How does healthcare work in England and the United Kingdom, and what travel insurance, health insurance or expat insurance do you need?

How does the healthcare system work in England and the United Kingdom?

What is the quality of healthcare in England and the United Kingdom?

• The healthcare system in the United Kingdom has been voted the best in the world for several years.
• In various studies, England comes out on top in the categories of effectiveness, safety, coordination and patient-centredness.
• The National Institute for Health and Clinical Excellence (NICE) determines the guidelines for the treatment of a specific condition in England. NICE also determines which care is reimbursed under the NHS and which is not.
• In England, there are rules on whether or not hospitals charge parking fees to their clients. Among others, disabled people, people who have to visit an outpatient clinic frequently, parents of sick children and staff who work night shifts park for free.

How does the public healthcare system work in England and the United Kingdom?

• The United Kingdom uses the National Health Service (NHS), a system in which the state provides for almost all the healthcare needs of its residents.
• England, Northern Ireland, Scotland and Wales each have their own NHS systems for publicly funded healthcare.
• Much NHS care is 'free', funded by taxes and government revenue. Residents pay little or no health insurance premiums, deductibles or additional costs.
• Do not expect luxury with this (free) public care. Waiting lists are often quite long and planned targets are not met.
• NHS care includes treatment by the GP (for basic care) and in hospital (for more specialised care, emergency care, care for people with psychiatric disorders). Ambulance transport (by road or by air) also falls under the NHS system.
• Whether you are entitled to medicines on NHS prescription is determined in England by your right of residence, not by nationality.
• Most patients do pay a modest contribution for medicines on prescription; a fixed amount per medicine (regardless of the value of your order).
• You always need a prescription from a doctor for medicines, with the exception of painkillers and cold medication.
• With a Prescription Prepayment Certificate (PPC) you can 'buy off' this contribution, which is worthwhile if you need the same medicine regularly. But not everyone actually pays this fee: exempt patients include those under 16 (18, if still in full-time education), over 60, with certain medical conditions, or on low incomes.
• No charge is made anywhere in the UK for prescriptions administered in a hospital, by a doctor or in an NHS walk-in centre.

How does the public healthcare system work in England and the United Kingdom?

• The private healthcare sector in England is relatively small; by far the largest part of care falls under the NHS.
• The largest part of private care is 'plannable care'; that is to say that care in emergency situations almost always falls under the NHS. For example, if you unexpectedly have to be admitted to an intensive care unit, you will be transferred to an NHS hospital.
• Private healthcare providers are increasingly entering into contracts with the NHS; for some procedures, you can also go to a private provider as an NHS insured person. And vice versa: as a private health insured person, you can sometimes also go to an NHS hospital for treatment. Reducing waiting lists is the main goal of these forms of cooperation.
• For some treatments, the waiting lists under private care are a lot shorter than under NHS care.
• Because there is a 'brake' on orthopaedic procedures and cataract operations under the NHS, people here more often opt for a private healthcare institution in combination with their own financing. Patients also more often end up at private care/private clinics for cosmetic procedures. Patients with private insurance outside London are often advised to opt for NHS treatment; private clinics are much more limited or have far fewer facilities (with some exceptions).
• Because the NHS sector in England is so large, it is well known in England that surgery in private hospitals can be dangerous(er) due to inadequate equipment, lack of intensive care beds, inadequate staffing arrangements and poor medical administration. Of course, this does not apply to every private hospital.

How is the general practitioner arranged in England and the United Kingdom?

• In England, they use General Practitioners (GPs) for primary health care.
• There are often multiple GPs associated with a GP practice.
• It is common in England to choose a clinic, with or without specific facilities. Much less attention is paid to which specific GP you get. You always need a GP to refer you to specialists.
• For care that you need in the evening, at night or at the weekend, you call a central call centre, which will then connect you to an on-call practice.
• In England, you can choose your own GP. A simple form is sufficient; then you get to know the practice of your choice. You will then receive a National Health Service (NHS) card.

How is the dentist arranged in England and the United Kingdom?

• If you have access to the NHS, minor dental procedures are reimbursed. You pay for extensive treatments yourself. Make sure you are well informed about what is and is not reimbursed.
• Not every dental practice performs work for the NHS; so make sure you are well informed in advance whether you can go there if you are looking for NHS dental care. You can easily find your nearest dental practice via the NHS website.

How is pregnancy care arranged in England and the United Kingdom?

• In England, there is a midwife; a combination of midwife and nurse.
• A home birth is also certainly possible in England, although relatively more people in England give birth in hospital. And the caesarean section is very common.
• After a home birth, or after returning home from a hospital birth, the community midwife will visit periodically for medical checks of mother and child. If necessary, you can also arrange a 'pregnancy and childbirth coach' yourself; there is no 'maternity nurse'.
• Breastfeeding is very common in England. Breastfeeding in public is also fine: many shops have special areas for mothers, so that you can easily feed.

How safe or unsafe is a trip or stay in England and the United Kingdom?

What should you pay attention to in terms of safety in England and the United Kingdom?

• The UK is generally a safe country, especially compared to other countries. However, there are a few things to keep in mind.
• Pickpocketing and bike theft are common in major cities such as London, Manchester and Birmingham, especially in tourist hotspots. Keep your phone and wallet out of sight and make sure your bike is locked.
• Brits love a night in the pub, but drunk people can be noisy and unpredictable around closing time.
• The UK doesn’t have extreme weather conditions, but be prepared for rain – always. If you’re walking in the mountains, such as the Scottish Highlands, make sure you wear good shoes and warm clothing, as the weather can change quickly.

What should you look out for in terms of diseases in England and the United Kingdom?

• Tap water is safe to drink and food hygiene is very good.
• There are virtually no major health risks. However, as in other northern countries, the British climate, particularly the short days and limited sunshine in winter, can contribute to seasonal affective disorder (SAD) or the winter blues. Make sure you have plenty of daylight or consider a daylight lamp in your home. Mental health services are also available through the NHS, although there can be some waiting times.

What should you pay attention to when it comes to traffic in England and the United Kingdom?

• In the UK people drive on the left side of the road, which can take some getting used to for many expats, especially at roundabouts. With a bit of practice, you’ll soon get used to it!
• The UK thankfully has relatively low numbers of road accidents.
• Check the signs – in cities, the speed limit is often 30 miles per hour (48 km/h).
• It is mandatory to have car insurance. If you are importing a car, make sure your vehicle meets UK standards.
• Look right when crossing the road, especially if you are used to right-hand traffic – this is crucial for pedestrian safety.
• Cycling in the UK is becoming increasingly popular, especially in cities such as London. It can be quite hectic though, so wear a helmet and take care!
• Trains, buses and the Underground are safe and well-run. Just be sure to keep an eye on your belongings, especially during peak hours.

What work and travel insurance policies are suitable for short and long stays in England and the United Kingdom?

• Is the trip to England and the United Kingdom and your return sufficiently covered? Are you sufficiently covered before, during and after your activities? Which insurance best suits your trip and your activity? Read more about insurances for abroad on JoHoinsurances.org.

What emigration and expat insurance can you take out for England and the United Kingdom if you are going to live there for a while?

• It is mandatory to register for the NHS, but it may be wise to also take out your own private insurance. Public healthcare has long waiting times and with private insurance you can get faster and more extensive help, especially in large cities such as London. You are also insured for medical repatriation, for example.
• Read more about insurances for abroad on Expatinsurances.org.