UK Healthcare – the basics
The National Health Service (NHS) provides virtually all primary care services in the UK. Even full private health insurance cover does not pay for General Practitioners (GP’s). All access to health care in the UK is via a GP, and becoming registered at a local GP surgery is the first step you should take when first moving into the UK.
The European Health Insurance Card
If you’re from a European Economic Area country, you may already be in possession of an EHIC (European Health Insurance Card). However despite the name of this card – it’s not intended to replace insurance. It entitles you to the same healthcare that a UK citizen would be entitled to. So if there’s a charge for, say dental work or drug treatments on prescription, you’ll need to pay for these too.
The other thing to remember about the EHIC is that it’s not designed for expatriates. If you hold an EHIC from a European Country but are resident in The UK, then you’ll need to apply for a UK card when you get here.
Registering with a GP
First of all, you will need to find out which surgeries in your local area are taking on new patients. The NHS is arranged as a group of Primary Care Trusts, each controlling the provision of healthcare on a regional basis. It is the Primary Care Trust for your region who will be able to tell you which local surgery or surgeries are able to add you to their patient list. Here’s a link to the NHS website where you can type in your postcode and find out the telephone number of your PCT: http://www.nhs.uk/ServiceDirectories/Pages/ServiceSearchAdditional.aspx?SearchType=PCT&ServiceType=Trust
As part of the GP registration process, you will be required to fill out a series of forms – the content of these forms can differ between surgeries and you may or may not be required to attend the surgery for an initial health check and consultation with a nurse, but once your registration has been fully processed you will receive your NHS card – this will arrive in the post.
GP Appointments
Once you are registered at a surgery, you won’t need to do anything else until you need an appointment. The timescales involved in making appointments to see your doctor can vary massively between surgeries. If you would like to see a specific doctor the waiting times can be lengthy, and if your problem is not urgent, is not uncommon to have to wait days or even weeks for an appointment.
Some surgeries operate a system where you are required to phone as soon as the surgery opens in order to make an appointment that day – refusing any advance bookings, instead allocating appointments on a first come first served basis. There is no central control which governs how a surgery’s appointments process can operate, so one of the things to think about when you initially register with a surgery is whether or not their system of appointments matches you and your lifestyle – otherwise you could find the whole thing very frustrating!
Accessing specialist consultants
If you need to see a consultant, your GP will have to refer you. Even if you have private health insurance you will need a GP referral before you will be able to register a claim with your insurers and get authorisation to see a specialist. Whether you see a specialist privately or via the NHS, the consultant will probably be exactly the same doctor, only the waiting time for an appointment will be different (depending on the department). The NHS waiting lists are notoriously long and can be anything from weeks to months, or even years. If you go privately you will usually get an appointment at your earliest convenience. As with everything, with healthcare in the UK you seem to get what you pay for.
Emergency services
If you have an emergency, it’s a different story entirely. Ambulance services in the UK are free, if you need one just dial 999 and one will take you directly to the accident and emergency department (A&E) of the nearest hospital. If your call out is deemed unnecessary, you might be presented with a bill for wasting their time but in all cases of severe trauma, suspected heart attack or stroke, the emergency services respond fast and efficiently, and even if the call is a false alarm which turns out to be nothing more than indigestion, for example, the message is to always call an ambulance – you won’t be charged if the grounds for calling were serious, regardless of the ouotcome.
Of course, you don’t have to go to A&E by ambulance – you can make your own way to the hospital and admit yourself. You will be asked a number of questions as part of the admission process and then required to sit and wait until someone can see you. Triage can be very slow, and you might find yourself in the waiting room for a number of hours depending on how urgent your problem is compared to everyone else who is waiting. If you are admitted to hospital via A&E and require a procedure, or further stabilisation you will be moved to a ward. This can be at a private hospital if you have health insurance, or are willing to pay – so ensure you make this known. Be aware of what your insurance will pay for though – many policies only cover scheduled procedures, others cover the procedures but not rehabilitation. Read your policy document carefully before you make any rash decisions and end up with a huge bill. Nothing impedes recovery quite like the worry of what it might be costing you!
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