If you are moving to England to work in the global financial hub that is London, or one of many other large cities across the country, there is a lot to get to grips with regarding the healthcare system.
We want to help you understand the difference between public and private healthcare in England, how to access them, and the impact Brexit may have.
Public healthcare in England is administered by the National Health Service (NHS). The NHS provides all levels of healthcare from community healthcare to hospital care. Most services through the NHS are free, with a few notable exceptions like:
In 2014, the Commonwealth Fund declared the NHS in England the most impressive public healthcare system when compared to 10 other European and North American countries. If you are a citizen of a European member state, you can access free treatment under the NHS once you are living in England with a valid visa or work permit.
If you are not a European Union Citizen you will only have the right to access the NHS for free once you have an immigration status of ‘indefinite leave to remain’. This means you have permission to stay in England for as long as you wish.
If you are moving to the UK for less than 6 months you may be charged for NHS services unless an exemption applies to you. If you are moving to the UK for more than 6 months but do not meet the requirements to be considered a resident then you will be charged an immigration health surcharge of:
You will pay this when you are applying for your visa. Once you have paid this charge you can access NHS services for free. However paying the surcharge does not mean you can avoid waiting lists or will be treated faster, it only allows you to access the NHS. Your needs will be assessed and, again, you may be added to a waiting list for treatment in a hospital.
The first thing you need to do to access medical treatment in England is register with a family doctor known as a General Practitioner (GP). You are entitled to choose the GP practice that best suits your needs. A GP can refuse you if:
However they cannot refuse to register you for discriminatory reasons like race, religion or an existing medical condition. The NHS covers all GP visits and routine healthcare. If needed, your GP will refer you for hospital treatment. If your condition is not urgent you may be placed on a waiting list.
Private healthcare is also available in England. Expats who have international health insurance can access private health cover if hospital treatment is needed.
As a private healthcare patient in England you can expect:
For these reasons it is well worth considering international health insurance while you are working in England.
It is as yet unclear what the impact of Brexit will be on healthcare for expatriates. It is possible that all expats in England will be treated in the same way when it comes to accessing the NHS whether they are from EU countries or not. Over the coming months and years, clarity will ensue and a better perspective on the realities of Brexit will develop.
If you want to find out more about international health insurance in England contact us, we would be happy to answer any questions you have.
With its gorgeous highlands, shimmering lochs and ancient castles, Scotland has a lot to offer. Friendly locals make it easy to feel at home in the birthplace of William Wallace, and there’s plenty to see and do throughout the country.
The healthcare system is relatively simple and easy to use, and most expats will qualify for free and subsidised care.
The healthcare system
The National Health Service (NHS) is the backbone of public healthcare throughout the UK and was initially conceived as a universal healthcare system. However, as each of the UK’s four countries are free to adapt the system, there are cross-border variations in policies. These have a knock-on effect on service efficiency and quality – though wherever one is in the UK, healthcare on the whole is of a high standard. That said, there are areas where Scotland stands out. For example, it has the UK’s highest ratio of GPs per person.
There are both public and private hospitals in Scotland, but in practice, there is little difference between the two. The quality of care is equally good and the same doctors often work in both sectors. If a patient needs something that is covered under the public system but for any reason can’t be provided by a public hospital, the NHS may send them to a private hospital. This is at no extra cost to the patient.
Health insurance
Anyone with a visa valid for more than six months is entitled to use the NHS, though a surcharge must be paid to access it. Thereafter, expats have the same healthcare benefits as citizens. This includes GP consultations, hospital visits, emergency treatment and prescribed medication at no cost. Some medical care under the NHS isn’t completely free but is subsidised.
To receive specialist treatment, patients need to see their local GP first for a referral. Waiting times for specialist appointments for non-emergency care or elective surgery can be long.
Private health insurance in Scotland is mainly used to cover dental or voluntary cosmetic procedures. However, it is also useful for skipping long waiting periods.
Pharmacies are easy to find, including chain and independent outlets. Normal pharmacy hours are from around 8am to 6pm, Monday to Saturday. Some pharmacies have extended opening hours and late-night services.
Emergency services
The NHS provides high-quality free emergency treatment, however waiting times in A&E (Accidents & Emergencies) can be long.
In the event of a medical emergency, dial 999 for an ambulance. Ambulances usually have a fast response time for urban areas, but callers from very remote areas will have a longer waiting time.
The NHS also has a 24-hour medical advice line, which is reached by dialling 111. This line is for those who have a medical situation that needs attention or advice but are unsure whether an ambulance or immediate treatment is necessary. Trained professionals are available to advise callers and connect them to a variety of resources.
Wales is an expat destination which has grown in popularity due to its good work-life balance and outdoor lifestyle. As part of the wider National Health Service (NHS) in the United Kingdom (UK), Wales also has a good reputation when it comes to healthcare. While NHS Wales is run separately from the public healthcare service across the rest of the UK, it does share many features with the common system. However, for expats who are willing to pay, the private sector provides excellent services and allows users to bypass waiting lists for treatment.
