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An overview of the United Kingdom healthcare system

The UK is home to a tax-payer funded healthcare system known as the National Health Service, or NHS for short. It provides the same quality of care to everyone for free – regardless of income. As one of the first universal health systems in the world, the NHS was set up in the wake of the second world war and is close to the hearts of many British people.

Nonetheless, a thriving private healthcare sector also exists in the country, catering to those who can afford it. The appeal of the private sector in the UK comes primarily from an overburdened NHS – long waiting times and lack of resources. In fact, in recent years, there has even been a surge in the sale of private health insurance due to this ongoing crisis facing the NHS.

If you’re an expat moving to the UK, you might be wondering if you should stick with the NHS or go down the private route. Before you make the decision, it’s crucial to understand how the UK’s healthcare system works. This Pacific Prime UK article gives you an overview of both the NHS and private healthcare sectors, outlining the pros and cons, as well as providing information about health insurance.

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All hospitals in the UK are run by NHS trusts, a healthcare provider set up to deliver hospital and community services. There are 223 trusts in the UK, with each trust running multiple hospitals.

The largest NHS Trust is Barts Health, with five hospitals and over 16,000 staff. It runs St Bartholomew’s Hospital, The Royal London Hospital, Mile End Hospital, Whipps Cross University Hospital and Newham University Hospital.

Accessing services and costs

In the NHS system, the first point of contact for health-related matters is a general practitioner (GP). According to government data from 2014, there are 76 general practitioners per 100,000 people in England.

As an expat, you will have to find a GP and register with them. This is usually done online, by phone, or in person. Once you’ve registered, you will be able to make appointments for non-emergencies.

Your GP will then assess your condition and refer you to a specialist if you require one. You can then visit a specialist clinic or hospital for further consultation and/or treatment.

For urgent medical issues, you can call NHS 111 to speak to an advisor. They’ll assess your symptoms and tell you what to do next. This usually involves going to an accident and emergency (A&E) room.

The NHS provides very comprehensive care that is free of charge. However, since 2015, expats from outside the EU/EEA/Switzerland have to pay a mandatory health surcharge of at least GBP £300-400 per year to get the same access to the NHS as locals.

Short-term visitors who did not pay the health surcharge and do not have medical insurance will be charged at 150% the standard NHS tariff for any care received. But some groups of visitors are exempt from paying for NHS treatment.

As a patient, you’ll get access to:

  • GP consultations.
  • Treatment at A&E.
  • Maternity services.
  • Sexual health and contraception.
  • If referred by your GP, consultation and treatment by a specialist.

However, you will generally have to pay for:

  • Prescription drugs – Fixed at GBP £9 per item, regardless of the type of medication or quantity.
  • Dental care.
  • Eye care.


  • Free comprehensive healthcare

Founded on the principle of everyone having equal access to healthcare, the best thing about the NHS is that it provides universal coverage. From routine consultations to specialist procedures, users of the NHS are generally not required to pay out of pocket.


  • Long waiting times

The NHS is notorious for having very long wait times. It is rare to get a same-day GP appointment. Even those in A&E have to wait hours at times. Key targets for cancer, hospital care and A&E are also routinely missed. This has led to the NHS being in crisis.

  • No freedom in making healthcare decisions

Patients may feel like they have very little control over their health under the NHS. This is because they can only see a specialist if referred to one by a GP. There is also very little choice in choosing a specialist and there might be limited treatments on offer.

Private healthcare sector

The private healthcare sector in the UK consists of hospitals and clinics that are run independently of the NHS. They are typically managed by companies, charities or non-profit organisations.

There are 515 private hospitals in the UK offering a range of world-class services and treatments. However, they generally do not have emergency, trauma or intensive-care facilities.

Accessing services and costs

There are private GPs you can register with instead of relying on an NHS one. With a private GP, you’ll be able to get same-day appointments and, if you’re willing to pay extra, VIP services.

GPs in the private healthcare sector will be able to refer you to a specialist. However, you do not need to be referred in order to see a specialist. You have the freedom to see whichever specialist you like.

You can access private healthcare in two main ways. First is by “self paying” or paying directly using your own money. Second is through a private health insurance plan bought either by yourself or your employer.

The costs of private healthcare in the UK will depend on the location, hospital provider and the treatment. In general, these are the average costs:

  • Consultations: GBP £200
  • Surgical procedures: GBP £1000 – £10,000

For more detailed pricing, Nuffield Health, a major private hospital provider in the UK, has a price list for its 31 hospitals.


  • Shorter waiting times

Time is of the essence when it comes to health-related matters. Within the private healthcare system, you can see a GP and/or specialist on the same day you make an appointment.

  • Better facilities

Private hospitals and clinics also have better facilities that make your visit more comfortable. Especially if you need to stay overnight for a treatment, being at ease makes all the difference.

  • More freedom in making healthcare decisions

You can also choose the specialist you want to see without having to go through your GP first. Furthermore, private hospitals may provide treatments that are not available on the NHS. This gives you more control over your health.


  • Very expensive

As the cost of private healthcare is not regulated, they are typically very expensive. The amount you have to pay out of pocket can quickly spiral – especially if you don’t have a good private health insurance plan.

NHS vs private healthcare

For expats moving to the UK, if you’ve already paid the immigration health surcharge, then you will have access to the NHS. However, many choose to supplement this with a private health insurance plan.

A good tip is to research the quality of care provided at hospitals near you. In England, the Care Quality Commission (CQC) publishes the ratings of health and social care services for both public and private hospitals in their new care directory.

If the care level isn’t up to mark and if you think you’ll be relying on medical services, due to, for instance, an underlying problem, then you should consider going private. As one-off payments are costly, it makes sense to get a good health insurance plan.

Finding health insurance plans

The main insurance companies in the UK are Allianz Care, Bupa Global and Cigna Global. Premiums will generally depend on your plan type, coverage, pre-existing conditions, as well as lifestyle.

With so many types of health insurance available for expats in the UK, it can be quite difficult to choose. Do you need local or international coverage? Do you need inpatient or outpatient coverage? What about dental, vision or preventive care?

That’s where Pacific Prime UK comes in. Whether you’re an individual or a family, working professional or a retiree, our two decades of experience as an insurance broker will be useful in helping you choose the right plan.

Contact us today for obligation-free advice!

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Content Creator at Pacific Prime UK
Suphanida aims to demystify the world of insurance by creating informative and engaging content. As a wordsmith, she spends the majority of her day writing and editing website content, blog posts, in-depth guides, and more.

Outside of work, Suphanida enjoys travelling to new places and immersing herself in different cultures.