The Relocation Bureau

Health

The UK’s approach to healthcare is different to that of most other countries. This web section sets to explain how both the state National Health Service, and private options, all work together. We explain how to register with a GP, and how to find a dentist. We also explain how maternity care works, the differences in access to paediatric care, and choices on opticians.

Health In The UK

Doctors

The first thing you need to do, as soon as possible after arriving in the UK to live, is to register with a GP (General Practitioner), please see our page Family Doctors/GPs. You can register with a GP either in the Private sector or with the NHS. Some GP's work in both sectors, the advantages of using a private GP is prompt appointments and more time for consultations. When you are feeling ill your first port of call will be your doctor. After the consultation your doctor may offer advice, prescribe a course of treatment or refer you to a specialist or hospital if necessary, at which point you also have the option to be treated privately or on the National Health Service (NHS), please see our page National Health Service.

The National Health Service (NHS)

The State provides free healthcare which is funded by public money, paid as Income Tax and National Insurance contributions. Anyone who makes these payments is entitled to free healthcare on the NHS. Even if you have private medical insurance you are entitled to use any of the services offered by the NHS.

Most visitors to the UK, whether short term or long term, will be entitled to some free healthcare. Guidelines explaining who is entitled to free NHS treatment are available from the Department of Health.
www.gov.uk/guidance/nhs-entitlements-migrant-health-guide

Private Patients

If you have Private Medical Insurance you can choose from the private options available, provided that they are covered by your medical insurance policy. Alternatively, you may decide to fund appointments or treatment yourself. The main advantage to private healthcare in the UK is the speed at which appointments and treatment are available compared to the NHS. Please see our page on Private Healthcare.

Accident and Emergency (A&E)

Treatments provided in an A & E department are free for everyone until the patient is admitted to hospital; at which point the regulations regarding who is eligible to receive free treatment come into effect.

More information about A & E can be found in the NHS section. Please see our page Hospitals for information about hospitals in the UK.

Useful Websites

National Health Service

The NHS is answerable to Parliament and managed by the Department of Health. It was established in 1948 to provide free healthcare for all citizens, regardless of ability to pay.

Doctors, dentists, opticians, pharmacists, ambulance services and hospitals are all part of the NHS, although these services are also available privately. Treatment at NHS hospitals and visits to your doctor are free at the point of use. Appointments and any treatment received from NHS dentists and opticians are subject to additional costs. Any medication prescribed by your doctor to collect from a pharmacy is chargeable, which as of April 2016 is £8.20 per item.

There are certain groups that are exempt from these charges. Children under the age of 16 or 16-18 and in full-time education and state pensioners are exempt from charges for prescriptions, dental treatment and eye tests. Pregnant women do not have to pay for dental treatment or prescriptions until their infant are one year old, provided they have a maternity exemption certificate.

Healthcare for expatriates living and working in the UK

Most visitors to the UK, whether short term or long term, will be entitled to some free healthcare. Guidelines explaining who is entitled to free NHS treatment are available from the Department of Health. Even if you have Health Insurance which enables you to use Private Health Care, the NHS is also available to you and may be your preferred option.
www.gov.uk/guidance/nhs-entitlements-migrant-health-guide

NHS

The NHS offers a very comprehensive service and whilst some hospitals may look shabby, the medical facilities are very good. You may not necessarily be referred to your nearest hospital for treatment but to the nearest specialist unit that would be appropriate for your needs.

Hospital waiting lists can be long but you have a legal right to start non-emergency NHS consultant-led treatment within a maximum of 18 weeks from referral. Waiting times for operations vary from hospital to hospital and different health authorities across the country, you should discuss your options with your GP prior to exercising your right to choose. This is the main reason for people choosing private treatment.

The NHS Gateway website has a useful links to other web sites.
www.nhs.uk

Many hospital consultants often work in both the NHS and the private sector.

NHS Direct

Call 24 hours on: +44 (0)845 4647

NHS Direct is a telephone helpline that was set up to ease the workload of GPs and the A&E departments. Staffed by nurses and trained professionals, they are on hand 24 hours a day, every day, to offer advice on health concerns. If necessary, you can be connected to the emergency services. Calls are charged at local rates and are recorded.

