Navigating UK healthcare
The UK runs a universal National Health Service and a parallel private system side by side. Both are open to you. This article sets out how each works, how to register with the NHS, what it covers, and what it does not.
Dr Seth Rankin
MBChB MRCGP. Founder of LoveMyLife. Former NHS Commissioner and Managing Partner of Wandsworth Medical Centre.
23 April 2026
9 min read
UK healthcare is delivered through two parallel systems that operate alongside each other. The National Health Service (NHS) provides universal care funded by general taxation. The private sector provides additional capacity that patients access through self-pay or private medical insurance (PMI). The two systems share many of the same doctors, and patients move between them freely.
If you are new to the UK, the single most useful thing you can do is register with an NHS general practice. Most of the rest of the system opens up from there. This article sets out how to do that, what your general practitioner (GP) will provide free of charge, what is paid for, what is not prescribed on the NHS at all, and where private care fits alongside. Sources for numeric and policy claims are listed at the end.
NHS general practice is the front door to almost all planned care in the UK. The GP is the patient's first point of contact and the person who decides when specialist care is needed. Your GP holds the central record of your health, coordinates referrals, manages long-term conditions, runs screening and vaccination programmes, prescribes repeat medication, and acts as your advocate across the rest of the system.
This design is deliberate. Every part of the NHS, from hospital specialists to community services to most mental health care, assumes that a patient has a GP. Being registered is how your records follow you, how your prescriptions are renewed, how referrals are made, how test results are filed, how immunisations are tracked, and how national screening invitations find you.
A patient who is not registered with an NHS GP is not shut out of the NHS, because emergency and urgent care remain available to everyone. But navigating anything beyond that becomes harder than it needs to be. Registering is the simplest thing you can do to make the UK system work in your favour.
Registration is free. It does not depend on your immigration status. You do not need a tenancy agreement, proof of identity, or proof of address. NHS England guidance is clear that practices are expected to register patients without these documents. Many practices will ask for them, but none can refuse registration on their absence alone. If a practice does refuse and you believe you are within its catchment area, you can contact your local Integrated Care Board (ICB) or the NHS England customer contact centre.
There are three routes to register, and you can use whichever is easiest for you.
Find a GP practice near you on the NHS website and contact the practice directly, either online through its own website form or in person. Search by postcode at nhs.uk/service-search/find-a-gp.
Register online through the national Register with a GP surgery service, offered by over 6,000 practices in England. It works without a login and is available 24 hours a day. Start at nhs.uk/nhs-services/gps/how-to-register-with-a-gp-surgery.
Register inside the NHS App, the official patient app. It lets you see your current GP, switch surgery, book appointments, order repeat prescriptions, view your medical record, and access NHS test results once you are set up. Download at nhs.uk/nhs-app.
Once you are registered, you are given an NHS number. The NHS number is the identifier that follows you through the rest of the system: hospitals, specialists, prescriptions, vaccination records, screening programmes. Keep a note of it. You will be asked for it often.
If you are not yet ordinarily resident in the UK, or you are unsure about your eligibility for free NHS care, the official guidance is at nhs.uk/nhs-services/visiting-or-moving-to-england. Eligibility for GP registration and eligibility for free secondary care are separate questions, and the guidance explains both.
A registered NHS patient receives a broad package of care at no cost at the point of use. It includes:
Consultations with GPs, practice nurses, clinical pharmacists, and other practice-based clinicians.
Management of acute illness and of long-term conditions, including diabetes, asthma, heart disease, and mental health conditions.
Referral to hospital specialists, community services, and mental health services.
Routine childhood and adult immunisations and national screening programmes, including cervical, breast, bowel, abdominal aortic aneurysm (AAA), and diabetic eye screening. Details of each programme are at NHS population screening programmes.
Repeat prescribing and medication review.
Test results, investigations, and care coordination across the wider NHS.
Beyond general practice, the NHS covers urgent and emergency care, hospital and specialist treatment, mental health services, maternity care, and a large part of prescribed medication. Most of this is free at the point of use for people ordinarily resident in the UK.
A small number of NHS services carry standard charges.
