Medical care
Medical care is available in the UK via the NHS - the National Health Service.
The NHS was launched in 1948 under the pretext that good healthcare should be available to all, regardless of wealth – a principle that remains at its core. With the exception of some charges, such as prescriptions and optical and dental services, the NHS remains free at the point of use for anyone who is a UK resident.
You may be surprised to hear that the NHS employs more than 1.6 million people, putting it in the top five of the world’s largest workforces together with the US Department of Defence, McDonalds, Walmart and the Chinese People’s Liberation Army.
Primary Care
Primary care is the first point of contact for most people and includes GPs, dentists, pharmacists and optometrists, NHS walk-in centres and the NHS 111 telephone service.
Choosing which service is right for you at a given time may not always be easy – often you have more than one option. Use the checklist below to guide you if you're not sure where to start.
Call NHS 111 if you urgently need medical help or advice but it's not a life-threatening situation. You can also call NHS 111 if you're not sure which NHS service you need.
Call 999 if someone is seriously ill or injured and their life is at risk.
Visit a walk-in centre, minor injuries unit or urgent care centre if you have a minor illness or injury (cuts, sprains or rashes) and it can't wait until your GP surgery is open.
Ask your local pharmacist for advice – your pharmacist can give you advice for many common minor illnesses, such as diarrhoea, minor infections, headache, travel advice or sore throats.
Make an appointment with your GP if you are feeling unwell and it is not an emergency.
General practitioners (GP)
GPs are the first point of contact for nearly all NHS patients. They can direct you to other NHS services and are experts in family medicine, preventative care, health education, and treating people with multiple and long-term conditions.
If you are planning to live and work in the UK, you need to register with a local GP. It is up to the GP practice to decide whether to accept new patients or not, but they can only refuse for non-discriminatory reasons. However, being registered with a GP practice does not in itself mean you will be entitled to free NHS hospital treatment.
If you are in the UK for a short visit but need to see a GP, you can register as a temporary patient with a local doctor. You need to be in the area for more than 24 hours but less than three months. Again, it is up to the GP practice to decide whether or not they will accept new patients. Treatment will be free of charge, but please ensure you present your European Health Insurance Card (EHIC) if you have one.
Hospital services
Hospital treatment is free to people classed as ordinarily resident in the UK. This is not dependent on nationality, payment of UK taxes, National Insurance contributions, being registered with a GP, having an NHS Number, or owning property in the UK.
To be considered ordinarily resident, you must be living in the UK on a lawful and properly settled basis for the time being – you may be asked to prove this.
A person is ordinarily resident if they are normally residing in the UK (apart from temporary or occasional absences), and their residence here has been adopted voluntarily and for settled purposes as part of the regular order of their life for the time being, whether for short or long duration.
If you are a citizen of the European Economic Area (EEA) or Switzerland, you can become ordinarily resident when you move to England, as long as you meet the criteria above.
If you are a non-EEA national subject to immigration control, you can only be considered ordinarily resident if you have been given the immigration status of indefinite leave to remain (the right to live here on a permanent basis).
If you are a visitor from the EEA, you will need to present a valid EHIC or other healthcare documents (such as S2 or S1 forms) or you may be charged for your care.
If you are visiting England from a non-EEA country, you need to ensure you are covered for healthcare through personal medical insurance for the duration of your visit, even if you are a former UK resident.
Should you need NHS treatment and you have not arranged insurance, you will be charged at 150% of the standard NHS rate, unless an exemption category applies to either you or the treatment. If you are coming for more than six months, you may need to pay the immigration health surcharge.
Immigration health surcharge
If you are coming to the UK on a temporary stay of more than six months, you may be required to pay an immigration health surcharge at the time of your visa application. The standard surcharge fee is:
£150 per year per person for students and each of their dependants
£200 per year per person for everyone else
The full amount will be paid upfront for the duration of your visa. There are circumstances when you do not have to pay the surcharge such as if you are the dependant of a member of the forces who is not subject to immigration control.
If you have paid the surcharge or you were exempt from paying it, and your visa allows you to be here for more than six months, you will be entitled to free NHS hospital treatment in the UK on the same basis as an ordinarily resident person. This will apply from the date your visa is granted until it expires.
However, if your visa is curtailed or ended earlier than planned by the Home Office, you will become chargeable for any further NHS hospital treatment from that date on, even if you have paid the surcharge. You will also be charged for any non-exempt treatment you received before the start date of your visa.
