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An Expat Guide to the UK Health System

If you live in the United Kingdom as an expatriate it is important that you have adequate medical coverage that will provide you with access to care and attention when you need it. In this article we take a look at the public and private sector healthcare provisions in the UK and provide details of who is eligible for them and how they can be accessed.

Public Health Service

A body called the National Health Service (NHS) runs the public health service in the United Kingdom. The NHS was established in 1948 and its role is to provide all UK residents, British Nationals, individuals on the Highly-Skilled Migrants Programme and those in employment and paying tax in the United Kingdom with free access to health care. The underlying philosophy of the NHS is that care should be provided at the point of need. This means that any qualifying individual who needs treatment will be able to access it at any NHS medical institution. The care provided under the NHS is funded by general taxation and the service is run by the Department of Health.

Types of Care Available Under the NHS

The health services that are available in the United Kingdom are divided into two types of services: primary and secondary. Primary level care covers everyday medical services such as access to doctors (General Practioners), dentists, pharmacists and opticians and these are delivered by “primary care trusts”. You can find details of your nearest primary care trust through the NHS website: primary trust care listing. Secondary care provides more specialist services, such as access to hospitals, ambulances and mental health provision and these are delivered by a range of other NHS trusts. The main trusts that are in operation are as follows:

  • Acute trusts: These look after hospitals that provide short-term care, such as Accidents and Emergencies, maternity, surgery and x-ray services.
  • Care trusts: These involve the provision of both health and social care services and include a variety of areas including mental health and counseling.
  • Mental health trusts: There are a number of specialist mental health trusts in England, providing care, such as psychological therapy and specialist medical and training services for people with severe mental health problems
  • Ambulance trusts: These trusts provide transportation services that assist patients to get to and from medical centers.

Who is Eligible for Care Under the NHS?

Generally speaking, the following groups are eligible to receive free healthcare under the NHS:

  • Those who have been living legally in the UK for at least 12 months (temporary absences of up to 3 months are ignored).
  • Individuals who have come to work in the UK, either as an employee or self-employed person. Short-term business trips are not considered to be valid.
  • Any individual who has a permanent residence permit in the UK.
  • Individuals that are studying in the UK on a course that lasts 6 months or more. Those on a course that is less than six months but is substantially funded by the UK government are also eligible.
  • Refugees and asylum seekers or those waiting for an asylum request to be considered.
  • State pensioners that spend less than 6 months a year living in another European Economic Area (EEA) country, but are not a resident of that country.
  • Individuals who are working in an EEA country but are paying compulsory UK national insurance contributions.
  • Overseas expatriates who have been working abroad for less than five years but have lived in the UK for ten continuous years at some point.
  • Individuals who are from an EEA country but are referred to the UK for specified treatment with an E112 or E123 form.
  • Unpaid workers who are employed by a voluntary organization that offers services similar to those of a Health Authority of Local Authority social services department.
  • Individuals who are employed on a ship or vessel registered in the UK or working offshore on the UK sector of the Continental Shelf.
  • Members of the UK armed forces, or a UK civil servant working abroad who was recruited in the UK and employed by Her Majesty’s government.
  • Workers who were recruited in the UK but currently work abroad for the British Council or the Commonwealth War Graves Commission.
  • Those drawing a UK war disablement pension or war widows pension.
  • Diplomatic staff who work for overseas embassies that are based in the UK.
  • Individuals who are currently working abroad in a job that is financed in part by the UK Government.
  • Prisoners and immigration detainees.
  • All NATO personnel who are posted in the UK and are not using their own or UK armed forces hospitals.
  • Individuals who have been referred by their home country for specified treatment in the UK under the terms of a bilateral healthcare agreement.
  • Missionary workers who are based overseas working for an organisation that is principally based in the UK.
  • Any individuals who have been formally identified or suspected as being a victim of human trafficking.
  • You are the spouse, civil partner or dependent child of anyone who is exempt under the above criteria, if you are living permanently with the exempt person. Visiting the exempt person for a few weeks or months does not constitute exemption.

