Understanding the healthcare system in the United Kingdom as an immigrant can be a little overwhelming, but here at Remitly we’ve got you covered! Here’s what you need to know.
The UK healthcare system: the basics
The NHS is the UK’s National Health Service, created in 1948 to provide healthcare to people based on their needs and not their ability to pay. It’s a well-respected healthcare system because of its quality of care. The NHS provides a wide range of healthcare services to all permanent UK residents—around 58 million people.
This includes General Practitioner (GP) services, accident and emergency (A&E), mental health, social, community and hospital services in England, Wales, Scotland and Northern Ireland. When you think of the NHS, you may just think of your local hospital, but when you go to your local pharmacist, GP, or dentist, that’s also part of the National Health Service.
What services does the NHS provide?
The NHS offers a wide variety of healthcare services. You can access most of them online to schedule and manage appointments, get health information and advice, order repeat prescriptions, view your health record and NHS number, and more. It’s an extensive network covering most aspects of mental and physical health:
General Practitioner (GP) surgeries: You can register with a GP to receive medical advice about health problems, vaccinations, examinations, treatment, prescriptions for medicines, and referrals to other health services and social services.
Pharmacies: You go to your local pharmacy to seek advice on what medicines to take, get your prescription medicines, and a variety of free services such as vaccinations, Covid-19 rapid tests, blood pressure checks and more.
Hospital care: If you need A&E (accident and emergency) servies, specialist care, operations and more, you can visit your local hospital.
Mental health services: To take care of your mental health, you can access online and in-person therapy and counselling services
The NHS also offers services for urgent and emergency care, sexual health, dental, vision, alcohol addiction, and more. You can find the complete list of NHS services here.
How is the NHS funded?
Healthcare in the UK is publicly funded, mostly by general taxation as well as National Insurance contributions. Only 1% of the healthcare budget is derived from patient charges for services like dental care and prescriptions.
In 2022/23, the UK spent £153 billion on healthcare through the NHS, or about 9% of the country’s whole annual budget. This was just above the average healthcare spending in similar countries. Most Department of Health and Social Care spending goes to local healthcare services.
What does this mean when it comes to taxes for UK citizens and residents? About 18% of a citizen’s income tax goes towards NHS healthcare services (around 4.5% of the average citizen’s income).
Accessing healthcare in the UK
Am I eligible to access NHS services?
Anyone can access primary healthcare with the National Health Service. This includes overseas visitors, asylum seekers, refugees, and those without a permanent address.
How can I register with a GP?
Anyone and everyone can register with a General Practitioner (GP) surgery in the UK free of charge.
And you have the right to be treated by a primary care nurse or doctor no matter your immigration status or nationality. When you have a health problem or need medical advice, usually you consult your GP first. In most cases, you register with a GP practice close to home. You can find your nearest GP surgery and see reviews here.
After choosing the GP you’d like to go to, simply fill out a registration form. You can find it on the NHS app, on the GP surgery’s website, or by using the link above.
What do I need to register?
When you register at a GP practice, you may be asked to show an ID as well as proof of address—this is helpful but not necessary. You also do not need an NHS number. If you have friends or family visiting and they need medical assistance, there’s advice on how to access NHS services for visitors from overseas here.
How to get medical attention: a step-by-step guide
Need medical attention in the UK? Usually, you contact your GP first to set up an appointment. If you need urgent medical treatment, go to an urgent treatment centre or see an evening and weekend GP (known as an out-of-hours GP). But if you’re having a life-threatening emergency, call 999 or go to the nearest hospital A&E department.
When in doubt, you can call 111 or go to NHS 111 online, to seek advice on what to do and where to go if you need medical assistance. You may be advised to:
- go to A&E,
• book a callback from a nurse,
• see a dental or mental health specialist,
• get in touch with your GP surgery,
• see a pharmacist.
You may even be given instructions on how to take care of yourself or another person safely at home.
What is the Immigration Health Surcharge?
The Immigration Health Surcharge is a fee that you pay as part of your visa application. It grants you access to NHS health services during your stay in the United Kingdom. The cost depends on the duration of your visa.
There are reduced fees for applicants under 18 at the time of the application, for students or anybody in the Youth Mobility Scheme. If for any reason your visa application is not approved, the surcharge is automatically refunded.
The reason? According to the Immigration Act of 2014, the immigration health surcharge is to “ensure that migrants make a proper financial contribution to the cost of their NHS care.”
Who needs to pay the surcharge? Are there exemptions?
All visa applicants, and each of their dependents, need to pay the NHS surcharge.
You do not need to pay the surcharge if:
- You have a visa such as a Business Visitor, General Visitor (tourists), or Academic Visitor, even if your stay is longer than six months.
- You submit an application for a visa to enter the UK from overseas that has a duration of less than six months.