It is particularly useful to have this helpline available outside of normal surgery hours if you are feeling ill and are not sure what to do. The NHS Direct website has a useful checklist to follow if you are not sure who to contact in case of illness or accident. If immediate, possibly life saving treatment is required, it will be obvious and you should call the emergency services on 999.

Their website also includes useful information such as a family health encyclopedia, local information database and a 'best treatments' area.
www.nhsdirect.nhs.uk

Private Health Care & Insurance

The use of Private health care in the UK has grown considerably and many UK companies offer their employees private health care insurance as part of their contracts. Although it is classed as a taxable benefit it is nevertheless highly valued.

If you have a private healthcare insurance policy it is advisable to check what, if any, coverage you have abroad before you move. You may need to increase your premiums to provide the extra cover whilst you are living abroad.

The majority of private treatment takes place in dedicated hospitals or clinics. Again, it is advisable to check with your insurance provider to see if your cover is restricted to particular hospitals or whether you can choose which hospital or clinic you wish to be treated in.

Some private treatment is also available within NHS hospitals, and whilst they may not offer the same level of comfort as private hospitals, they are competitively priced. There is the added security within NHS hospitals of knowing that there is a full range of general and specialist medical services on site at all times. In fact in the event of emergency complications, some patients in private facilities may have to be transferred to NHS hospitals.

For more information about private healthcare go to:
www.privatehealth.co.uk

The Harley Street guide is aimed at patients from the UK and abroad who are seeking information about doctors, dentists, hospitals and medical and clinical services available.
www.harleystreetguide.co.uk

Major Healthcare Insurers in the UK
  • Aviva Healthcare

    Each Aviva Healthcare plan has a hospital list from which you can choose where to have your treatment as an in-patient or day-patient.
    www.aviva.co.uk/healthcarezone

  • BUPA

    Bupa is a global health and care organisation, with members in nearly 190 countries worldwide. In the UK BUPA works in association with Spire Healthcare using their network of hospitals.
    www.bupa.com
    www.spirehealthcare.com

  • PPP Healthcare

    PPP Healthcare is one of the UK's leading Medical Insurers and is part of the AXA insurance group.
    www.axappphealthcare.co.uk

Family Doctor / General Practitioner

When you have a medical problem the first person to visit should be the doctor, unless it is an emergency, in which case it will be your nearest A&E Department. General Practitioners normally work from a surgery or practice, with several other doctors. You will need to register with one of the doctors at the surgery in your area before you can make an appointment to see any of them.

Registering with a Doctor

It is probably best to find a surgery close to where you and your family will be living, or one that has been recommended to you, and pay them a visit. The receptionist will help you register and advise you on the services available at the surgery. Most surgeries will have a practice nurse, and there may also be other facilities on offer, such as a well woman/man clinic or an ante-natal clinic.

After filling in the forms, you will probably be asked to make an appointment to see the doctor or the practice nurse for a routine check-up. The surgery will apply for your medical card and obtain an 'NHS Number' for you, and the members of your family who require one. This may take a while but you will be able to go to your GP for treatment in the meantime.

Since January 2015, all GP practices in England are free to register new patients who live outside their practice boundary area, but it is for a practice to decide, at the point of registration, whether it is clinically appropriate and practical to register individual patients in that way.

If you wish to find a private GP service Private Healthcare UK has a good database. 247-GP is a private telephone consultation service which offers access to a private GP by telephone at any time for an annual fee. An operator will take brief details from you and arrange for a doctor to call you back at a time that is convenient to you.
www.privatehealth.co.uk
www.benenden.co.uk/health/cover/healthcare/247-gp-advice-line

Appointments

You may not be able to see the same doctor on every visit as they may not have an available appointment. You will be offered the next available appointment which may be with any of the other doctors at the practice. Alternatively, you may be able to request a later appointment with your own doctor.

Depending on the nature of your problem, the GP may be able to treat you himself or refer you to a specialist. At this point you also have the choice to be referred to a consultant privately or on the NHS.

Most doctors will also make house calls, normally after morning surgery, if the patient is too poorly to go to the surgery.