Prescriptions in England. The NHS prescription charge is £9.90 per item and has been frozen at that rate through 2025-26 and 2026-27. The charge applies per item on the prescription, not per prescription. If you pay for more than a few items a year, a Prescription Prepayment Certificate (PPC) is usually cheaper, at £32.05 for three months or £114.50 for twelve months, covering unlimited NHS prescriptions. A long list of people are exempt, including under-16s, over-60s, pregnant women and those who have given birth in the last twelve months, people with certain long-term conditions, and people receiving specific benefits.
NHS dentistry. NHS dental care is charged in three bands. Many adults pay, and eligibility for free care is more limited than for GP services.
NHS eye tests and optical vouchers. Free to some groups, charged to others.
Prescribed wigs, fabric supports, and a few other specific items.
Prescriptions are free in Scotland, Wales, and Northern Ireland. The numbers above apply to England only.
NHS general practice covers NHS clinical work. A defined list of services sits outside the NHS contract, and GP practices are allowed to charge patients for them directly. The list includes occupational and regulatory medicals (Driver and Vehicle Licensing Agency D4 for HGV/PSV drivers, Transport for London 204 for taxi and private-hire drivers, pre-employment medicals, safety-critical worker medicals), fitness-to-perform medicals (sports, SCUBA diving, motorsport, firearms certificate reports), insurance and legal reports, adoption and fostering medicals, school and university reports, passport counter-signing, Lasting Power of Attorney (LPA) and Court of Protection (COP3) capacity assessments, visa medical reports, and most non-NHS-funded travel vaccines. Fees vary by practice. The British Medical Association guidance on private fees sets out the scope of this work.
If your NHS practice does not offer the service you need, a travel clinic, an occupational health provider, or a private GP clinic will. We cover the full picture in a dedicated article: What NHS GP practices charge patients for.
The NHS funds a broad range of medication, but not all medication. National guidance from NHS England, applied locally by ICBs, sets out items that should not be routinely prescribed on NHS prescription. The categories include short-acting sedatives for flights (diazepam is specifically not prescribed for fear of flying), sleep aids for travel, melatonin for adult insomnia outside the Circadin licence, Kenalog (triamcinolone depot injection) for hay fever, most antimalarials and most non-funded travel vaccines, an NHS England over-the-counter (OTC) list for minor self-limiting conditions, erectile dysfunction (ED) and weight-management medication outside specific criteria, cosmetic procedures, and a published list of treatments of limited clinical value including homeopathic and herbal preparations.
Every GP retains clinical discretion, and individual cases can fall outside the standard reasoning. If you need an item from the restricted list, private routes exist. The detail, category by category, is in a dedicated article: What the NHS does not routinely prescribe.
Emergency and urgent care are available to everyone, regardless of GP registration or immigration status, and are free at the point of use.
999 for medical emergencies where there is a risk to life.
Accident and Emergency (A&E) at the nearest hospital for serious or urgent problems that cannot wait.
NHS 111 for urgent medical advice that is not an emergency, 24 hours a day. Online at 111.nhs.uk or by phone.
Urgent treatment centres and walk-in centres for minor injuries and conditions that need same-day attention but not A&E.
Community pharmacies for minor conditions, most of which can be dealt with by a pharmacist without a GP appointment, including under the Pharmacy First service in England.
Private healthcare in the UK sits alongside the NHS. It uses, in many cases, the same doctors, who split their time between NHS and private practice. Private providers include large hospital groups, standalone clinics, and individual consultants in private rooms.
Private care is typically used for three things. The first is faster access to a specialist for a defined problem. The second is services the NHS does not routinely provide, which includes most aesthetic work, some fertility treatments, most travel vaccines, most medicals and reports, and a number of the medications listed above. The third is planned primary care, where a patient chooses private general practice for convenience or for longer appointment times.
Private primary care is not a substitute for NHS registration. The systems work best in parallel. Most private GP clinics, including LoveMyLife, send a consultation summary to your NHS GP so your record stays in one place.
There are three main routes.
Self-pay. The patient pays per consultation, test, or procedure. Prices are published by most clinics and hospitals.
Private medical insurance (PMI). Policies vary widely. Most cover elective and diagnostic work. Few cover planned primary care. Many are provided as an employment benefit.
