Since 1948, the UK has operated a publicly-funded healthcare system called the National Health Service (NHS). This initiative was born after World War II as part of a broader welfare reform aimed at eradicating unemployment, poverty and illness while enhancing education. Healthcare in England is primarily funded through income tax, with approximately 18% of an individual's income tax contribution directed toward this purpose.
As for the private healthcare sector in England, this is growing - particularly in response to NHS waiting lists, and a significant portion of the country's population now have private health insurance. That said, growth in the private sector isn't static - some areas like ophthalmology have seen growth, whereas others have not. Regardless, the NHS remains dominant and the primary provider of healthcare in England.
The NHS in England
In England, the system is simply referred to as the NHS. Across the UK, you'll also find NHS Scotland, NHS Wales and Health and Social Care in Northern Ireland. The NHS is the British people's pride because it was founded when the country showed the world that it puts citizens' health and well-being over financial profit despite the post-war adversities. Before the creation of the NHS, healthcare was available to employed citizens, the wealthy, or those supported by charities. With the introduction of the NHS, everyone was and still is eligible for healthcare.
Overall, the NHS is an efficient, high-quality system that helps British people lead healthy lives through prevention and timely treatment. The NHS provides preventive services such as screenings, immunisations, maternity care, mental healthcare, rehabilitation (e.g., physiotherapy), palliative care, and clinically necessary dental and eye care. People who need assistive devices such as wheelchairs and hearing aids can access those via the NHS.
On the downside, public hospitals often lack modern equipment and medical staff due to limited funding. At the same time, people tend to use free medical services inconsiderately, burdening the system, which is weighted down with longer waiting times for specialist care and non-emergency surgery.
2025 NHS Reforms
The NHS is currently undergoing significant changes, owing to the government's published 10 Year Health Plan for England. This document outlines the long-term vision for NHS modernisation and improvement.
As part of these reforms, the government has plans to transition NHS England's functions to the Department of Health and Social Care (DHSC) over a two-year period, which will require primary legislation. Additionally, the NHS is moving toward a more devolved system where Integrated Care Boards (ICBs) and trusts will have greater autonomy and flexibility in managing healthcare services at a local level.
Good to know:
As of March 2025, the NHS in England employs approximately 1.38 million full-time equivalent staff (or 1.54 million individuals). This workforce continues to grow year-on-year to meet increasing healthcare demands.
Useful links:
Health and Social Care in Northern Ireland
10 Year Health Plan for England
Healthcare for different patient categories in England
The NHS is concerned with patients' individual needs and the type of care they need and strives to do its best for each individual with the means it has, which are often minimal.
For example, under the government's National Service Framework, people with long-term neurological conditions are considered for support to live an independent life and access medical specialists as close to home as possible.
Also, older people are offered extended access to NHS services such as free sight tests, breast screenings for women, annual influenza immunisation, and increased access to dental care. Patients with terminal illnesses are given the option of home nursing instead of hospital care or staying at a nursing home.
Lastly, disabled people can benefit from a Disability Living Allowance and Attendance Allowance, which offer help with personal care and mobility.
Private healthcare in England
Private healthcare services in England are available alongside the public NHS system and offer faster access to specialists, shorter waiting times and access to more personalised care in modern, well-equipped facilities. Many private hospitals and clinics operate across the country, particularly in larger cities, offering services ranging from diagnostic tests and surgery to outpatient consultations and wellness care.
While the use of private healthcare is growing in popularity, especially among expats and higher earners, most people in the UK still rely on the NHS for everyday care and emergencies.
To access private treatment, many people take out private health insurance. Some of the UK's major private health insurance providers include BUPA, AXA Health, Aviva, and Cigna Global. These companies help cover the cost of private medical care, though policies vary in terms of what's included.
It's important to note that even with private health insurance, emergency services - such as ambulance transport and A&E (Accident & Emergency) treatment - are still typically handled through the NHS. Private healthcare is mainly used for elective treatments, diagnostics, or specialist consultations.
Good to know:
If you have landed a job in England, you may get private health insurance as part of your employment package. Contact your HR department for more information. Wealthier individuals purchase private insurance independently, irrespective of their employer.
Regional healthcare in England
As mentioned earlier, healthcare in England is managed at the national level, so it does not differ from region to region. The available healthcare facilities usually depend on where you live.
In major cities and surrounding areas, you will find many public hospitals, dentists, drop-in centres and general practitioners. There is always a GP and hospital near populated areas in smaller towns and villages across the country.
Good to know:
Add your postal code to the NHS's search tool to find the nearest healthcare facility.
Healthcare for expats in England
Expats and their dependents with valid visas for at least six months can receive free medical care via the NHS. As part of your visa application, you must pay the Immigration Healthcare Surcharge (IHS) with fees depending on your visa category.
Immigration Healthcare Surcharge fees
As of 2025, the IHS costs are:
- £1,035 per year for most visa applicants (standard rate).
- £776 per year for students, their dependents and those under 18 years old.
Those fees are paid upfront for the entire duration of your visa when you apply.
There are exemptions. Health and Care Worker Visa holders and certain other healthcare professionals are exempt from paying the IHS. This year, this exemption has been expanded to include additional roles like mental health practitioners and social care workers.
Registering with a GP in England
New expats in England should register with a local General Practice (GP) to receive primary care before being referred to a specialist if needed. Anyone can register with a GP for free without showing proof of address or immigration status.
However, you may be unable to register with the GP closest to your home because many practices have reached their capacity and cannot accept new registrations. Some areas have walk-in centres where you can show up anytime within the opening hours without an appointment or registration.
Getting an NHS number as an expat
When you register with a GP, you can obtain an NHS number after you pass an interview, complete some paperwork, present your National Insurance number (usually obtained with the biometric residence permit) and demonstrate your residence. Upon completing these steps, your personal NHS number will be sent to you by post or online within a few days.
An NHS number is a ten-digit number unique for each patient that helps NHS staff identify patients and match them to their health records.
Note that having an NHS number does not mean you are entitled to free NHS services - you may still have to pay contributions towards the cost of prescriptions, dental care, eye care, etc.
Important:
A GP surgeon can reject adding you to their patient list if they have reached their capacity. If so, you must contact the Primary Care Trust in your area to find alternatives. If you need emergency medical help, you should head directly to the hospital.
Useful links:
European Health Insurance Card in England
EU citizens used to be covered in the UK through their European Health Insurance Card (EHIC), and their health-related costs were charged following the same terms and conditions given to British nationals. Despite Brexit, if you have an EHIC, it will be valid until its expiration date is written on the card. But before it expires, you should start replacing it with a new variant: a UK EHIC or UK GHIC (Global Health Insurance Card). To apply for any of these cards, you must live in the UK legally.
The card allows you to access necessary medical healthcare, meaning you don't need to postpone your care until you return to your home country. A healthcare provider decides whether your healthcare is medically necessary. Generally, emergencies and accidents, treatments for pre-existing conditions (e.g., chemotherapy), monitoring for pre-existing conditions, maternity care and kidney dialysis fall under the necessary care category.
Good to know:
The Health Insurance Card is free of charge. But the card is not a replacement for travel insurance since it may not cover all costs and repatriation costs.
Useful link:
Emergency numbers in England
You shall not contact the GP if you need urgent medical attention in the UK. Instead, go directly to the A&E Department of the local hospital or call the following emergency numbers:
- 999 for the police, ambulance services, fire brigade, or coastguard;
- 111 for urgent medical help via the phone before you are advised to come to the A&E Department or take some self-care steps.
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