National Healthcare System England

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If you are moving to England to work in the global financial hub that is London, or one of many other large cities across the country, there is a lot to get to grips with regarding the healthcare system.

We want to help you understand the difference between public and private healthcare in England, how to access them, and the impact Brexit may have.

The National Healthcare System in England

Public healthcare in England is administered by the National Health Service (NHS). The NHS provides all levels of healthcare from community healthcare to hospital care. Most services through the NHS are free, with a few notable exceptions like:

  • Prescriptions
  • Optometry
  • Dentists

In 2014, the Commonwealth Fund declared the NHS in England the most impressive public healthcare system when compared to 10 other European and North American countries. If you are a citizen of a European member state, you can access free treatment under the NHS once you are living in England with a valid visa or work permit.

Non-European Union citizens

If you are not a European Union Citizen you will only have the right to access the NHS for free once you have an immigration status of ‘indefinite leave to remain’. This means you have permission to stay in England for as long as you wish.

If you are moving to the UK for less than 6 months you may be charged for NHS services unless an exemption applies to you. If you are moving to the UK for more than 6 months but do not meet the requirements to be considered a resident then you will be charged an immigration health surcharge of:

  • £150 per year per person for students and each of their dependents
  • £200 per year per person for everyone else

You will pay this when you are applying for your visa. Once you have paid this charge you can access NHS services for free. However paying the surcharge does not mean you can avoid waiting lists or will be treated faster, it only allows you to access the NHS. Your needs will be assessed and, again, you may be added to a waiting list for treatment in a hospital.

Accessing public healthcare in England

The first thing you need to do to access medical treatment in England is register with a family doctor known as a General Practitioner (GP). You are entitled to choose the GP practice that best suits your needs.  A GP can refuse you if:

  • They have no capacity for new patients
  • You live outside their catchment area

However they cannot refuse to register you for discriminatory reasons like race, religion or an existing medical condition. The NHS covers all GP visits and routine healthcare. If needed, your GP will refer you for hospital treatment. If your condition is not urgent you may be placed on a waiting list.

Private Healthcare in England

Private healthcare is also available in England. Expats who have international health insurance can access private health cover if hospital treatment is needed.

 As a private healthcare patient in England you can expect:

  • To avoid NHS waiting lists
  • A guaranteed admission date
  • To be treated by a consultant surgeon
  • First class facilities
  • Treatment at a choice of private hospitals
  • Repatriation to your own country should you need it

For these reasons it is well worth considering international health insurance while you are working in England. 

The impact of Brexit

It is as yet unclear what the impact of Brexit will be on healthcare for expatriates. It is possible that all expats in England will be treated in the same way when it comes to accessing the NHS whether they are from EU countries or not. Over the coming months and years, clarity will ensue and a better perspective on the realities of Brexit will develop.


If you want to find out more about private healthcare in England contact us, we would be happy to answer any questions you have.

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