Find a GP in your Area

You can use the NHS service below to find the nearest GP surgeries to you by entering your postcode.
www.nhs.uk/Service-Search/GP/LocationSearch/4

Hospitals

There are two types of hospital in the UK, NHS and private. Your GP will refer you to hospital for treatment or consultation and you can choose a private or an NHS facility. The great advantage of choosing a private consultant is that you will get an appointment within the month, if not within days, whereas you are likely to have to wait some months to see anyone on the NHS.

NHS Hospitals

Most NHS hospitals now have some private facilities and consultants who are available to see privately. Their prices are competitive with private hospitals and there is the added assurance that there is a full range of general and medical services on site at all times. In fact, in an emergency, private patients are sometimes transferred to an NHS hospital.

NHS hospitals are managed by NHS Trusts which are responsible for ensuring that the hospital provides a high quality of care and that it spends its money efficiently. The trusts are also responsible for employment of most of the hospital staff, including non-medical employees.

Some hospitals have specialist units, where patients from other hospitals may be sent for treatment. Some are teaching or research hospitals where the latest medical techniques are developed. Some specialist hospitals in the UK are world famous. The following table shows some UK hospitals with specialist facilities.

Great Ormond Street - Children's hospital www.gosh.nhs.uk
Royal Brompton & Harefield -Heart and lung specialists www.rbht.nhs.uk
Stoke Mandeville - National Spinal Injuries centre www.buckinghamshirehospitals.nhs.uk/NSIC Home/spinal
Mount Vernon - Plastic and reconstructive surgery, burns and a cancer unit www.thh.nhs.uk/About/mountvernon.htm
John Radcliffe - has many specialist areas and also home to the Institute for Molecular Medicine www.ouh.nhs.uk/hospitals/jr/default.aspx
Kings College Hospital - Liver disease and transplantation, foetal medicine, neurosciences and cardiology. www.kch.nhs.uk
St Mary’s Hospital - National Prion Disease Clinic, Recurrent Miscarriage Clinic www.imperial.nhs.uk/our-locations/st-marys-hospital
Queen Charlottes Hospital - Maternity www.imperial.nhs.uk/our-locations/queen-charlottes-and-chelsea-hospital

If you wish to search for a hospital offering a particular service, search the database at:
www.nhs.uk

Since April 2009 a new government initiative known as the Patient Choice initiative has been brought in to allow NHS patients to choose which hospital they receive their treatment in if they are being referred to a specialist by their GP. Patients can choose any hospital capable of providing appropriate treatment that meets NHS standards and costs and can be either run by the NHS or private. More information on this initiative can be found at:
www.nhs.uk

Accident and Emergency (A&E)

Not all NHS hospitals have an A&E Department, to find the nearest one to you search the database at the NHS or if you have an emergency, dial 999 and ask where the nearest emergency unit is. You can also ask for an ambulance from this number.
www.nhs.uk/Service-Search

You may find you have a long wait at A&E as the most serious cases take priority. If you do not think that the situation is serious, you can call your GP for advice. Alternatively you can call 111 for medical advice. If they think it's necessary, the medical advisor can transfer your call to the emergency services to request an ambulance.

Private Hospitals

BMI Healthcare is the largest independent provider of acute surgical services in the UK. There are 59 BMI hospitals and treatment centres in the UK, each with a High Dependency Unit and the facilities to undertake complex and advanced surgical procedures, such as cardiac and neuro surgery.

There are two ways to pay for treatment at a BMI hospital, either by a medical insurance policy or by one of the company's self-pay schemes.
www.bmihealthcare.co.uk/hospitals

Nuffield Hospitals are the biggest, not-for-profit acute services network in the UK. There are 29 hospitals, 5 medical centres and 75 fitness and wellbeing centres in England and one hospital in Scotland. Nuffield Hospitals provide a full range of healthcare facilities from diagnostic to surgical.

Nuffield Hospitals also have their own payment schemes for people without private medical insurance.

