting times can be long - around 3 weeks to be seen by your local doctor  and if you’re referred to a hospital for non-urgent treatment, it can take around 18 weeks to get an appointment. 

To avoid the long waiting times and have access to a range of private medical facilities in the UK, some expats choose to take out private health insurance. You can also pay to see a private doctor or specialist without using insurance – though this can be expensive.

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Choosing a family doctor & booking appointments

Local doctors in the UK are known as general practitioners (GP) and work in what’s known as a local practice or GP surgery. In the UK you register with your local GP surgery rather than an individual doctor. And it’s not unusual to be seen by different doctors within the surgery. However, you can request to be seen by a specific doctor if you prefer. 

You’re free to choose which GP practice you want to register with. Though sometimes a practice will only take on new patients who live within a certain distance, known as a catchment area, so you’ll have to choose one that is close to where you live.  You can search GP services by location on the NHS website.

To register, you’ll firstly need to book an appointment at your chosen GP practice. At the appointment, you’ll usually be given a basic check-up and be asked to fill out some forms. You’ll then get a letter in the post confirming you’re registered and your medical records will be transferred to that practice. To book an appointment, you’ll need to call the surgery and see when they have availability. It can take a few weeks to be seen but if you need to be seen urgently you can be put on a triage service. This means a doctor or nurse will call you back that day to discuss your issue and decide whether you need to come in for an emergency appointment.    

There’s also a wide range of private medical specialists in the UK from General Practitioners, to Physical Therapists and Cardiologists. You can book an appointment to see a doctor or specialist privately though you’ll be expected to pay the full cost of any consultations or treatments. If you have private medical insurance, you can choose a doctor from your insurer’s list of approved doctors and medical specialists. You’ll then be able to call and book an appointment when needed and would usually be seen much faster than if you went through the NHS.    

Seeing a specialist

To see a specialist - sometimes called consultants in the UK – you may need a referral from your GP. Once you’ve spoken to your GP, they’ll send you the referral in the post which will tell you when and where your appointment is. It will often be at a hospital where many specialists are based and it can take up to 18 weeks on the NHS if it’s not urgent.    

If you choose to see a specialist privately or you have private health insurance, you won’t need a referral to book an appointment. Though you may want to speak to your doctor first as they can put you in touch with a suitable specialist for the treatment you need.      

Getting prescriptions 

Your doctor, GP or consultant can prescribe you medicine if they think you need it. This could be as a one off to overcome a short-term illness or as a repeat prescription for longer term illnesses.   

If you’re given a repeat prescription, your pharmacy or GP surgery will sometimes give you access to an online portal where you can re-order the medicine as needed. Or you may have to call the surgery beforehand so they can prepare your prescription. Once you’ve placed an order it should take around 2 working days before you can go and collect it.

You can collect prescriptions from the dispensary at your local GP practice or your local pharmacy. Local pharmacies work on a rota to extend their opening hours and provide on-call services. If you need to collect a prescription late in the evening or at a weekend you can search online for the nearest open pharmacy. You can also pick up prescriptions for friends or relatives – you’ll just need to confirm their name and address when you pick it up.  

Dentists

If you need to see a dentist in the UK, you’ll either pay the full amount of your treatment, or if you’re registered with the NHS, you’ll pay a contribution depending on what you need to have done.

Though you don’t have to register with a dentist like you do a GP in the UK, it’s usually a good idea as waiting times can be long and not all dentist surgeries will see you on a one-off basis – so you might end up on a long waiting list. 

You can also choose to see a private dentist. And this can either be self-funded, which can be expensive. Or you can choose a private health insurance plan that includes dental work.

Emergencies

If you have a medical emergency in the UK, call 999 and ask for an ambulance.  

An ambulance will take you to the most appropriate hospital (not always the closest) and make sure you get the treatment you need.  

If you have a medical emergency and there is someone with you who can take you to a hospital, you would need to go straight the nearest hospital with an Accident and Emergency (A&E) department and sign in at the A&E reception. A&E departments are open 24 hours a day, 365 days a year. Waiting times can be long but if you need to be seen urgently then you will take priority over patients with less serious conditions.   

If you're worried about an urgent medical concern but don’t need emergency assistance, call 111 and speak to a fully trained adviser. The NHS 111 service is staffed 24 hours a day, 7 days a week. Depending on the situation, the NHS 111 team can connect you to a nurse, emergency dentist or even a GP, and can arrange face-to-face appointments if they think you need one. They can also assess if you need an ambulance and send one immediately if needed. 

Don’t be surprised if…

  • It takes a while to get an appointment when using the NHS 
  • You have to register with a doctor who is local to you and within the practice’s ‘catchment area’  
  • People refer to a doctor as a GP and a specialist as a consultant
  • You’re asked to pay for treatment upfront if you’re not registered with the NHS
  • You don’t always see the same doctor when you book an appointment unless you specifically ask to

 

Sources
  1. https://en.wikipedia.org/wiki/National_Health_Service_(England)
  2. http://www.bbc.co.uk/news/health-38853707
  3. https://www.telegraph.co.uk/news/2017/06/01/gp-appointment-waiting-times-rocket-towards-three-weeks/
  4. https://www.nhs.uk/NHSEngland/appointment-booking/Pages/nhs-waiting-times.aspx
  5. http://www.bbc.co.uk/news/health-38876527
  6. https://www.nhs.uk/NHSEngland/AboutNHSservices/Emergencyandurgentcareservices/Pages/urgent-care-overview.aspx