SIDA & VIH
Who has to pay for NHS treatment in the UK?
UK medical treatment
If you're in the UK and in need of medical treatment, it can be confusing trying to find out how to access the services you need, or whether you're allowed to receive free healthcare. This page explains how you can get medical treatment in the UK, and who can get it for free.
The National Health Service (NHS) is the UK's public health system, and provides free medical treatment for millions of people every year. Most of the people receiving free NHS treatment are British residents, but some are visitors from other countries. You can access NHS treatment through a variety of different services, but there are two main ways to get it: firstly, through General Practitioners (GP) at local surgeries, and secondly, through hospitals.
Getting medical treatment from a GP in the UK
If someone in the UK is ill, but not in need of urgent hospital treatment, they will usually go to see a GP (a family doctor) at a local surgery. GPs are qualified doctors that can diagnose and treat illnesses. They can also send patients to see other doctors or specialists who are better suited to treating that illness. In some cases, this means sending someone to a hospital for further medical treatment.
GPs are mostly there to treat people who are ‘ordinarily resident’ in the UK – i.e. living in the UK legally, and for a settled purpose. However, they can also treat overseas visitors, under certain conditions that we detail later in the page.
Registering with a GP
You generally have to be registered with a GP in the UK before they can give you medical treatment. Registering with a GP means giving them details such as your name, UK address, nationality, and any health conditions that you suffer from (or have done in the past). These details need to be given in writing, on a form that you can get from the surgery. The surgery will store these details on their computer and you will then be included on a GP’s ‘lists’, meaning that they can give you medical treatment for free.
There are two types of registration for GP services: you can either register as a ‘temporary’ resident, or as a ‘permanent’ resident. If you’ve been in the UK for a long time, or are in the country for a settled purpose, you’ll probably be registered as a permanent resident. Overseas visitors who have been in the UK less than three months may be registered as ‘temporary’ residents. This depends on what the surgery decides, though. They can choose to treat overseas visitors who have been in the UK less than three months privately, meaning that the patient will have to pay in order to be seen.
To sign up with a GP, ask at a local surgery. They will tell you whether you can register, and what information you need to provide them with. A surgery will generally only accept people who are living or staying in their local area. To find out where your nearest surgery is, see the NHS website.
Being treated by a GP
Once you’re registered with a GP in the UK, you can make appointments to see them at the surgery. If you become too ill to get to the surgery, a doctor may be sent out to visit you at home, or wherever you are staying.
If a GP thinks that a patient needs to be given drugs, they will write them a prescription – a piece of paper that can then be taken to a pharmacy (chemist or drugstore) and exchanged for medication. Most adults have to pay a standard charge (currently £7.10) when they collect their prescription at the pharmacy. Some people, however, don’t have to pay prescription charges. This includes men and women over 60 years of age; children under 16; young people aged 16, 17 and 18 who are in full-time education; pregnant women or women who have had a child in the past 12 months and have a valid exemption certificate; people suffering from certain conditions such as diabetes and epilepsy; and people (or the partners of people) who are receiving a form of government benefit called income support. 1
Getting NHS hospital treatment in the UK
There are two main ways to access NHS hospital treatment in the UK: you can either be referred to hospital by your GP, or treated at the accident and emergency (A&E) department of a hospital.
Getting hospital treatment in an emergency
If you suddenly fall ill, or an accident happens and you (or people around you) are in need of urgent medical treatment, then this will usually be dealt with in the A&E department of a hospital. You can make your own way there, but in most cases people should call 999 and ask for an ambulance to come to the scene of the incident.
In the UK, medical treatment for emergencies is always free – regardless of your nationality, how long you’ve been in the UK, or any other factors. So, for instance, if you fall, break your leg, and have to be taken in an ambulance to A&E, you won’t have to pay for the immediate NHS treatment you receive. It’s important to note, though, that if you enter hospital through an A&E department and then need to receive care from another part of the hospital, then this further treatment may not be free for everyone.
Getting hospital treatment for non-emergencies
If you have a condition that requires you to visit a hospital, but which isn’t an emergency, you should usually visit your GP first, and they will then refer you to a hospital if they think that it is necessary. Depending on your condition, they may refer you to a specialist doctor or department. They will help you to make an appointment, and you will then have to go to the relevant department of a hospital at a given date and time.
Who is entitled to free NHS treatment?
NHS treatment that is always free
In the UK, medical treatment for emergencies is always free. Certain other parts of medical care in Britain are always free to everyone. Treatment from certain NHS walk-in centres (which offer fast and convenient medical advice and care, and are located at various places around the country) is free when they are treating an emergency. Treatment for certain infectious diseases is also free, but this does not include HIV and AIDS, for which only diagnosis and connected counselling sessions are free for everyone. Family planning services and compulsory psychiatric treatment are universally free.
Free NHS treatment from a GP
People who are ‘ordinarily resident’ in the UK are entitled to register with (and be seen by) a GP for free. An ‘ordinary resident’ is usually considered to be someone who has legally been in the UK (or is planning to be in UK) for six months or more, and can prove that they are here for a settled purpose – for instance, they may be studying or working in the UK.