If you apply for an extension of your visa, you might also have to pay a further surcharge. If you apply for, and are granted, indefinite leave to remain, you will not have to pay the surcharge.
Paying the surcharge only gives you access to services the NHS provides. Paying the surcharge does not mean you are treated faster. Doctors will assess the urgency of your condition in the same way as ordinarily resident patients are assessed, and if necessary will be placed on a waiting list.
Patients in the UK are required to make contributions towards the cost of their NHS care, such as paying prescription costs or dental charges. You are required to make the same contributions.
Some services or treatments carried out in an NHS hospital are exempt from charges, so they are free to all. These include:
accident and emergency services – not including emergency treatment if admitted to hospital
family planning services – this does not include termination of pregnancy or infertility treatment
treatment for most infectious diseases, including sexually transmitted infections (STIs)
treatment required for a physical or mental condition caused by torture, female genital mutilation, domestic violence or sexual violence – this does not apply if you have come to England to seek this treatment
Children born in the UK to those here lawfully for more than 6 months
If you give birth to a child in the UK, then your child will be entitled to free NHS hospital treatment in the UK on the same basis as someone who is ordinarily resident. Your child is covered until three months of age, but only if he/she hasn't left the UK during that period. You'll also need to meet one of the below criteria:
you have a valid visa of more than 6 months and paid the surcharge for that visa
you have a valid visa for more than 6 months, but were exempt from paying the surcharge
you have a valid visa for more than 6 months, which you applied for prior to April 6 2015
You should apply for a visa for your child during the three-month period after your child's birth. If required, you may have to pay the surcharge for your child. Failure to do so means you may be charged for NHS services provided for your child after the three-month period.
Find your local NHS services
Pregnancy
Antenatal care
When you first learn that you're pregnant, get in touch with a midwife or GP as soon as possible. Although your first hospital antenatal appointment may not be until you are around 12 weeks pregnant, telling your GP and/or midwife promptly will help to make sure you receive maternity healthcare that takes into account all your health needs and preferences.
You'll be offered a series of appointments with a midwife, or sometimes with a doctor who specialises in pregnancy and birth (an obstetrician).
They will check that you and your baby are well, give you useful information to help you have a healthy pregnancy (including healthy eating and exercise advice) and answer any questions you may have.
You will also be offered antenatal classes, including breastfeeding workshops. You need to book antenatal classes in advance, so ask your midwife about when you should book classes in your area.
If you're expecting your first child, you'll have up to 10 antenatal appointments. If you've had a baby before, you'll have around seven antenatal appointments. Under certain circumstances, for example if you develop a medical condition, you may have more.
Your appointments can take place at your home, in a Children's Centre, in your GP surgery or in hospital. You will usually go to the hospital for your scans.
To give you the best pregnancy care, your midwife will ask you many questions about your health, your family's health and your preferences. Your midwife will do some checks and tests, some of which will be done throughout your pregnancy. The results of these tests may affect your choices later in pregnancy, so it’s important not to miss them.
Your first visit with your midwife or GP is the appointment when you tell them that you're pregnant. At this first visit, you will be given information about:
folic acid and vitamin D supplements
nutrition, diet and food hygiene
lifestyle factors that may affect your health or the health of your baby
antenatal screening tests
Your next appointment should happen when you are 8-12 weeks pregnant. This is called the booking appointment. It will last for up to two hours, and could take place either at a hospital or in the community, for example in a clinic at a health centre, in a GP surgery or at home.
You'll see a midwife and sometimes a doctor. You may also be offered an ultrasound scan. You will be given information about:
how the baby develops during pregnancy (see the pregnancy development slideshow)
nutrition and diet
general exercise and pelvic floor exercises
antenatal screening tests
your antenatal care and antenatal classes
breastfeeding workshops
maternity and paternity benefits
planning your labour and where to have your baby
The midwife or doctor will ask questions to build up a picture of you and your pregnancy. This is to make sure you're given the support you need, and so that any risks are spotted early.
Several antenatal screening tests are performed on a sample of your blood. In some cases, the baby's father may be asked to have a blood test to check for inherited conditions, such as sickle cell or thalassaemia.
