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Healthcare in the UK
Health Insurance and the Healthcare System of the UK Explained
The National Health Service (NHS) provides healthcare for non-residents and residents in the UK. It provides most healthcare services free of charge, and the vast majority of people in the UK rely on it without having any additional private health insurance.
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The healthcare system and health insurance in the UK are free at the point of use. This means that you can access care across a range of medical services, such as giving birth, whatever your residential status.
The local GP (general practitioner) should be one of your first ports of call when you arrive in the UK. Finding a doctor is easy and they will register you on the NHS system, giving you access to the full service, including some of the best hospitals in the country. Note that there are some areas not covered by the NHS, most notably dental care that you have to pay for (or insure) yourself.
There are no common health risks in the UK, but the NHS recommends immunization against tetanus.
How Healthcare Works in the UK
As soon as you’ve found a place to live, you should become a part of the UK healthcare system by registering with your nearest General Practitioner (GP). Should you need it, they can refer you to a hospital. In case of an emergency, you should go straight to your nearest A&E (accident and emergency) department.
Does the UK Have Free Public Healthcare?
The short answer to the above question is yes. However, although public healthcare covers most necessary treatment, there are UK healthcare costs for things like dental care, eye care, prescriptions, wigs, and spinal and abdominal supports.
Dental care in the UK can be expensive – you need to find your own dentist and pay a contribution for every treatment. However, some people, such as under-18s, are eligible for free dental treatment.
In general, NHS services are enough to cover common ailments, and, in an emergency, you’ll usually be seen immediately. However, waiting lists for treatments of non-life-threatening issues can be long. Refer back to the NHS website for details on the different packages regarding dental care.
What Does Public Healthcare Cover?
Although the healthcare system across the UK is known as the NHS, the systems of the four countries differ slightly.
As long as you’ve registered with a GP and are in the UK legally, you’re entitled to free healthcare that covers everything you could possibly need.
Recent reforms to the NHS have caused some controversy, however, it is still known as one of the best healthcare systems in the world.
Thus, it is easy to see why the NHS, while still being a popular target for criticism due to waiting times, low wages for nurses, and the shortage of available beds in hospitals, is more or less unrivaled.
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An Overview of Private Health Insurance
How does health insurance work? Some people choose to take out private health insurance, and many big companies offer their employees a healthcare scheme as part of their package. A private health insurance plan gives you access to private doctors, specialists, and hospitals, as well as NHS facilities.
The benefits include shorter waiting times, private rooms in, and a choice of, hospitals, and the freedom to pick your doctor.
While private healthcare providers do exist, most people buy private insurance to complement the services the NHS offers, and most people won’t need private health insurance in the UK.
Types of Health Insurance Plans
Private health insurance coverage in the UK includes plans, such as individual, family, child, and joint health insurance. Individual health insurance lets you bypass waiting times so you can be treated quickly, while joint insurance could suit a couple without children. Family insurance covers your whole family, while child insurance provides improved service for your children.
There are two more types of private health insurance you should know about: full underwritten and moratorium. For a fully underwritten policy, as opposed to moratorium, you have to give your full medical history and it’s more expensive, however, it covers more.
UK Health Insurance Average Cost
Research by Which?, a UK consumer magazine, showed that for a 55-year-old with no excess or outpatient cover pays around 1,000 GBP per year for private health insurance. This figure went up to 1,375 GBP at 65 years old and more than 2,000 GBP for those 74 years old and over.
If you stay healthy, some insurance companies will give you money back when you next renew your policy.
“The” NHS: Not a National Body?
Technically, the NHS is not a “British” institution in the sense that there is only one body in charge of healthcare across the entire UK. England, Scotland, and Wales actually have separate public health bodies – however, they all are called national health services. The equivalent to the NHS in Northern Ireland is the HSC or Health and Social Care.
In practice, the differences between the services the respective institutions offer are negligible. As a resident of any UK country, you’re entitled to NHS healthcare services in any other part of the UK as well. However, there are a number of more notable differences, for example, in regard to prescription fees.
What Am I Entitled To?
The NHS offers a wide range of services, covering every aspect of healthcare. As per the institution’s core principles, most of the services covered by the NHS are free at the point of use. As well as dental, GP and hospital care, there are some other useful services that will help keep you healthy.
- Pharmacies are not only your go-to institution for obtaining medicine. Pharmacists can also help you with minor ailments
- Sexual health services are always free and include advice and treatment by GPs, in sexual health clinics, STI clinics, sexual assault referral centers, and contraception clinics
- The UK has one of the most comprehensive systems of mental health services in Europe. You can view the full scope of mental health care in the UK on the pages of NHS England
- Getting eye care and having your vision checked is obviously important. However, it is up to your optician or ophthalmic practitioner to decide whether a sight test is clinically necessary. If it’s not, you must pay for it; otherwise, it’s free
Sometimes you can obtain brochures on the different services, as well as consultations, in languages other than English.
