Introduction to the National Health Service (NHS)
The National Health Service (NHS) is the UK's state-funded healthcare system. For many newcomers, the concept of a system that is 'free at the point of use' is a significant change from their home country. However, while the NHS provides a wide range of services, understanding how to access them-and who is eligible for free care-is essential for a smooth transition to life in the UK.
It is important to distinguish between primary care (GPs, pharmacies, and some community services) and secondary care (hospital treatment and specialists). While primary care is generally available to everyone regardless of immigration status, secondary care is often subject to residency rules or the payment of the Immigration Health Surcharge (IHS).
Navigating these rules is a key part of your first few months in the country. If you are planning your long-term future here, you might also be interested in the British Citizenship Roadmap for Newcomers, which outlines the journey from arrival to naturalisation.
Registering with a General Practitioner (GP)
A General Practitioner, or GP, is your first point of contact for most health issues. They are family doctors who treat common medical conditions and refer patients to hospitals and other medical services for urgent or specialist treatment. In the UK, you cannot usually see a specialist doctor (like a cardiologist or dermatologist) without a referral from your GP.
How to Find and Choose a GP
Most people register with a GP surgery near where they live. You can find local practices using the 'Find a GP' tool on the NHS website. When choosing a surgery, you may want to look at their opening hours, whether they offer online booking, and patient reviews.
The Registration Process
To register, you will typically need to visit the surgery or check their website to see if they offer online registration. You will be asked to fill out a form called a GMS1. This form asks for basic details such as your name, date of birth, and previous address.
Your Rights as a Newcomer
There are several common misconceptions about GP registration that can prevent newcomers from seeking help. It is vital to know your rights:
- No ID Required: You do not legally need to show a passport, proof of address, or proof of immigration status to register with a GP. While surgeries may ask for these to make the process easier, they cannot refuse to register you because you lack them.
- Free Registration: It is completely free to register with a GP and to have a consultation with a doctor or nurse.
- Safe Surgeries: Many practices are part of the 'Safe Surgeries' initiative, meaning they commit to being accessible to everyone, including those with uncertain immigration status or those experiencing homelessness.
If you are worried about how your status affects your access to services, you should read our guide on Benefits and Public Funds Risk for Newcomers, which clarifies that using the NHS is generally not a breach of visa conditions.
The NHS Number
Once your GP registration is processed, you will be assigned an NHS Number. This is a unique 10-digit identifier used to link your medical records across different parts of the health service. It ensures that when you see a specialist or go to a hospital, the doctors have access to your medical history, allergies, and previous treatments.
You do not need to know your NHS number to receive care, but having it can speed up administrative processes. You will usually receive a letter in the post with your number a few weeks after registering. If you lose it, you can find it on any prescription or by asking your GP surgery.
Secondary Care and the Immigration Health Surcharge (IHS)
While seeing a GP is free for everyone, hospital treatment (secondary care) is based on being 'ordinarily resident' in the UK. For most newcomers on visas, this eligibility is secured by paying the Immigration Health Surcharge (IHS) as part of their visa application.
What the IHS Covers
If you have paid the IHS, you are entitled to use the NHS in the same way as a permanent UK resident. This includes:
- Hospital treatments and surgeries.
- Consultations with specialists.
- Maternity services.
- Mental health support.
Services That Are Always Free
Regardless of whether you have paid the IHS or your immigration status, certain services are free to everyone in the UK:
- Accident and Emergency (A&E) services (until the point you are admitted as an inpatient).
- Family planning services (excluding abortions and infertility treatment).
- Treatment for most infectious diseases (including COVID-19 and TB).
- Treatment for physical or mental conditions caused by torture, female genital mutilation (FGM), or domestic/sexual violence.
| Service Type | Eligibility Requirement | Cost |
|---|---|---|
| GP Consultation | Open to all | Free |
| A&E (Emergency) | Open to all | Free |
| Hospital Inpatient | Ordinarily Resident / IHS Paid | Free (if eligible) |
| Prescriptions | Varies by UK nation | Fixed charge (England) |
Urgent and Emergency Care
Knowing where to go when you are unwell can save time and ensure you get the right level of care. The UK uses a tiered system for urgent medical needs.
NHS 111: Non-Emergency Advice
If you need medical help quickly but it is not a life-threatening emergency, call 111. This service is available 24 hours a day. A trained adviser will ask you questions and direct you to the best service, which might be a late-night pharmacy, an urgent treatment centre, or an out-of-hours GP. They can also book appointments for you.
