Understanding the Healthcare System in the UK
The United Kingdom (UK) is an independent country, an island nation situated in Europe, separated from the continent by the English Channel. It shares an extensive history with the 56 countries of the Commonwealth. And it is one of the world’s top destinations for visitors and expats.
The U.K. is also famous for its national health system. It differs from the systems in many countries and serves as a role model for many more. Its services vary for citizens, visitors, and citizens of other countries living in the United Kingdom.
However, due to long wait times, an increasing number of U.K. citizens are opting for private care, and you may want to consider doing the same. Here’s what expats and digital nomads need to know about healthcare in the United Kingdom.
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An Overview of the United Kingdom Healthcare System
The United Kingdom has a universal healthcare system known as the National Health Service (NHS). The NHS is responsible for all aspects of the U.K. healthcare system.
Today, the NHS is also one of the largest public health systems in the world. It serves an average of 1 million people every 36 hours. Its guiding goals include universality, free delivery, equity, and central funding.
UK Healthcare System Pros & Cons
Even the famous NHS has its positives and negatives. Learn about what makes the United Kingdom’s healthcare system a global leader and the challenges it faces today.
Pros of the UK Healthcare System
By global standards, the NHS provides an excellent standard of care – the healthcare system in the U.K. ranked 18th overall in the 2024 World Index of Health Innovation.
Visitors and new residents in the UK will note that the NHS is a respected public institution. In a 2013 survey, it was ranked number one on a list of things that make people proud to be British.
The NHS continually seeks to enhance its services, with a focus on community health and online care options.
The NHS standardizes healthcare costs across each region of the United Kingdom. Many items are free, including medicines prescribed for hospital patients. The NHS substantially subsidizes other healthcare items, such as leg braces or wigs for cancer patients.
Many private healthcare services in the U.K. seem affordable to North Americans. For instance, IVF (in vitro fertilization) treatment is approximately 35% cheaper in the United Kingdom than it is in the United States.
Cons of the UK Healthcare System
The main criticism of the U.K. healthcare system in the 21st century is that the NHS is under pressure and not performing as well as in the past.
The NHS is known for long waiting times in both emergency rooms and offices with scheduled appointments.
With recent pressures on the NHS – including reduced funding and a shortage of staff – these waits are longer than ever. There are further waits to get referrals to specialists.
These wait times are long enough to impact patients’ health. 26% of patients wait more than 6 weeks for a diagnostic test (a problem with suspected cancer), and many wait over 13 weeks.
39% of patients with cancer do not get their first treatment within two months. Over 10,000 patients in the UK have waited as long as 18 months for a specialist referral.
The NHS is working to reduce waiting and overall visit times for emergency care. However, the crises around care providers and funding for the NHS have made this goal harder to achieve.
Lately, there have also been criticisms that the public NHS is relying on outdated equipment and technology, which contributes to slow care delivery.
This may not affect the care that you receive as a general patient. It may be important if you anticipate surgery or have specialized needs.
Note that while Britons may grumble about wait times or old equipment, they still value the NHS. Visitors should think twice before offering criticism!
Challenges of Healthcare in the United Kingdom
One challenge of the healthcare system in the U.K. is that healthcare services differ across various regions of the country.
England, Northern Ireland, Scotland, and Wales each have their own NHS healthcare system. For example, if you live in London, England, and are on the NHS for six months, you will pay £9.35 per prescription item.
If you relocate to Edinburgh, Scotland, you will be part of a different UK healthcare system. Your prescription items will be free.
If you are moving around within the country and need regular health care, keep track of these differences. Your general practitioner (GP – similar to a primary care provider or family doctor) will be able to help you.
Many expats love the idea of the British countryside. However, if you are in a rural area, you will have limited access to GPs and specialists. This includes maternity care, dental services, and opticians, covering both the NHS and private practices.
With the long NHS wait times, many adults have had to seek private care to receive the care they need promptly. In 2024, when the U.K.’s King Charles and Princess Catherine both required surgery and cancer treatment, they did not go to an NHS hospital.