Formerly BUPA Hospitals, there are 51 Spire Healthcare hospitals and clincs in the UK which are open to anyone; you do not need to have BUPA medical insurance. If you are an NHS patient who cannot be treated within a specified time at a NHS hospital, you may be offered treatment at a private hospital instead, depending on the agreement that has been made by your NHS Trust. All costs of the treatment will be funded by the NHS, but you will have to pay for sundry items such as telephone calls and newspapers.
www.spirehealthcare.com

Aspen Healthcare own and manage four acute private hospitals, one cancer centre and three ambulatory day surgery centres. They are owned by Tenent Healthcare, a leading provider of diversified healthcare services in the United States.
www.aspen-healthcare.co.uk

Ramsay Healthcare (formerly Capio) have 22 private hospitals, 9 treatment centres and 3 neurological units in the UK. Ramsey Healthcare is included in the NHS Patient Choice government initiative.
www.ramsayhealth.co.uk

HCA International has 6 acute hospitals in London and is part of an American company, Hospital Corporation of America, which also has hospitals in the USA and Switzerland. The London Hospitals include the Portland which is London's only private hospital dedicated entirely to women and children.
www.hcahealthcare.co.uk

Maternity

If you think you are pregnant you should firstly visit your GP. Your GP will discuss plans for your antenatal care which may either be provided by your GP's practice, at a local NHS hospital or with a private health facility. He will write you a letter of referral to the hospital of your choice.

The majority of your antenatal care will be conducted by a midwife, a specialist who is qualified to give total care to a woman and her baby during pregnancy, labour and after the baby is born whether in a maternity hospital or at home. Most GP surgeries will have community midwives who work for the NHS and visit the GP surgeries in their area to conduct the antenatal check-ups.

The Independent Midwives Association is a group of fully qualified midwives who have chosen to work outside the NHS in a self-employed capacity. Their role encompasses the care of women during pregnancy, birth and afterwards. Your GP can inform you of your nearest Independent Midwife.

Whether at the GP surgery or at the hospital, your first appointment (called the booking in appointment) will be longer than the usual antenatal check-ups. The midwife will ask you about your medical history and conduct some assessment tests, such as blood pressure, weight and take a blood sample. The midwife who provides your antenatal care will not necessarily be the person who will deliver your baby.

NHS Maternity Hospitals

www.midwife.org.uk/hospitals.htm

Your GP will advise you of the hospitals in your area that provide maternity services. Most maternity departments conduct tours of the labour ward at specified times, your midwife or doctor will advise you of the procedure for arranging a tour.

Some NHS hospitals will have consultants who can be visited privately. Your GP can refer you as a private patient if you wish. Probably your only contact with the consultant will be when he delivers your baby. All antenatal and labour care will be conducted by a midwife. Your stay in hospital is likely to be in a private room in the postnatal ward of the hospital, and care received will be the same as NHS care. Postnatal care is from the community midwives from the GP surgery.

The recommended hospital stay is one night for a first baby to establish feeding but can be as little as 6 hours for subsequent births.

Postnatal care is conducted by community midwives who will visit you at home. A 6 week check is carried out by the GP at the surgery for you and your baby.

Private Maternity Hospitals

Private maternity care is available at many hospitals but two in London with excellent reputations are:

The Portland Hospital

The Portland Hospital has established a worldwide reputation for the care of women and children. Commitment to the needs of their patients is demonstrated by consistent evaluation of new developments in the medical world and, if appropriate, making them available. The Portland Hospital has its own Special Care Baby Unit.
www.theportlandhospital.com

St Mary's Hospital

St Mary’s Hospital in Paddington offers a full range of maternity and obstetric services from midwifery-led care to complex high risk obstetric-led care. Private care is offered by consultant obstetricians with the purpose of providing a specialised continuity of care from conception to delivery and beyond.
www.imperial.nhs.uk/our-locations/st-marys-hospital

Paediatrics

Most NHS hospitals have a Paediatrics department available to both NHS and private patients. You can check the services available at the hospitals in your area on the NHS website below. Your GP will be able to provide you with more information. Most hospitals will allow a parent to stay overnight with their child, and a few have residential facilities.
www.nhs.uk/Service-Search

Great Ormond Street Hospital for Children

This is Britain's biggest and best known specialist hospital for children. Great Ormond Street is dedicated to treating and caring for children and every year over 100,000 children from across the country and overseas, go there for treatment.