Best Private and Public Hospitals
In England, the Care Quality Commission (CQC) works to ensure care centers’ performance is monitored, inspected and regulated. In January 2019, they released a new care directory, with ratings of health and social care services in the UK, including private and public hospitals.
They rate these services either ‘inadequate’, ‘requires improvement’, ‘good’, or ‘outstanding’. Some examples of the best private hospitals, hospices, clinics, and other private services which achieved an outstanding rating, are:
North of England
|Nuffield Health Tees Hospital||Stockton On Tees|
|Greater Lancashire Hospital||Preston|
|Rochdale Ophthalmology Clinical Assessment and Treatment Service||Rochdale|
|Spire Cheshire Hospital||Warrington|
|Spire Washington Hospital||Washington|
|The Christie Clinic||Manchester|
|The Clatterbridge Clinic||Wirral|
Yorkshire and The Humber
|Nuffield Health Leeds Hospital||Leeds|
|Spire Leeds Hospital||Leeds|
|Spire Elland Hospital including Longlands Consulting Rooms||Elland|
|Nuffield Health Hereford Hospital||Hereford|
|Nuffield Health Leicester Hospital||Leicester|
|Nuffield Health Warwickshire Hospital||Leamington Spa|
|The Nottingham NHS Treatment Centre||Nottingham|
|BMI Three Shires Hospital||Northampton|
|Barlborough NHS Treatment Centre||Chesterfield|
|Registered Offices PrimaryCare-Scanning Ltd||Worcester|
|Spire Nottingham Hospital||Nottingham|
South of England
|Nuffield Health Plymouth Hospital||Plymouth|
|Nuffield Health Taunton Hospital||Taunton|
|The Whiteley Clinic Limited||Guildford|
|Circle Hospital (Bath) Ltd||Bath|
|The Whiteley Clinic Bristol||Bristol|
|BMI The Ridgeway Hospital||Swindon|
|Spire Bristol Hospital||Bristol|
|Spire Sussex Hospital||St. Leonards-on-Sea|
|Centre for Sight Limited||East Grinstead|
|Holy Cross Hospital||Haslemere|
|Peninsula NHS Treatment Centre||Plymouth|
|The Royal Buckinghamshire Centre for Rehabilitation and Specialist Nursing||Aylesbury|
|Oxted Health Centre||Oxted|
|Kent Medical Imaging||West Malling|
|The Montefiore Hospital||Hove|
|Centre for Sight Oxshott||Leatherhead|
|Saint Francis Hospice||Havering-atte-Bower|
|The London Clinic||London|
|Demelza, Hospice Care for Children – SE London||London|
|St Christopher’s Hospice||London|
|Greenwich and Bexley Community Hospice||London|
|The Harley Street Clinic||London|
|HCA Healthcare UK at University College Hospital||London|
|The Lister Hospital||London|
|The London Bridge Hospital||London|
|The Portland Hospital for Women and Children||London|
|Bupa Cromwell Hospital||London|
|The Whiteley Clinic London||London|
|Royal Trinity Hospice||London|
|Southleigh Community Independent Hospital||South Croydon|
|Woodleigh Community Independent Hospital||Croydon|
|Cancer Centre London LLP||London|
|Kent House Hospital||Orpington|
|The CyberKnife Centre London||London|
|Shooting Star House||Hampton|
The CQC also reviewed NHS public hospitals and other public health services. Here are some public hospitals in the UK that they class as outstanding too:
North of England
|St Helens Hospital||St Helens|
|Liverpool Heart and Chest Hospital||Liverpool|
|Alder Hey Children’s Hospital||Liverpool|
|The Christie Main Site||Manchester|
|South Tyneside District Hospital||South Shields|
|The Clatterbridge Cancer Centre||Wirral|
|Liverpool Women’s Hospital||Liverpool|
|The Walton Centre||Liverpool|
|Sunderland Royal Hospital||Sunderland|
|Salford Royal Hospital||Salford|
|Royal Liverpool Site||Liverpool|
|Queen Elizabeth Hospital||Gateshead|
|Royal Albert Edward Infirmary||Wigan|
|Thomas Linacre Centre||Wigan|
|Freeman Hospital||Newcastle Upon Tyne|
|Royal Victoria Infirmary||Newcastle Upon Tyne|
|Wansbeck General Hospital||Ashington|
|North Tyneside General Hospital||North Shields|
|The James Cook University Hospital||Middlesbrough|
|Royal Lancaster Infirmary||Lancaster|
|Furness General Hospital||Barrow In Furness|
|University Hospital of North Tees||Stockton On Tees|
|Fairfield General Hospital||Bury|
|Stepping Hill Hospital||Stockport|
|Walkergate Park||Newcastle Upon Tyne|
|Blackpool Victoria Hospital||Blackpool|
|Chorley and South Ribble Hospital||Chorley|
|Burnley General Hospital||Burnley|
|Royal Blackburn Hospital||Blackburn|
Yorkshire and The Humber
|Harrogate District Hospital||Harrogate|
