UK (England)

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Health in Britain

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Healthcare in the UK is free to all citizens, registered long-term residents and members of the armed services who are serving abroad. It is one of the few countries, which provides a free walk in system of healthcare with very few supplementary charges.

The National Health Service (NHS)
The NHS is in charge of healthcare in the UK. The Department of Health centrally governs the NHS. Originally it consisted of one national organisation, which covered the whole of the country, but more recently, it has been decentralised into four independent organisations; one for each of the countries, which make up the United Kingdom. Each service has its own legislation, but each service will treat the needs of citizens from other parts of the UK.

Care trusts in charge of treatment policies, vaccination programmes and healthcare budgets run the NHS service.

The NHS is a free service to all residents of the UK, including members of the armed forces who are working abroad. British citizens who reside outside of the UK are subject to charges regardless of whether they have paid National Insurance contributions. The service is financed from mandatory national insurance taxation paid by employees directly from their salaries and supplemented by an obligatory contribution form employers. Self-employed persons have to pay the full contribution themselves. The onus is on the employer to deduct contributions from its employee’s wages. Dependant family members and vulnerable groups like the unemployed are exempt from contributions.

Private Healthcare
The UK has a relatively strong private healthcare sector, which is funded largely by private insurance contributions, but it is used only by a limited percentage of people, often as a top up to the basic state healthcare.

Private hospitals are owned by private companies. Contributions to private funds vary from person to person and are dependant on age, general health, and the existence of previously diagnosed diseases and the level of care required by each subscriber. Many companies offer their employees and their dependants’ private health insurance as a benefit of the job. BUPA and Nuffield Hospitals are the leading private hospital operators in the UK.

There are many incidences when private patients will be treated in an NHS hospital because the private hospital lacks the specialist equipment. In these cases, the private patient is given their own room and is treated before NHS patients. Emergency patients supersede all patients both private and NHS.

General Practitioners (GP's)
General practitioners provides basic general healthcare and are the first point of contact with the UK health system. GPs operate in practices, which consist of several other practitioners. They employ clerical staff to handle the daily running of the practice and nurses to deal with routine vaccination, health education, preventative care and maternity. Citizens are free to register with the GP of their choice. If you need to consult a doctor, you have to make an appointment at his practice or if you need urgent attention, you can call him to your home, attend the surgery on a speculative basis or visit your nearest emergency department.
 
GP's prescribe drugs, treat acute and chronic illnesses, and provide preventive care and health education. Some GP's also care for hospitalised patients, conduct minor surgery and obstetrics.

Consultants
Consultants are senior doctors who have completed a higher level of specialised training. GP's refer patients to a Consultant if he believes that a patient may need specialist help and diagnosis. There are numerous specialist fields of medicine in the UK like gynaecology, oncology, paediatrics and dermatology. There is often a waiting list to see Consultant doctors.

Dispensing and Prescription Charges
Only doctors and consultants can prescribe medicine in the UK. Prescription medicine is only available from a qualified and registered chemist or from a hospital pharmacy. There is, however, a wide choice of over-the-counter drugs, which can be purchased in many retail outlets including supermarkets. Drugs like painkillers and cold remedies are available over-the-counter and do not require a prescription or consultation with a doctor.

All working adults must pay prescription charges of £6.85 for any medicine prescribed by a doctor. Children under 16 or 18 if they are in full time education, the over 60's, pregnant women, patients with certain medical conditions, low income earners or those receiving state benefits are exempt from any prescription charges.

Citizens who find they need a repeated course of medicine, but do not fall into one of the exempt categories are entitled to use single-charge pre-payment certificate which allows an unrestricted number of prescriptions during the period for which it is valid.

Prescription charges are the same regardless of the actual cost of the medicine needed, but higher charges apply to medical appliances.

Dentistry
Most dentistry in the UK is now private although some dentists still work for the NHS. Dental practices only take a limited number of NHS patients. People who are exempt from paying prescription charges (except those with certain medical conditions) are exempt from dental charges too. Many dentists have waiting lists of NHS patients wishing to register with their practice. If you are not enrolled into a practice, you will not receive treatment unless you are a private patient. Fees are paid directly to the dental practice once a series of treatment is complete.

Opticians
Eye care in the UK is private but a limited amount of care is available on the NHS. This tends to be confined to people exempt from prescription charges and generally only covers a free eye test and where necessary the provision of a pair of glasses, which can be chosen from a limited selection of designs. All other optical work is private and fees are paid at the time of consultation, directly to the optical practice.

Accident and Emergency (A&E)
A&E departments (sometimes referred to as Casualty) provide emergency treatment to patients with a wide range of illness and injury, some of which may be life threatening and requiring immediate attention. Citizens do not pay to for treatment or use of  the A&E service.

A&E departments are open non stop all year. You may use their services if you need immediate attention, or if your GP refers you to them, or if there is no GP service available.

Upon arrival at A&E, a nurse assess the nature and seriousness of your condition. Individuals with serious illnesses are seen immediately by a doctor. Once the patient has been assessed and treated, they may be admitted to the hospital, transferred to a different hospital or discharged. Emergency departments are located in main hospitals and are staffed by hospital doctors and nurses with specialised training in emergency care, emergency medical technicians, radiology technicians, healthcare assistants and  voluntary staff who all work together to treat emergency patients and provide support to concerned family members.

NHS Direct
England, Wales and Northern Ireland have a 24-hour private telephone service, online consultancy and an interactive digital TV health advice programme, which is provided by NHS Direct. Similar services exist in Scotland under the name NHS24. The service was designed to relieve waiting times at GP surgeries and to provide care out of surgery hours. It is staffed by trained nurses who provide guidance on which healthcare provider the caller should access and how to cope with a bout of sickness at home.


NHS Walk-In Centres
There are over 80 NHS Walk-in Centres in the UK, but some do not treat children. NHS Walk-in Centres give you quick access to health information and medicine. They can be used by everyone and an appointment is not necessary. They are open every day from early morning to late evening, 365 days a year.

Their aim is to provide fast access to health advice and treatment. They work in a similar manner to NHS Direct.


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