Public healthcare in Wales
Registering with a local GP should be a priority for expats when moving to Wales, as an NHS number is allocated through a local doctor. This number will allow expats to take advantage of the public healthcare system in the UK. To make use of the local public healthcare facilities, an expat may need to show the doctor or nurse their passport and visa to demonstrate their eligibility for NHS benefits. Expats from outside the European Economic Area (EEA) must pay a health surcharge as part of their visa application if they are staying longer than six months. Payment of this fee grants expats access to all NHS services.
When it comes to seeking medical treatment in the UK, the local GP is likely to be an expat’s first point of contact. These professionals are qualified to deal with the majority of general medical queries. If a patient requires further tests or specialist medical treatment, the GP will provide a referral.
The NHS covers almost all medical services, excluding dental and eye treatments. For these, expats will have to pay out of their own pockets or rely on private health insurance. However, NHS dentists offer the basics at a much lower rate than private dentists. There are also many people who qualify for free eye tests through the NHS.
Long waits can be part of the NHS experience, but this is mostly associated with doctor’s appointments. It can be difficult to get a same-day appointment with a GP, and specialists often have waiting lists lasting more than a month. When it comes to emergency medical treatment however, public health institutions are generally quick and efficient, and expats can rely on quality care.
Private healthcare
Private hospitals and clinics in Wales are expensive, but the medical services offered are of a high standard. They mostly offer more specialised services or treatments that are not offered by the NHS. If expats plan to use private healthcare services in Wales, it is highly recommended that they invest in a comprehensive private health insurance plan.
It’s important to note that not all private hospitals are equipped for emergencies. Expats who rely solely on private institutions should ensure that they know where their closest accident and emergency department is located, and this may well be at an NHS hospital.
Most pharmacies in Wales do not only dispense medication, but can often also offer medical advice from qualified professionals. Expats can rely on pharmacists to diagnose and advise on minor ailments such as stomach problems or headaches.
Pharmacies and chemist shops in Wales are plentiful and can even be found in smaller villages. Unlike England, written prescriptions are free in Wales, and most pharmacies are well-stocked.
Emergency services
All visitors to the UK are entitled to free emergency treatment, but foreign patients will be charged for any medical services following the direct emergency. The emergency number in Wales is 999. Ambulances are well-prepared for almost every medical emergency, and the crew usually consists of a paramedic and an emergency medical technician. Emergency call centre agents in Wales speak both English and Welsh.
Emergency situations categorised as life threatening will be attended to swiftly. Non-emergency medical advice is available through NHS Direct Wales on 111 or 0845 46 47, where patients can call in for medical advice or check their symptoms online. Other patient transport services can also be booked through regional Non-Emergency Transport Centres.
While Northern Ireland shares a border with the Republic of Ireland, it is officially part of the United Kingdom and this affects how healthcare in the country is administered. The quality of public healthcare in Northern Ireland generally is good with free medical treatments available to all legal residents.
Public healthcare is provided by Health and Social Care of Northern Ireland (HSC), a branch of the National Health Service (NHS). While the HSC is run separately from the NHS, many of its features are shared. Other medical services are also available to expats willing to pay the high fees associated with private healthcare.
Public healthcare
To receive medical treatment in Northern Ireland, expats will need a medical card from the HSC. This will be issued when registering with a General Practitioner (GP) for the first time. Expats might need to present their passport and visa to a GP to show that they qualify. Nationals from outside the European Economic Area (EEA) will also need to pay a surcharge on top of their visa fees to access public healthcare.
A GP will most likely be an expat’s primary link with the HSC. These professionals are well-versed in general medical queries, and offer referrals to specialists when needed. Some GP’s may not take new patients or they might only treat those living in a specific catchment area. Luckily, there are more than 350 GP practices in Northern Ireland, so expats shouldn’t struggle to find a family doctor.
Public healthcare in Northern Ireland is funded by local Health Trusts which means that some treatments available in one area may not be available in the next. The HSC does not pay for dental or eye care. Expats might want to consider taking out private health insurance to cover themselves for services that fall outside their public healthcare entitlement.
Private healthcare
Private medical facilities are of a high standard in Northern Ireland. Usually, these institutions offer specialised medical services, or services that are not covered by the Health Service. The services offered by private hospitals can be expensive, so private health insurance is a good idea. Policies can range from supplementary cover that includes dental and eye care, to comprehensive policies that cover most treatments at a private facility.
Expats should take note of where their closest emergency department is located, as not all private hospitals are equipped to deal with emergencies.
Pharmacists (or chemists) in Northern Ireland can provide basic medical advice, sell over-the-counter medication and fill prescriptions. Expats should keep in mind that seeing a pharmacist for minor ailments can be as useful as visiting a doctor.
Most hospitals and some doctor’s offices have pharmacies located onsite for convenience. Expats will also be able to find a number of 24-hour pharmacies in most major cities. It is advisable to note the generic name of any chronic medication being taken before arrival in Northern Ireland, as brand names tend to vary from country to country.
Emergency services
Ambulances in Northern Ireland are generally well-equipped and staffed with trained professionals. Dialling 999 connects callers to the general emergency line where their situation will be assessed. Visitors will get free emergency treatment, but any follow-up treatment will be billed.
For broken bones, minor concussions, sprains and other non-emergency medical issues, consider visiting the Minor Injury Unit, where waiting times can be shorter.