|Sheffield Children’s Hospital||Sheffield|
|Royal Hallamshire Hospital||Sheffield|
|Weston Park Hospital||Sheffield|
|The Royal Stoke University Hospital||Stoke On Trent|
|Kings Mill Hospital||Sutton In Ashfield|
|New Cross Hospital||Wolverhampton|
|Northampton General Hospital||Northampton|
|Birmingham Children’s Hospital||Birmingham|
|The Royal Orthopaedic Hospital||Birmingham|
|Queen Elizabeth Hospital Birmingham||Birmingham|
|Lincoln County Hospital||Lincoln|
|Nottingham City Hospital||Nottingham|
|Queen’s Medical Centre||Nottingham|
|Sandwell General Hospital||West Bromwich|
South of England
|Royal Surrey County Hospital||Guildford|
|Weston General Hospital||Weston-super-mare|
|University Hospitals Bristol Main Site||Bristol|
|Musgrove Park Hospital||Taunton|
|North Devon District Hospital||Barnstaple|
|Milton Keynes Hospital||Milton Keynes|
|Southampton General Hospital||Southampton|
|Queen Alexandra Hospital||Portsmouth|
|Royal Berkshire Hospital||Reading|
|East Surrey Hospital||Redhill|
|Epsom General Hospital||Epsom|
|Conquest Hospital||St Leonards On Sea|
|Royal Sussex County Hospital||Brighton|
|Stoke Mandeville Hospital||Aylesbury|
|St Richard’s Hospital||Chichester|
|The Royal London Hospital||London|
|St Bartholomew’s Hospital||London|
|The Royal National Orthopaedic Hospital (Stanmore)||Stanmore|
|The Hillingdon Hospital||Uxbridge|
|Kingston Hospital||Kingston Upon Thames|
|St Thomas’ Hospital||London|
|St George’s Hospital (Tooting)||London|
|Princess Royal University Hospital||Orpington|
|The Whittington Hospital||London|
|Great Ormond Street Hospital||London|
|Moorfields Eye Hospital||London|
|The Royal Marsden – London||London|
|The Royal Marsden – Sutton||Sutton|
|Chelsea and Westminster Hospital||London|
|Homerton University Hospital||London|
|University College Hospital & Elizabeth Garrett Anderson Wing||London|
|Royal Brompton Hospital||London|
|Mount Vernon Cancer Centre||Northwood|
|Charing Cross Hospital||London|
How to Find a Doctor or Dentist
Generally speaking, you have the freedom of choice when it comes to GP practices. This freedom is somewhat restricted by the fact that practices are only obligated to accept you as a patient as long as you live in the area they service.
Signing Up to a GP
GPs are the first stop for any new UK resident, especially those with health problems, so finding the right one for you could be crucial. As always, word of mouth is key, but there are also special search tools available.
In order to receive any treatment on the NHS, you must be registered at a doctor’s surgery in the UK – so make this a top priority.
While the details of your registration process might vary from practice to practice, the information you have to provide will be the same as in this example form. You might also be asked to show your passport and visa.
Once you’ve signed up, you’ll be issued your personal NHS number. Medical staff across the UK can use it to access your health records. Within a few months from the date of registration, you might be asked in for a health check. This includes questions about your personal medical history and that of your family, as well as a number of tests, such as checking your blood pressure. If you’re not content with your GP, you have the right to change.
My GP: What Do They Do?
Your GP is a highly-skilled professional, knowledgeable and experienced in a variety of fields. These may include ophthalmology, dermatology, reproductive health, diagnosis of acute medical and surgical problems, and more. Some practitioners may also have specialized skills in one of the fields above, or virtually any other. Others may also carry out small procedures, such as minor surgery.
Services all practices provide:
- Issuing an official Statement of Fitness for Work (“fit note”)
- Referrals (to a hospital or a specialist)
- Asthma clinics
- Chronic obstructive airways disease clinics
- Coronary heart disease clinics
- Diabetes clinics
Services that can be expected from every practice, but which are not mandatory:
- Cancer screenings
- Child health
- Maternity services
- Contraceptive services
These are the main services and responsibilities you can expect your practice to offer in almost any case. There are a number of additional services a GP can choose to provide.