Great Ormond Street has accommodation for over 1000 parents of children receiving treatment. Accommodation is provided for one parent or two parents if their child is receiving intensive care and is free of charge.

There are two Nuffield wards in the hospital which are dedicated to the treatment of international and private patients. Interpreters are available if you do not speak English.

Specialist doctors from Great Ormond Street also go to local hospitals where they offer expert advice on a wide range of children's medical problems from heart disease to asthma. An increasing number of different clinics operate regularly across the country.
www.gosh.nhs.uk

The Portland Hospital for Women and Children

The Portland Hospital is part of HCA International and is London's only private hospital entirely dedicated to the treatment of women and children.

Their Paediatrics unit cares for babies, toddlers and children up to the age of 16 years who require treatment and support for a wide range of conditions. These include oncology, urology, neurology, orthopaedics, ophthalmology, ENT and long stay rehabilitation.
www.theportlandhospital.com

St Mary's Hospital

St Mary’s Hospital has a dedicated children's Accident & Emergency department. The hospital has developed a series of specialities within paediatrics, which include paediatric allergy, infectious diseases, HIV, paediatric and neonatal intensive care, and respiratory medicine and nephrology.

St Mary's pioneered a special retrieval unit for collecting critically ill children from other hospitals, which has since been copied and adopted by other units within the hospital.
www.imperial.nhs.uk/our-locations/st-marys-hospital

The Royal Brompton Hospital

The Royal Brompton is a heart and lung specialist hospital and has a paediatric department specialising in these areas also. The hospital has the largest cystic fibrosis clinic in Europe, and is a world leader in development of new treatments for the disease.
www.rbht.nhs.uk

The Royal National Orthopaedic Hospital

Located in Stanmore, Middlesex, the RNOH is recognised as a national centre of excellence for the treatment of musculoskeletal conditions in children. Their paediatric specialities also include a cerebral palsy team, limb lengthening and pain management.
www.rnoh.nhs.uk

Pharmacists, Drugs & Medicines

Pharmacists, also known as chemists or druggists, are experts in the safe and effective use of medication. They are qualified to advise you and may be able to suggest medication for you without the need for a visit to your GP. They will recommend a visit to the GP if they think it is necessary.

Pharmacies are located in most towns and villages alongside other high street stores. Boots the Chemist is probably the largest and most well-known chain in England, and branches can be found in most High Streets and shopping centres. Most large supermarkets now have an in-store pharmacy counter as well.

Prescriptions

If your GP decides to treat you with a course of medication he will give you a prescription which details the drug and dosage required. You will need to take this to a pharmacist who will ask you to complete and sign the declaration on the prescription. This confirms your identity and whether or not you are exempt from prescription charges. Information about exemption from charges is available on the Department of Health website.
www.nhsbsa.nhs.uk/1126.aspx

Although pharmacists are part of the NHS and their advice is free, prescribed medication has to be paid for and is currently charged at £8.20 per item. If you have been prescribed a drug that can be bought over the counter it may be cheaper to pay for it this way rather than by prescription. Your pharmacist will generally advise you if this is the case.

If you know you will have to pay for more than 3 items in 3 months or 14 items in 12 months, you can save money by paying for a Prescription Pre-payment Certificate. Details of how to buy a PPC are available, please see below.
www.nhsbsa.nhs.uk/1127.aspx

Repeat Prescriptions

GPs will only prescribe a relatively small amount of a drug at any one time (usually a month's supply) and many drugs only have a limited shelf life. If your treatment is continuous you will need to get repeat prescriptions from your doctor. Most GPs have a limit on the number of repeat prescriptions they will issue and will ask to see you again in a few months to manage your progress.

Identifying your Medication

If you are taking a specific medication from your home country it may have a different name in the UK. You will obviously need to ask your doctor for his recommendation but a good source of information is the Electronic Medicines Compendium. This can be found on the below website.
www.medicines.org.uk/emc/search

Dental Care

Many dentists offer both NHS and private dental treatment. If dental treatment is clinically necessary you should be able to get it on the NHS.

Children, pregnant women, women with a child under the age of 1 year old, and people receiving state benefit are exempt from any charges for dental treatment.