However, if you do have to pay the NHS surcharge, you must pay it even if you have private medical insurance.
How does the surcharge affect accessibility to healthcare?
If you have paid the surcharge—or if you’re exempt or have had it waived—you’re given the same access to the NHS as an ordinary resident, as long as your visa is valid.
Rights and barriers for immigrants
What are common barriers faced by immigrants in UK healthcare?
The most common barriers faced by immigrants are not fully understanding how the NHS works and how to access healthcare services. Not having enough information about what you’re entitled to is another reason immigrants sometimes don’t get the most out of available healthcare.
So it’s well worth educating yourself on the system and its health services. Other barriers can include not being able to travel to appointments or healthcare centres and limited English proficiency. If you need a medical interpreter in your language, don’t hesitate to ask.
What are my legal rights and entitlements for healthcare in the UK?
In general, primary care health services—those provided by a doctor or nurse at the first point of contact—are free for everyone who’s resident in the UK. This applies if you’ve registered with a GP surgery, or if you’re simply accessing the NHS as a temporary patient (from as little as 24 hours up to three months).
When it comes to secondary care, this is residency-based. So if you’re from any country outside the European Economic Area (EEA), you need to have Indefinite Leave to Remain to be entitled to free secondary healthcare in the UK.
If you’re from the European Union (EU) and find yourself as a temporary visitor in the UK, you still can access the healthcare you need through your European Health Insurance Card (EHIC). You can even access planned care and treatments through the S2 planned funding route. This is possible through UK-EU reciprocal healthcare agreements.
What about everyone else?
Generally, the UK takes a “treat first, worry about payment later” approach to emergency care, and some services are offered free of charge no matter your residency status or nationality. There’s more information here, or you can check out this video to learn more about how to access the NHS as an immigrant in the UK.
Specialist healthcare services for immigrants
How can I access mental health services and support?
Your mental health is just as important as your physical health, especially when it comes to the added stress of navigating life in a new country. You can find the mental health support like therapy and counselling by:
- Reaching out to your GP who can recommend the best services for you. This is called a GP referral.
- Contacting your local health council. They can offer helplines, crisis support, and therapy.
- Visiting your local pharmacy. They can give you advice on medicines used to treat mental health conditions and may be able to direct you to other sources of support.
- In England you can even access talking therapy without a GP referral if you struggle with anxiety or depression.
If you need help right away and you don’t know what to do, go to 111 online or call 111 and choose the “mental health” option. You’re not bothering anyone, ever.
Here are some links you may find helpful:
How to find local mental health services
Find an NHS talking therapies service
What about maternity and child healthcare?
Maternity care will be provided to you free of charge if you’re “ordinarily resident” in the UK or if you’re exempt from charges. This includes those who have already paid the immigrant health surcharge.
If you’re not part of these groups, there may be a charge for healthcare, but you cannot be refused maternity care.
Learn about your rights and get advice on maternity care from Maternity Action here.
If you have children, it’s natural to want the best care for your little ones. All children living in the United Kingdom are entitled to free healthcare, from basic check-ups to more costly health services and care for children with special needs and disabilities.
Are there special considerations for undocumented immigrants?
According to the Migration Observatory, there were between 800,000 and 1.2m people living in the UK in an irregular or unauthorised situation (without a valid residence permit) in 2017. For those who are not ordinarily resident in the UK, there are free healthcare services available regardless of immigration status.
This includes GP services, walk-in centres where you can be seen by a nurse, along with other services. Other primary care like prescriptions, dental services and sight tests have a charge for all working-age adults, whether they have an irregular status or ordinary residence.
If you need some confidential advice, PALS (Patient Advice and Liaison Service) is a free service that can help you navigate the UK healthcare system. They can also answer any health-related questions you have and help you get more involved in your own healthcare.
FAQs
Is healthcare free in the UK for immigrants?
As long as you’re ordinarily resident in the UK, you can access free healthcare from the NHS in England, Scotland, Wales, and Northern Ireland. Therefore, if you have Indefinite Leave to Remain—in other words, the right to live in the UK permanently—your healthcare is free.
How long do you have to live in the UK to access free healthcare in the NHS?
As long as you meet the requirements for entitlement to free healthcare with the NHS, the length of time you’ve lived in the UK doesn’t matter.
Do illegal immigrants get free dental care in the UK?
Unlike most NHS healthcare services that are free of charge, most adults in the UK do pay for dental services. However, some people are entitled to free services in general, or help with costs. For example, dental care in the UK is free if you’re under 18 or are 19 and a full-time student, if you’re receiving certain benefits, or if you’re a woman who’s pregnant or has had a baby in the last 12 months.
If you have a low income and don’t have access to public aid or benefits, you can ask for full or partial help with dental costs through the NHS Low Income Scheme (LIS).