Usually, you can find out about the qualifications of a GP in the practice they work in, or by using the NHS service search engine.
How To Find a Family Doctor
The role of a GP has evolved over the years and so-called ‘family doctors’ don’t really exist in the same way in the UK. These family doctors could provide care to you and your family for a large proportion of your lives and they tended to be specialized in certain areas, whereas GPs aren’t, so they might have saved you a trip to a specialist.
Now, you’re more likely to find a GP who shares certain responsibilities a family doctor would have, such as treating several members of the same family and keeping in regular contact with individual patients.
If you’d like to find a doctor who can provide a more personal approach, you can contact your local surgery and ask if someone can fulfill your needs, or even ask friends for a recommendation.
Booking an appointment is straightforward and is usually done on the phone or online. If you need to see your GP urgently, you can also visit the practice and wait. Or you can call at 8:00 to see if you can be seen the same day. In some cases, you can also opt for a consultation via phone or with the practice nurse.
The average wait time to see a doctor in the UK is less than a week. However, figures from 2018 show that 23.8% of patients waited longer than a week for an appointment, while some said they didn’t have a specific day in mind to see their doctor.
You’re Never Short on Information
No other facet of the UK’s healthcare system is as well-documented as GPs and their services. Not only will you be able to get in-depth information on GPs on the various NHS websites, e.g. NHS England, but you can also get all kinds of information brochures either at the practice or online. The excellent It’s Your Practice patient guide will surely answer any questions on general practitioners that might pop up. It’s well worth a look!
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Giving Birth in the UK
Giving birth in the UK for non-residents should be pretty straightforward. The following persons are allowed to give birth in the UK, free-of-charge, on the NHS:
- Ordinarily resident – someone who lives in the UK lawfully and with the intention of settling. It’s up to the NHS to decide if you meet the criteria
- EEA nationals with health insurance from another European state
- Anyone who’s exempt, such as asylum seekers, refugees, people who have lived legally in the UK for at least 12 months, employees of UK business, and the self-employed
Pregnancy tests can be obtained free from your GP or sexual health clinic and they can be purchased for a small fee in any pharmacy or supermarket.
Once you’re certain you’re pregnant, the first person to see is usually your general practitioner. They will guide you through much of the early stages of your pregnancy, take care of many of the necessary tests and scans, and can refer you to another professional, e.g. an obstetrician.
Guiding You Through: Your Midwife
The other person of great importance throughout your pregnancy is your midwife. You’ll usually be recommended a midwifery service through your GP. As a trained professional and expert in pregnancies and births, your midwife is the person who’ll be in charge of much of the prenatal care you receive and, in many cases, is also the person to deliver your child. However, there is a chance you’ll be tended to by different midwives.
Midwives generally work in hospitals, but frequently work out of GP practices and conduct home visits. You will, of course, meet a number of other medical professionals during your pregnancy, but your GP and midwife are arguably your most important contacts throughout. If you are unhappy with the care your midwife offers, you can always talk to their supervisor about your issues and ask to be taken care of by another midwife.
Things to know:
- All necessary prenatal checkups and the birth itself are free of charge on the NHS in the United Kingdom, and you can choose which type of healthcare professional you want to oversee your pregnancy
- Depending on the circumstances of your pregnancy you have a number of options on where to give birth
- It’s important that expat women don’t neglect their health. Luckily, all women’s checkups are free of charge and the NHS will send you a reminder when you’re due for a test
Preparing for Your New Arrival: Prenatal Care
Some of your prenatal care consists of appointments which aim to inform. You’ll get info on nutrition and vitamin intake, lifestyle factors which may be detrimental to your health or that of your child, pelvic floor exercises, breastfeeding workshops, and more. But you’ll also inform your healthcare professionals, for example, of previous pregnancies, any chronic diseases, if your family has a history of inherited diseases, etc.
Of course, regular screenings and tests are another essential aspect of your prenatal appointments. You can get a first overview of the various appointments usually offered to first-time mothers on the NHS England website.
Keeping an Eye on the Little One: Ultrasound Scans
Your GP or midwife will offer you at least two ultrasound scans during your pregnancy. The first one, usually conducted between 8-14 weeks into your pregnancy, determines the due date of your baby, and if you carry more than one child. The second, optional one is conducted between week 18 and 21. It serves to detect possible physical anomalies your unborn child may have. Please keep in mind that this ultrasound scan is not capable of detecting every problem there might be.
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