If you are registered as an NHS patient, your dentist is obliged to give you any treatment that is necessary to maintain your oral health. If your dentist cannot provide you with any NHS treatment options, you are entitled to be referred to another practice or hospital within the NHS. Most cosmetic treatments are not carried out under the NHS. Any treatment carried out on the NHS is guaranteed for one year and if necessary, will be replaced free of charge within this time.

All dental patients have the right to a free choice of dental practitioner and the option to change if necessary. Patients should also have access to emergency advice and treatment outside of normal working hours. Visit the NHS website to search for a dentist near to you. The search results also specify whether the dental practice is registering NHS patients or not.
www.nhs.uk

Costs and Payment

Dentists are not employed by the NHS but are independent businesses that have to make their practices financially viable. A comparison of NHS and private charges for dental treatment shows the reason why most dentists nowadays only offer private treatment. The current NHS dental costs can be found via the below link.
www.nhs.uk/NHSEngland/AboutNHSservices/dentists/Pages/nhs-dental-charges.aspx

All dental practices will have a list of their private prices on display and are obliged to inform you how much your treatment is going to cost.

Methods of payment vary from practice to practice so it is advisable to find out when you will have to pay before you start a course of treatment. Some practices may allow you to pay in instalments or at the completion of the treatment, whilst others may ask for payment up front.

If you already have Private Health Insurance you may want to check if dental cover is included. If it is not then you may wish to consider separate dental insurance, either with your Private Health Insurer or with one of the UK's dental insurance companies. Most people in the UK pay for dental treatment out of their own pocket.

With fixed monthly payments, Denplan can help you to budget for regular, preventative dental care. In addition to personal dental payment plans, Denplan also provides corporate dental cover for employee benefit schemes.
www.denplan.co.uk

Opticians

Optometrists or ophthalmic opticians carry out eye tests to determine the quality of your eyesight. They also examine the eye for any sign of disease which may need treatment from a doctor or eye surgeon. They prescribe and fit spectacles or lenses to correct any defects in your eyesight.

Ophthalmologists are medical eye doctors who specialise in the diagnosis and treatment of eye disorders and diseases. They prescribe medication and perform surgery where necessary.

Dispensing opticians do not carry out eye tests or prescribe spectacles and lenses. They interpret prescriptions supplied by optometrists and ophthalmologists and can give advice on types of lens and frames which they then have made up.

Orthoptists diagnose and treat anomalies of binocular vision, which are normally associated with the misalignment of the eye. Most of their work is with children as they treat defects such as squints and lazy eye. They also carry out screening for visual defects in schools and clinics.

Sight Tests

The Royal National Institute for the Blind recommends that you have an eye test once every two years. The optometrist can detect any eye disease before you notice the effects on your eyesight, and can possibly prevent your eyesight from deteriorating any further.

You can visit an optometrist of your choice; you do not have to be referred by your GP. You can search for the opticians in your area on the NHS website below. Opticians and most optometrists are independent businesses and their shops can be found on the high street. You can walk in off the street and request an appointment for an eye test. Eye tests can cost between £15 and £30, but there are exemptions to payment such as under 16’s, under 18 in fulltime education and over 60's. An eye test will take about 30 minutes and you are entitled to request a copy of your prescription at the end of the test. You are not obliged to purchase your spectacles from the same place that you had your eyes tested.
www.nhs.uk/Service-Search/Opticians/LocationSearch/9

National Opticians

The following list represents the largest national chains of opticians. You will also find independent opticians in your area, and it may be worth visiting them all to find out where you feel most comfortable.

Many have an online catalogue which enables you to make an initial selection before you visit the store and an online facility to see your image in various frames by downloading a photograph of yourself.

  • Boots Opticians

    Boots Opticians are to be found in most Boots Chemists stores on the High Street. Some have their own dedicated stores. You can search for your nearest Boots Opticians on their website.
    www.boots.com/en/Opticians

  • Vision Express

    Vision Express also has stores on the High Street. You can search for your nearest Vision Express on their website.
    www.visionexpress.com

  • Specsavers

    Specsavers are another chain of high street opticians. You can search for your nearest Specsavers on their website.
    www.specsavers.co.uk