Individuals who are not eligible under the above categories may still be eligible for free medical assistance if their condition became evident after they arrived in the UK and they meet one or more of the following criteria:

  • They normally live in another EEA member state but is visiting the UK.
  • They are the spouse or child of anyone, receiving a UK state pension who has either lived legally in the UK for 10 continuous years at some point or has worked as a UK Civil Servant for at least 10 continuous years.
  • They are the spouse or child of anyone, who is a national of a country that has signed the European Social Charter but is not entitled to be provided with services under a bilateral agreements (currently Turkey and areas of Cyprus not covered under the EEA arrangements) and is genuinely without the means to pay for their treatment.
  • They are, or are the spouse or child of anyone, who has lived legally in the UK for 10 continuous years at some point but who is now living in another EEA member state or in certain countries with which the UK has a bilateral healthcare agreement.
  • Anyone who is entitled to receive industrial injury benefit from Israel if the treatment is in connection with the industrial injury.
  • Anyone living in a country with which the UK has a bilateral healthcare agreement.

If you do not meet the above criteria then you will need to arrange private medical insurance to cover your stay in the United Kingdom.

Registering for the National Service

If you relocate to the United Kingdom and are eligible for care under the NHS, the first thing you should do is register with your local doctor (general practitioner) and they will assist you to complete the necessary paperwork to register for the NHS. A few weeks later you will receive your National Health Service Number through the post and you will need this whenever you need medical care. You can find your local GP on the NHS website.

Receiving Care

If you are feeling ill and need non-urgent medical attention you should visit your local doctor (GP) in the first instance. They may then refer you for more specialist medical attention if your condition warrants it. Visits to your local GP are free of charge if you are eligible for NHS care. If you need any prescription medication you will be expected to pay a 6.00 GBP flat rate per prescription.

Accessing Emergency Care

If your need for medical attention is more urgent, you have three options:

  1. Accident and Emergency: The A&E departments in hospitals are strictly reserved for people who have serious injuries or serious illness that required immediate treatment. You can find out more about A&E on the NHS website.
  2. Walk in Centres: Walk-in centres offer access to medical advice, emergency contraception and for treatment for minor injuries, such as cuts, burns and sprains. More about walk-in centres.
  3. Minor injuries units: For treatment of such things as cuts, sprains, minor burns or broken bones.
More about minor injuries units.

If you are unsure as to the level of care you need, you should contact NHS Direct on 0845 4647 for further advice.

If you have a life or death medical situation on your hands you should always dial 999 to access emergency help and assistance.

Private Health Service

In addition to the NHS there is also private healthcare available in the United Kingdom. People can gain access to this level of care by making regular insurance payments or paying for services when they need them. The number of private healthcare facilities available in the United Kingdom is much smaller than those available under the NHS but they are often considered to be able to provide superior levels of care in a more accessible and efficient manner. Private health care services are very similar to those available under the NHS in the fact that they provide access to doctors (GPs), nursing homes, ambulances, hospitals and medical specialists. However, private service providers are under no obligation to follow the national treatment guidelines that are outlined by the government and they do not have any responsibility for the health of the wider local community.

Private Health Insurance Schemes

Many people access private health care through membership of a health insurance scheme. Details of health insurance providers in the UK can be found here: private health. Expatriates who are living in the United Kingdom are often provided with private medical insurance as part of their relocation package.

The cost of private medical insurance in the UK

The majority of medical insurers in the UK provide different levels of cover that allow you to select coverage for the services that meet your needs. The more services you require, the higher your insurance premiums will be.

The average fully-comprehensive policy for a single person in their forties would be around 145 GBP per month, while a very basic policy can start from just 15 GBP per month.

If you are not eligible for help under the NHS and do not have insurance provided by your employer you will need to arrange a private insurance policy. While you may be tempted to sign-up for the cheapest insurance on the market, you should also ensure that the coverage that such a policy will be sufficient enough to meet all your needs. See our free medical insurance checklist for more information.

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