The NHS and healthcare in the UK

AT A GLANCE · AS OF NOVEMBER 2026

Family doctor (GP)	registration and treatment free, registration usually within 5 days
Emergency department (A&E)	free, open around the clock; if in doubt, NHS 111 first
Prescriptions in England	£9.90 per item; annual prepayment certificate £114.50; free in Scotland and Wales
NHS dentist (England)	three charge bands: £27.90, £76.60, £332.10
On a visa	Immigration Health Surcharge, usually £1,035 a year, paid up front with the visa application

How the NHS works: the GP first, then everything else

The National Health Service is not an insurer but a public health service. There are no premiums to a fund and no insurance card. It is paid for through taxes and National Insurance, and it treats the people who live in the country. Your passport is not what decides it: hospital treatment is free for people who are ordinarily resident in the UK, regardless of nationality, taxes paid or whether you own a home.

The central figure is the General Practitioner, the GP, your family doctor. In the NHS you normally only reach a specialist through them: the GP refers, prescribes and is your first contact for almost everything. If you are used to booking a dermatologist or an orthopaedic surgeon yourself, this takes some adjusting. It is not a bug; it is the system.

One important point: the NHS is organised separately in the four countries of the kingdom. England, Scotland, Wales and Northern Ireland each run their own health service with their own rules, for example on prescription charges. This article describes England and names the differences where they matter day to day. Why there are four systems in the first place is explained in our overview of the regions of the kingdom.

Registering with a GP in four steps

In England anyone can register with a GP surgery free of charge. Online is the easiest way.

1
Find a practice
Search by postcode on nhs.uk. Most practices only take patients from their catchment area, so pick one near your home.
2
Fill in the form
Online, on paper at the practice or through the practice's website. Allow about a quarter of an hour per person; a parent usually registers children under 16.
3
No proof required
A practice may not turn you away because you lack proof of address or of your immigration status. It still helps to have your tenancy agreement and passport to hand.
4
Wait for confirmation
Registration is usually done within 5 days, sometimes longer. You then get an NHS number and can use the NHS App.

What is free and what you pay for

The GP is free, so is hospital treatment for residents, and so is A&E, which is free even regardless of where you live. What costs you money is mainly two things: prescriptions and the dentist.

In England you pay a fixed charge of £9.90 per item for every medicine prescribed, not per prescription. Three medicines on the slip means paying three times. If you need medication regularly, buy a prescription prepayment certificate: three months cost £32.05, twelve months £114.50, and it pays off once you need more than eleven items a year. Certain groups are exempt; check on nhs.uk whether you are before your first trip to the pharmacy. In Scotland and Wales prescriptions are free for patients registered there, a point that tends to be underrated when people weigh up where to live.

At the dentist most adults pay even on the NHS. Treatment falls into three charge bands: check-up and cleaning in band 1 for £27.90, fillings and root canals in band 2 for £76.60, crowns, bridges and dentures in band 3 for £332.10. You only ever pay the highest band of your course of treatment. The bad news: finding an NHS dental practice that takes new patients is a test of patience in many places, which is why many newcomers end up with a private dentist.

On a visa: the health surcharge up front

Since Brexit, citizens of the EU, Norway, Iceland, Liechtenstein and Switzerland who move to the UK for more than six months on a visa pay the Immigration Health Surcharge with their application. The standard rate is £1,035 per person per year, or £776 for children under 18 and students. It is due in advance for the full length of the visa, and for every family member. From the start of your visa you then use the NHS like everyone else. There are exceptions, for example for the Health and Care Worker visa.

For a family with two children on a three-year visa that adds up to more than £10,000 before the removal van is booked. How the surcharge fits into the overall bill is in our article on the real costs of moving. Which visa fits in the first place is covered in our visas and residence section.

Applications to the EU Settlement Scheme carry no surcharge. And if you draw a state pension from an EU country, Norway, Iceland, Liechtenstein or Switzerland, you may be covered through an S1 certificate, with that country paying for your NHS care. We go into this in our article on retiring to the UK.

In an emergency: 999, 111 or A&E?

If life is at risk, call 999 or go to the emergency department, which in England is called A&E, Accident and Emergency. A&E is open around the clock. Don't drive yourself if it is serious; get someone to take you or call an ambulance. And expect to wait: the NHS itself says emergency departments are very busy at the moment and you will probably wait a while. Who is seen first depends on the initial assessment, not on when you arrived.

For everything in between there is NHS 111, online, in the app or by phone. 111 tells you whether you need A&E, an urgent treatment centre, an out-of-hours doctor, a pharmacy or simply your bed. For children under five, call rather than using the online service. And don't underrate the pharmacy: for minor complaints it is often the quickest port of call in England.

As a visitor, and with private cover

If you are only visiting, you need no NHS registration. People from the EU can use a valid European Health Insurance Card, the EHIC, to get medically necessary treatment during a temporary stay in England; that has continued since 1 January 2021. Planned treatment is not covered by the card. What else changed for travellers from the EU is summarised in our article Brexit for EU citizens.

Many Britons, and even more newcomers, top up the NHS with private health insurance, often through their employer. Its main benefit is shorter waits for specialist appointments and planned operations. It is not required, and it usually does not replace the GP either. Whether it is worth it depends on your age, your health and your patience.

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