The midwife or doctor might ask about:
the date of the first day of your last period
your health
any previous illnesses and operations
any previous pregnancies and miscarriages
ethnic origins of you and your partner, to find out whether your baby is at risk of certain inherited conditions, or other relevant factors, such as whether your family has a history of twins
your job or your partner's job, and what kind of accommodation you live in to see whether your circumstances might affect your pregnancy
how you're feeling and whether you've been feeling depressed
From around 24 weeks, your antenatal appointments will usually become more frequent. However, if your pregnancy is uncomplicated and you are in good health, you may not be seen as often as someone who needs to be more closely monitored.
Later visits are usually quite short. Your midwife or doctor will:
check your urine and blood pressure
feel your abdomen (tummy) to check the baby's position
measure your uterus (womb) to check your baby's growth
listen to your baby's heartbeat if you want them to
You can also ask questions or talk about anything that's worrying you. Talking about your feelings is as important as all the antenatal tests and examinations. You should be given information about:
your birth plan
preparing for labour and birth
how to tell if you're in active labour
induction of labour if your baby is overdue (after your expected date of delivery)
the "baby blues" and postnatal depression
feeding your baby
vitamin K (which is given to prevent bleeding caused by vitamin K deficiency in your baby)
screening tests for newborn babies
looking after yourself and your new baby
At each antenatal appointment from 24 weeks of pregnancy, your midwife or doctor will check your baby's growth. To do this, they'll measure the distance from the top of your womb to your pubic bone. The measurement will be recorded in your notes.
In the last weeks of pregnancy, you may also be asked to keep track of your baby's movements. If your baby's movements become less frequent, slow down or stop, contact your midwife or doctor immediately. You'll be offered an ultrasound scan if they have any concerns about how your baby is growing and developing.
At your booking appointment, your midwife will enter your details in a record book and will add to them at each visit. These are your maternity notes, sometimes called handheld notes. You’ll be asked to keep your maternity notes at home and to bring them along to all your antenatal appointments.
Take your notes with you wherever you go in case you need medical attention while you're away from home. Always ask your maternity team to explain anything in your notes that you don't understand.
Waiting times in clinics can vary, and having to wait a long time for an appointment can be particularly difficult if you have young children with you. Planning ahead can make your visits easier, so here are some suggestions:
Write a list of any questions you want to ask and take it with you
Make sure you get answers to your questions or the opportunity to discuss any worries
If your partner is free, they may be able to go with you. This can make them feel more involved in the pregnancy
In some clinics you can buy refreshments. If not, take a snack with you if you're likely to get hungry
Going to hospital
If it's your first pregnancy, you may feel unsure about when you should go into hospital or a midwifery unit. The best thing to do is to call your hospital or unit for advice.
If your waters have broken, you'll probably be told to go in to be checked.
If it is your first baby and you are having contractions but your waters have not broken, you may be told to wait. You'll probably be told to come in when your contractions are:
regular
strong
about five minutes apart
lasting about 45-60 seconds
If you don't live near your hospital, you may need to come in before you get to this stage. Make sure you know the signs of labour and what happens.
Second babies often arrive more quickly than the first, so you may need to contact the hospital, midwifery unit or your midwife sooner.
Don't forget to phone the hospital or unit before leaving home, and remember to take your notes.
If you are planning a home birth, follow the procedure you have agreed with your midwife during your discussions about the onset of labour. Make sure you know the signs of labour.
Maternity units vary, whether they are in hospitals or midwifery units, so the following is just a guide to what is likely to happen.
You can talk to your midwife about the way things are done at your local hospital or midwifery unit, and what you would like for your birth. If your wishes can't be met, it's important to understand why.
If you carry your own notes, take them to the maternity unit's admissions desk. You will be taken to the labour ward or your room, where you can change into a hospital gown or other clothes of your own.
Choose something that is loose and ideally made of cotton, because you'll feel hot during labour and won't want to wear anything tight.
The midwife will ask you about what has been happening so far and will examine you. If you are having a home birth, this examination will take place at home. The midwife will:
take your pulse, temperature and blood pressure, and check your urine
feel your abdomen to check the baby's position and record or listen to your baby's heart
probably do an internal examination to find out how much your cervix has opened, so they can then tell how far your labour has progressed (tell your midwife if a contraction is coming before they perform this examination, so that she or he can wait until it has passed)
These checks will be repeated at intervals throughout your labour. Always ask about anything you want to know. If you and your partner have made a birth plan, show your midwife so they know what kind of labour you want and can help you to achieve it.