They were admitted to the London Clinic, a private hospital. Many expats living in the U.K. also must rely on private healthcare.
As a result, many more people are opting for U.K. private health insurance, ensuring they have access to the care they need when they need it.
Does the United Kingdom Have Universal Healthcare?
For U.K. citizens and residents who qualify for an NHS number, the United Kingdom provides universal healthcare. For these individuals, the NHS provides comprehensive medical services free of charge.
That includes ambulance rides, emergency room visits, preventive measures, surgical procedures, and ongoing treatment programs, such as chemotherapy.
There are no copays, deductibles, or excess. All medications associated with hospital visits are free of charge. Prescription medication at pharmacies is either subsidized or provided free of charge in the U.K. healthcare system.
The NHS Covers Dental, Optical, Mental Health, and More
In the United Kingdom’s public health system, the NHS covers or subsidizes many areas of care. Check this list and its links to NHS pages to learn more.
- Dental: The NHS offers subsidized dental care coverage. You need to make a payment towards the cost of your care, ranging from $33.00 for an examination or cleaning to $392.00 for more extensive dental work, such as crowns or dentures.
- Optical: The NHS provides free eye tests for many people. If you are an adult in good health, you can expect to pay for an eye exam or glasses prescription and for your eyeglasses, too. If you are eligible for a free eye test, you may also qualify for an optical voucher towards vision aids.
- Mental Health: The NHS provides free mental health services. Most mental health services are accessed through a GP referral.
- Physical Therapy: The NHS provides free physiotherapy to patients who have a referral from a GP, a doctor, or through occupational health services.
- Alternative Care: In most cases, the NHS does not cover alternative care. Rarely, the NHS may cover a few physical or herbal treatments.
- Prescription Drugs: The NHS subsidizes prescription medication. You need to make a payment to obtain a prescription in some parts of the U.K., such as England.
While these areas of care are covered, it’s important to note that there are very long waits to get them through the NHS. Up to 25% of people seeking NHS mental health care wait more than 12 weeks.
In some areas of England, people face a three-year wait for dentist appointments. Many people in the U.K. turn to the private health system for prompt or emergency care.
How to Access & Receive Healthcare in the UK
Many expats will qualify for NHS healthcare in the United Kingdom. The sign-up process takes patience and preparation.
For UK Healthcare, Get an NHS Number and a General Practitioner
Foreign residents in the U.K. must have an NHS number to make routine appointments with a General Practitioner (GP).
To get an NHS number, international residents must register with a GP or make an appointment with their local health authority.
Getting the NHS number involves an interview and completing forms, including demonstrating your residency.
You will need to provide proof of your address in the United Kingdom. Once you complete this successfully, you will receive your NHS number via mail.
One of the supporting documents expats need for an NHS application is a National Insurance (NI) number. Everyone who already has a biometric residence permit already has an NI number – it’s printed on the back.
After you have obtained an NHS number, your next step is to register with a general practitioner. You must be connected to a general practitioner (GP) practice to access care.
Your GP is your primary care provider and your gateway to specialist health care. You need a GP even if you are paying for your care privately.
In rural areas, it may be challenging to find a GP who accepts new patients into their practice. And if you move to a different region of the United Kingdom, you may need to find a new GP.
Getting Different Types of Medical Care in the UK
Here is how to get different types of medical care in the U.K., from emergency care to private specialist care.
Do you have an NHS number, or are you outside the NHS system?
Your answer determines your first step in getting U.K. healthcare. If you have an NHS number and a GP, you can access NHS care, from the emergency room to your NHS GP.
If you are outside the NHS system, you will need to visit private practices and clinics. Alternatively, you may need to be prepared to pay for care from NHS providers, such as an emergency department.
Do you need a check-up or a family appointment?
Call or visit your GP, your primary care provider. They can provide you with the routine health care you need, including vaccinations and medical exams for travel.
Do you need urgent medical care?
Urgent treatment centers are open at least 12 hours a day. They are a way to get fast care instead of going to the emergency room.
