2.1 National Health System (NHS)
The NHS is the British Health System. Anybody, while living in the UK has the right to get free medical service through the NHS. In general the NHS covers all that you would expect from a medical system such as General Practitioners (GPs), specialists and hospitals. However, the standard might be different from your home country and you may want to opt for private insurance in addition to the NHS. The most important advantage of private insurance is shorter waiting periods for an appointment or treatment. Most specialists do, however, treat both NHS and private patients. For Private insurers (i.e. BUPA, PPP), check yellow pages, www.yell.com.
The NHS covers:
- Doctor care, including home visits when required.
- Dentistry (children under 18).
- Specialist and hospital care.
- Eye tests.
- Child-care clinics for children under the age of five.
- Prenatal and postnatal care.
- Family planning clinics/fertility services.
- Well Women's Clinics.
2.2 Register with a GP
Under the NHS you are expected to register with a doctor at your local clinic (called Surgery or Practice). As several doctors serve each area, you have some choices. Check phone listings under Medical Practitioners, ask other ACS families or neighbors for advice or see list in Chapter 13 of this booklet. When you register with a local GP, he/she will provide forms to fill in and later you will be sent confirmation that you and each separate member of your family have a National Insurance Number. This identifies you as being eligible for free health care within county guidelines. Take good care of this card as you will need it if moving homes within the UK.
If you are unhappy with your GP, you have the right to change without giving any reasons. You can go to a NHS General Practitioner of your choice, not just the one in your vicinity, though some will claim that you should choose the nearest one.
When you register with a GP, you are actually registering to see anyone who works in that practice. Regular MDs and specialists are called "Dr", while consultants/specialist surgeons are called "Mr.". For vaccines, routine health checks, weighing, blood pressure, etc. you often just see the nurse. Someone who has young children is entitled to the Health Visitor's visit. The way to contact the Health Visitor is to go to the local surgery and give your name. Prescriptions are covered under NHS free of charge for all children sixteen and under. You will be asked to sign a form at the "chemist"/pharmacist when you get the prescription.
If you have a visitor who is ill, a NHS doctor can see him/her. You register your visitor as temporary resident and a small charge may be incurred.
Some Medical Centers have been known to tell people that they must apply as a private patient for one year before they qualify under NHS. This is not true.
2.3 Appointments
Some practices have "open surgery", meaning you go to the facility and it is operated on a first-come first-served basis. For others you need to make an appointment. For out-of-hours services there will be an emergency number on the telephone answering machine at your GP's office. GP's do in general make home visits as well. This is one of the reasons why you need to register with a GP in your area.
2.4 Referrals System
Your local GP is the primary care provider and the Gatekeeper of the NHS system. An NHS patient must see his/her GP initially with a medical problem and will then be referred by the GP to a specialist (a "consultant") if appropriate. It is not possible to see a specialist in the UK without a referral from a GP or from a casualty consultant. In the private sector of medicine, the situation is not so clear. Many private consultants require a referral letter before seeing you, but some do not.
Therefore:
- Find a physician/doctor before you really need one.
- Call the GP's surgery (office) to see if it is taking new patients. You may be asked questions to determine eligibility.
- Visit the surgery if possible; ask about hours, appointment policy, emergency care, night and weekend coverage, home visits, etc.
- Once you have found a GP whom you like and who is willing to accept you as a patient, both of you need to fill in a form which is submitted to FHSA. You might be asked to give a urine and blood sample as well. You are then assigned a NHS number and issued a Medical Card.
- The entire family need not be registered with the same GP.
2.5 Medical Emergencies
Phone 999 for a life-threatening emergency. Be prepared to give the location, the type of emergency and the telephone number you are calling from (used to locate you if disconnected).
In case of emergency, you go to the A&E department (Accident & Emergency) of the nearest public hospital (see chapter 11 and 12). Once you have seen a GP for assessment, you can ask to be treated as a private patient if you have coverage for it. You can stay for treatment at the public hospital or you can ask to be seen at a Private Hospital.
2.6 Specialists (Consultants)
Your GP will refer you to a consultant. Consultants often work in a hospital rather than their own surgery and treat NHS as well as private patients. In order to avoid long waiting, it is advisable that you register with the consultant as a private patient if your private insurance covers this. The consultant will send results from examinations and tests, documentations etc, back to your GP.
2.7 Dentists
Register with a surgery of your choice. You will find both private and NHS dentists, therefore check beforehand whether yours will accept NHS patients if you want to be covered under the NHS system. Some dentists only take private patients, others do have a quota for NHS patients and the quota may be full. Before an individual treatment, you can decide whether you want it to be covered under the NHS or a private insurance. Please note that even as an NHS patient you still need to pay for 80% of the cost (up to max. £275) by yourself. Treatments are free for children up to age 18, for pregnant women and for the first year after the delivery of a baby. You should also be aware that most private insurers will not cover the cost for private treatment of children. If your child needs urgent treatment, and the dentist can not treat him straight away, you might end up paying the treatment in full yourself.
2.8 Orthodontist (Teeth correction)
Little choice here, approx. 98% of the consultants in this field will ask for direct payment. Private insurance coverage can be difficult to obtain.
2.9 Ophthalmic Doctor (Eyes)
Your GP will refer you. The Ophthalmologist often works in a surgery or hospital specializing in eye treatments.
2.10 Gynecologist
Be aware that the level of cancer prevention medical check ups might be different to those in your home country. You might find them to be very basic here in England. If you want to go for more elaborate medical check-ups you could do so in private hospitals or "well-women-clinics", however it is regarded as "luxury" and will not be covered by the NHS, sometimes not even by the private insurers.
2.11 Pediatricians
All Children, including infants, will be seen and treated by your GP. Your GP decides then, whether your child needs to be referred to a pediatrician in a given situation.
2.12 Pharmacies/Chemists
Medication for children up to the age of 16 is free. Quite often your GP will issue a prescription for no-brand/generic medication, as these are cheaper but as good as the brand products. Since medication in general is quite cheap in England, your GP will often recommend you to buy prescription-free medication in a pharmacy, rather than giving it to you at the surgery. Medication from the pharmacies is pre-packed, labeled with your name and dosage instructions. Descriptions with the content of the medication and possible side effects etc, as you may expect, are not normally included and you have to ask your GP or the pharmacist to get specific information.
2.13 Prescriptions
As mentioned, medication for children up to the age of 16 is free. Other than that, the fee per prescription is currently approx. £6.50. If you need frequent medication there is a cheaper way. You need to obtain a "Prepayment Certificate". Application for this ("Application for Certificate of Prepayment of Prescription Charges") is available at your local Post Office or from your Chemist. This form needs to be completed and sent to your respective "Health Authority" (ask your GP or Chemist for the address). A cheque in the amount of £91.80 (to cover 12 months) or £33.40 (to cover 4 months) needs to be enclosed (status April 2004. For current amount check www.doh.gov.uk/nhscharges). With this certificate you can then get free medication for the respective period.