NHS Right to Choose. For a small number of conditions, notably adult attention-deficit/hyperactivity disorder (ADHD) assessment, NHS patients can choose to be referred to any NHS-funded provider in England, including some independent providers contracted to the NHS. The referral is initiated through your NHS GP. Full detail at NHS patient choice and in the NHS Constitution.
Each route suits different circumstances. Understanding which route applies to which need is most of the work.
Register with an NHS GP where you live. Use nhs.uk/service-search/find-a-gp and register online if possible, or through the NHS App.
Note your NHS number.
Download the NHS App and set it up. It is the easiest way to manage appointments, repeat prescriptions, and medical records.
Transfer or request childhood immunisation records from your previous country so they can be added to your UK record.
Know the difference between 111 for urgent advice, 999 for emergencies, and your GP surgery for everything else.
Locate your nearest A&E, pharmacy, and urgent treatment centre.
If you have an ongoing condition that needs specialist follow-up, ask your new GP for a referral early, and plan around waiting times.
If you need a private route (for a specific medical, report, travel vaccine, ADHD assessment, or faster access to a specialist), decide which of self-pay, PMI, or Right to Choose fits.
LoveMyLife is a private GP clinic. We work alongside the NHS, not in place of it. We actively encourage every patient to register with an NHS GP, because that registration gives you the full reach of the NHS and a complete medical record. After any consultation with us, we send a clinical summary to your NHS GP so your record stays in one place.
We see patients on a self-pay basis or through private medical insurance for consultations, assessments, medicals, reports, travel health, and services the NHS does not routinely fund. For anything urgent, for long-term condition management, and for most prescriptions over time, the NHS is the right route.
UK healthcare is two parallel systems that most patients use together. The NHS is entered through GP registration, which unlocks the rest of it. Your NHS GP provides a broad package of free care, a small number of charged NHS services, a list of private-fee services outside the NHS contract, and a defined scope of medications. Private care sits alongside for the needs the NHS does not routinely cover and for faster access when it matters.
For most newcomers, the practical order is GP registration first, familiarity with the urgent-care routes second, and considered use of private care for the needs that warrant it.
NHS, Find a GP. Postcode search for NHS practices.
NHS, How to register with a GP surgery. Registration routes, including without proof of address.
NHS England, Registering with a GP long read. Official NHS England policy on registration.
NHS App, nhs.uk/nhs-app. Official patient app.
NHS, NHS prescription charges. Current charge, bands, exemptions.
NHS Business Services Authority, Prescription Prepayment Certificates (PPCs). PPC costs and how to buy.
NHS Business Services Authority, NHS prescription charges frozen for 2026/27. Confirmation of the frozen charge.
NHS, Understanding NHS dental charges. The three NHS dental bands.
NHS, Free NHS eye tests and optical vouchers. Eligibility groups.
NHS, Visiting or moving to England. Eligibility for free NHS care by residency status.
gov.uk, NHS population screening programmes. The national screening programmes Britain runs.
NHS England, Pharmacy First. The NHS community-pharmacy scheme for seven common conditions.
NHS England, Over-the-counter items not routinely prescribed. National guidance on OTC items.
NHS England, Items not routinely prescribed in primary care. Treatments of limited clinical value.
gov.uk, NHS Constitution for England. Patient rights including Right to Choose.
British Medical Association, Fees for GPs. BMA guidance on non-NHS GP fees.
NHS 111, 111.nhs.uk. Online urgent-medical-advice service.
Clinically reviewed
Dr Seth Rankin · MBChB MRCGP - Founder and Medical Director, LoveMyLife
Dr Seth Rankin qualified in medicine at Auckland School of Medicine in New Zealand in 1990 and worked as a junior doctor across New Zealand, Australia, and the UK before qualifying as a Member of the Royal College of General Practitioners (MRCGP) through the London Deanery in 2004. He was Managing Partner of Wandsworth Medical Centre from 2006 to 2016 and served as a Board Member of Wandsworth Clinical Commissioning Group for nine years. He is the founder of London Travel Clinic, London Doctors Clinic, London Medical Laboratory, and LoveMyLife.
If you are new to the UK and would like a consultation with an MRCGP-registered GP while you settle in, the next step is to book.
Begin your consultation at this link. Online or in person at Westfield London.