The rules around who GPs should treat for free are fairly flexible. A GP can choose to register overseas visitors as temporary residents, or, if they are in the UK for longer than three months, accept them onto their lists. Technically this could apply to failed asylum seekers or immigrants, although this is left down to the decision of the individual GP. If a GP decides not to register an overseas visitor or treat them as a temporary resident, they can still treat that individual on a private basis, but this means that they will be charged.
Nationals of countries that are part of the European Economic Area (EEA), and who are carrying a European Health Insurance Card, are entitled to the same level of GP care that UK residents get, for conditions that arise during their stay. This includes on-going medical treatment, such as blood tests or injections.
In addition, asylum seekers or refugees who have been given leave to remain in the UK, or are awaiting results of an application to remain in the country, are eligible for free GP treatment.
Free NHS treatment at hospitals
Even if you’re entitled to free GP treatment in the UK, medical treatment from hospitals will not necessarily be free, unless your condition is considered to be an emergency. You can receive NHS hospital treatment for free if:
- You’ve been living legally in the UK for at least 12 months (temporary absences of up to 3 months are ignored).
- You’ve come to work in the UK, either as an employee or self-employed person. This does not include people on short business trips, and it only relates to people who are actually working, not just looking for work.
- You’ve come to permanently live in the UK, and have had an application for permanent residence approved.
- You’re studying in the UK on a course that lasts 6 months or more, or which, if it lasts less than 6 months, is substantially funded by the UK government.
- You’re a refugee or asylum seeker, or are waiting for your asylum request to be considered.
- You’re a UK state pensioner that spends up to six months a year living in another European Economic Area (EEA) country, but are not a resident of that country.
- You’re working in an EEA country but are paying compulsory UK national insurance contributions.
- You’ve been working abroad for no longer than 5 years, but have lived legally in the UK for ten continuous years at some point.
- You’re from an EEA country but are referred to the UK for specified treatment with an E112 or E123 form.
- You’re an unpaid worker with a voluntary organisation that offers services similar to those of a Health Authority of Local Authority social services department.
- You’re employed on a ship or vessel registered in the UK or working offshore on the UK sector of the Continental Shelf.
- You’re a member of the UK armed forces, or a UK civil servant working abroad who was recruited in the UK and employed by Her Majesty’s government.
- You were recruited in the UK but work abroad for the British Council or the Commonwealth War Graves Commission.
- You receive a UK war disablement pension or war widows pension.
- You’re a diplomat, or diplomatic staff, working in embassies or Commonwealth High Commissions in the UK.
- You’re working abroad in a job financed in part by the UK Government in agreement with the Government or a public body of some other country or territory.
- You’re a prisoner, or detained by the immigration authorities, in the UK.
- You’re serving NATO personnel, posted in the UK, and are not using your own or UK armed forces hospitals.
- You’ve been referred by your home country for specified treatment in the UK under the terms of a bilateral healthcare agreement.
If you don’t fit into any of these categories, you will still be able to get NHS treatment for conditions that occurred after arrival in the UK only, if you fit into the following categories:
- Anyone who normally lives in another EEA member state but is visiting the UK.
- Anyone, or the spouse or child of anyone, receiving a UK state pension who has either lived legally in the UK for 10 continuous years at some point or has worked as a UK Civil Servant for at least 10 continuous years.
- Anyone, or the spouse or child of anyone, who is a national of a country that has signed the European Social Charter but is not entitled to be provided with services under a bilateral agreements (currently Turkey and areas of Cyprus not covered under the EEA arrangements) and is genuinely without the means to pay for their treatment.
- Anyone, or the spouse or child of anyone, who has lived legally in the UK for 10 continuous years at some point but who is now living in another EEA member state or in certain countries with which the UK has a bilateral healthcare agreement.
- Anyone who is entitled to receive industrial injury benefit from Israel if the treatment is in connection with the industrial injury.
- Anyone living in a country with which the UK has a bilateral healthcare agreement.
So, what happens if you don’t fit into any of the categories that we’ve listed? Well, technically, you should then be charged for any UK medical treatment that you receive. If a hospital thinks that you need to be charged for treatment, you will usually be interviewed by an administrator. They will probably ask for any evidence that you’re entitled to free NHS treatment.
If you think that you will be charged for medical treatment, but can’t afford to pay, then you should still talk to a hospital administrator as they may be able to help you. The NHS is supposed to treat its patients in confidence, so even if you’re not living in the UK legally, your details should not be passed on. You could also contact other organisations for help, such as Citizens Advice Bureau. Citizens advice Bureau provides free information and advice, both online, over the telephone, and in person at their many locations around the UK. In some places they even operate from within local surgeries and hospitals.
For more information about who has to pay for NHS hospital treatment in the UK, and for other information such as which countries have reciprocal/bilateral healthcare agreements with the UK, see the Department of Health Website.
Treatment for sexually transmitted infections and HIV
People who think that they may have a sexually transmitted infection (STI) should usually visit a GP or a genito-urinary medicine (GUM) clinic to be tested. To find out where your nearest family planning or GUM clinic is, visit the Family Planning Association website.
These clinics offer advice and information, and provide STI testing and treatment. Testing, advice and counselling from these clinics is free for everyone, and medical treatment for all STIs except HIV is also universally free.
For more information about who is able to receive HIV/AIDS treatment in the UK, visit our treatment in the UK page.