Urgent Treatment Centres (Walk-in Centres)
For minor injuries like sprains, small burns, or cuts that need stitches, you can visit an Urgent Treatment Centre. These are often nurse-led and do not require an appointment. They are a better choice than A&E for minor issues, as the wait times are usually much shorter.
999 and A&E: Life-Threatening Emergencies
In a genuine emergency-such as a heart attack, stroke, severe difficulty breathing, or serious trauma-call 999 immediately. This will connect you to the ambulance service. Alternatively, you can go directly to a hospital's Accident and Emergency (A&E) department. A&E is for life-threatening situations only; using it for minor issues puts unnecessary pressure on the system.
Prescriptions and Health Costs
While medical consultations are free, there are costs associated with medicines and certain specific services.
Prescription Charges
In England, you must pay a fixed charge for each item on a prescription. However, many people are exempt from these charges, including:
- People aged 60 or over.
- Children under 16 (or under 19 if in full-time education).
- Pregnant women or those who have had a baby in the last 12 months (requires a Maternity Exemption Certificate).
- People with specific medical conditions (requires a Medical Exemption Certificate).
- Those on certain low-income benefits.
In Scotland, Wales, and Northern Ireland, prescriptions are free for everyone registered with a GP.
The NHS Low Income Scheme
If you are not automatically exempt but have a low income, you can apply for the NHS Low Income Scheme by completing an HC1 form. If successful, you may receive an HC2 certificate (full help) or HC3 certificate (partial help) for costs like prescriptions, dental care, and eye tests.
Dental and Optical Care
Unlike GP services, NHS dental and optical care are not free for most adults. Even if you are eligible for NHS dental treatment, you will usually have to pay a contribution towards the cost.
Finding an NHS Dentist
Finding a dentist accepting new NHS patients can be difficult in many parts of the UK. You do not need to register with a dentist in the same way you do with a GP; you can contact any dental practice to see if they have space. If you have a dental emergency and do not have a regular dentist, call 111 for advice.
Eye Tests
Most adults pay for eye tests and glasses. High-street opticians provide these services. Some groups, such as children and people with certain eye conditions, are eligible for free NHS eye tests and vouchers for glasses.
Maternity Care
If you become pregnant, your first step should be to see your GP or a midwife. Maternity care in the UK is comprehensive and includes prenatal check-ups, scans, the birth itself, and postnatal care. If you have paid the IHS, this care is free. Even if you have not paid the IHS, maternity care is considered 'immediately necessary' and cannot be withheld, though you may be billed later if you are not eligible for free care.
For those balancing new parenthood with work, understanding Childcare Costs and Help in the UK is often the next logical step in planning your family's future.
Healthcare and the Life in the UK Test
While this guide focuses on practical steps for newcomers, the history and structure of the NHS are important topics for those preparing for settlement. The Life in the UK Test often includes questions about the founding of the NHS in 1948 and its role as a pillar of British society. As you settle in, you can use our handbook and free practice tests to learn more about how the UK government and public services function.
Frequently asked questions
Do I need a permanent address to register with a GP?
No. According to NHS England guidelines, you do not need a fixed address or proof of ID to register with a GP. You can use a temporary address or even a friend's address if you are currently unsettled.
Is the NHS a 'public fund' for immigration purposes?
No. Using the NHS is not considered a 'public fund' in the context of visa conditions like 'No Recourse to Public Funds' (NRPF). However, you must still be eligible for free care through the Immigration Health Surcharge or residency.
What is the difference between 111 and 999?
111 is for non-emergency medical advice when you need help quickly but it is not a life-threatening situation. 999 is strictly for life-threatening emergencies like chest pain, severe bleeding, or loss of consciousness.
How do I get an NHS number?
You are usually assigned an NHS number when you first register with a GP surgery in the UK. It will be sent to you by post, or you can ask your GP practice for it once your registration is processed.
Are prescriptions free in the UK?
In England, most adults pay a fixed charge per prescription item, though many groups (like children, seniors, and those on certain benefits) are exempt. In Scotland, Wales, and Northern Ireland, prescriptions are generally free for all residents.
Can a GP surgery refuse to register me?
A GP surgery can only refuse to register you if they have reasonable grounds. These include the practice being full (closed list) or you living outside their designated 'catchment area.' They cannot refuse you based on your race, religion, disability, or immigration status.
What should I do if I need a doctor at night or on the weekend?
If your GP surgery is closed, you should call 111. They can direct you to an 'out-of-hours' GP service or an urgent treatment centre. Do not go to A&E unless it is a life-threatening emergency.