They are meant to ease the pressure on hospitals. Locate and learn about your local urgent treatment center. You can book appointments through your GP or by dialing 111.
Are you having a serious or life-threatening emergency?
Go to your nearest hospital’s emergency room, also called the A&E. Though this is an experience Britons try to avoid because of long wait times, you will receive excellent care.
Do you need to see a specialist?
You may ask your GP to refer you to a specialist. In the U.K., if your GP refers you, you have the right to start treatment with a specialist within 18 weeks.
You can also make an appointment with a specialist in private practice. Most specialists cost $100 to $400 per appointment.
Do you want faster treatment or a private hospital?
Seek out the United Kingdom’s private health system, where you pay for health care. Private hospitals and clinics in the UK differ from NHS hospitals.
Private hospitals tend to specialize in providing care. For instance, if you had a heart attack, you would not go to a private hospital to access emergency services.
However, you may want to follow up with a private visit to a cardiology clinic.
Who is Eligible for UK Healthcare?
Anyone legally residing in the United Kingdom is entitled to free NHS healthcare.
You do not have to be a British citizen or employed to be part of the system, although you may be required to pay an immigration health surcharge. Some foreigners and visitors in the U.K. can receive some treatment.
Citizens of some Commonwealth countries and of the EU (with a European Health Insurance Card) have limited emergency coverage in the United Kingdom.
If you are a visitor to the United Kingdom, you can be treated in a U.K. hospital’s emergency room, regardless of whether you have an NHS number or not. However, you must pay for the cost of your treatment at a rate of 150% of the NHS rate.
As a result, most visitors and short-term residents in the U.K. carry travel medical insurance to cover the cost of medical emergencies.
Healthcare for Expats in the UK
Some expats choose to pay out of pocket for the healthcare they need, but the costs can add up fast in an emergency.
If you plan to live in the United Kingdom for six months or more and are not entitled to NHS healthcare, consider international health insurance.
Expat Insurance for the United Kingdom
Expatriates living in the United Kingdom who are not part of the NHS can also opt for private health insurance.
Approximately 13% of U.K. residents hold private healthcare coverage. The main benefits of private insurance include reduced waiting times and access to more comfortable and private facilities, such as private hospitals. Foreigners with private health insurance also receive these advantages.
The Best Health Insurance in the UK for US Citizens
Many US citizens living in the U.K. choose the BCBS Global Solutions Worldwide Premier plan. It has an excellent global network of hospitals and offers up to 9 months of coverage in the USA, allowing you to return home for a prolonged stay if needed. It also provides excellent customer service.
BCBS Global Solutions Worldwide Premier
- Unlimited annual and lifetime coverage
- Pre-existing conditions covered with prior insurance
- For U.S. citizens abroad or foreign nationals in the U.S.
The Best Health Insurance Options in the UK for Non-US Citizens
One of the top choices for expats in the U.K. is Cigna Global. It has an extensive network of healthcare providers worldwide, including in the United Kingdom.
With offices in London and Glasgow, there is always help available in your time zone. Its modular system offers you the flexibility to tailor the plan to your needs.
Cigna Global Insurance Plan
- Flexible plans tailored to your needs and budget
- 1.5M+ providers in 200+ countries
- 24/7 multilingual customer support
Another option for foreigners in the U.K. is IMG Global Prima. They offer a flexible plan design, affordable plan options, and a Europe-only coverage area option.
IMG Global Prima Medical Insurance
- Five flexible plan levels with optional add-ons
- Choose your coverage area based on where you live or travel
- Freedom to select your healthcare provider anywhere in the world
The Best Health Insurance for UK Expats Globally
U.K. expats living overseas will also want to have international health insurance. Some countries, such as Australia, may provide some reciprocal health coverage. However, overall, U.K. citizens outside the U.K. must pay for healthcare.
Joe Cronin, President of ICI, is a leading expert in international health, life, and travel insurance. An MBA and founder of multiple global businesses, he helps expatriates and travelers access trusted, comprehensive insurance solutions worldwide.
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