Delivery rooms have become more homely in recent years. Most have easy chairs, bean bags and mats, so you can move about in labour and change position. Some have baths, showers or birthing pools. You should feel comfortable in the room where you are giving birth.
Some maternity units may offer you a bath or shower. A warm bath can be soothing in the early stages of labour. Some women like to spend much of their labour in the bath as a way of easing the pain.
Some maternity units have birthing pools so that you can labour in water. Many women find that this helps them to relax. If labour progresses normally, it may be possible to deliver the baby in the pool. Speak to your midwife about the advantages and disadvantages of a water birth. If you want one, you'll need to make arrangements well in advance.
If you have your baby in hospital, you may be able to go home with your baby straight from the labour ward, or you may be moved to a postnatal ward, where you will be with other mothers and babies.
If your delivery is straightforward, your stay in hospital is likely to be short. It helps if you've discussed your postnatal care with your midwife during pregnancy so you know what to expect. Any preferences can then be recorded on your birth plan so staff on the postnatal ward are aware of them.
You'll probably need quite a lot of help and advice with your first baby. Whether you are in hospital or at home, the midwives are there to guide and support you, and also check you're recovering from the birth. Don't hesitate to ask for help if you need it.
Post-natal care
You should have your postnatal check about six weeks after your baby's birth to make sure that you feel well and are recovering properly.
You may be offered an appointment to go back to the hospital or midwifery unit where you gave birth, but otherwise you should see your GP. It's time to introduce your baby to your GP as the new member of the family.
It's also a good opportunity to ask any questions and sort out any problems you may have. You may want to make a list of questions to take along with you so that you don't forget what you want to ask.
You can also ask the doctor about contraception. You may wish to choose a different method from the one you previously used, especially if your pregnancy was not planned. The doctor or nurse can help you decide which method is right for you now.
What happens at your postnatal check
you should be weighed and can get weight loss advice if you need it (find out about healthy diet and fitness after the birth)
your urine will be tested to make sure your kidneys are working properly and that you haven't got an infection
your blood pressure will be checked
you may be offered an examination to see if your stitches have healed (if you had any), and that all the muscles used during labour and delivery are returning to normal
your doctor may discuss carrying out a cervical screening test (smear test) with you if you have not had one in the past three years – the test won't usually take place until three months after delivery
if you are not immune to rubella (German measles) and were not given an immunisation before you left hospital, you will be offered one now – you should avoid becoming pregnant for one month after this immunisation
you will be asked if you still have any vaginal discharge and whether you have had a period since the birth
Tell your doctor if
you are having trouble holding urine or wind, or you are soiling yourself
having sex is painful
you are feeling very tired, low or depressed
you are worried about anything
Health visitors
A health visitor will usually visit you for the first time around 10 days after your baby is born. After that, you will see your health visitor at the child health clinic, although you can ask to see them at any time. If you're bringing up a child on your own or struggling, your health visitor will probably come to see whether you need any help.
A health visitor is a qualified nurse who has had extra training. Part of their role is to help families avoid illness and stay healthy, especially families with babies and young children. Health visitors are members of a team that offers screening and developmental reviews as part of the Healthy Child Programme, as well as vaccinations.
Talk to your health visitor or a member of the team if you feel anxious, depressed or worried. They can give you advice and suggest where to find help. They may also be able to put you in touch with groups where you can meet other mothers.
Your health visitor can visit you at home, or you can see them at your child health clinic, GP surgery or health centre, depending on where they're based. Your health visitor will make sure you've got their phone number.
Child health clinics
Child health clinics are run by health visitors and doctors. They offer regular health and development reviews and vaccinations. You can talk about any problems to do with your child, but if your child is ill and likely to need treatment, go to your GP. Some child health clinics also run mother and baby, parent and toddler, breastfeeding and peer support groups.
Community midwives
You'll be given contact details for midwives based in your local community. Midwives provide antenatal and postnatal care in several different places, including children's centres. They can also visit you in your own home.
Sure Start Children's Centres
Children's centres are linked to maternity services. They provide health and family support services, integrated early learning, and full-day or temporary care for children from birth to five years.
They also provide advice and information for parents on a range of issues, from effective parenting to training and employment opportunities. Some have specific services for young parents.