Understanding & Using the NHS: A Simple Guide for Beginners
If you’re a new UK resident, and especially if you’re new to universal healthcare, the whole system may seem overwhelming.
There’s no one to explain to newcomers how the system works, so I’m here to do exactly that.
I’m an American who has lived in the UK for several years, and I’ve learned firsthand how tricky this complex healthcare system can be.
Here’s my complete guide to navigating the NHS: how it works, how to use it, what types of services are available, and how to access care when you need it.
Please Note: this article is written from personal experience as an American learning to navigate the NHS, and comes from my experience in London only. It is not meant to represent everyone’s experience using the NHS, and opinions expressed within are mine alone.
Table of Contents
1. What Is the NHS and How Does It Work?
The NHS – National Health Service – is the UK’s publicly funded healthcare system. It’s residence-based, meaning that you must be a UK resident to use it (in most cases, though there are exceptions).
The biggest misconception about UK healthcare is that it’s free, but it’s not. Residents pay for our healthcare through taxes and National Insurance contributions, and most immigrants pay for it up front through the Healthcare Surcharge when you apply for your Visa.
Unlike in America or other insurance-based countries, you won’t pay a copay for your medical treatment. But you will still need to pay for things like prescriptions, glasses, dental treatment, and more (more info about this below).
Healthcare in the UK still much cheaper than in America, but keep in mind that not all services are actually “free.”
Most NHS services are stretched to their limits, especially in large cities like London. But that does not mean you won’t get care; it just means it will take a little longer.
2. How to Register with the NHS
To access care in the UK, the GP (General Practitioner) is always your first point of contact. This includes registering for the NHS for the first time.
You need to register your children with a GP, too, as there are no pediatric-specific GP offices within the NHS.
GPs treat all ages, from babies to seniors.
Research Local GP Surgeries
Doctor’s offices in the UK are called “surgeries.” GP surgeries are residence-based, meaning each practice has a catchment area in which you need to live in order to be a patient with them.
Once you have your permanent UK address, research your local GP offerings. Find the ones near you here.
Find out which GP surgeries you can register with, then check their reputation. Google Maps reviews are often helpful, as are reviews on the GP Patient Survey.
If you’ve met your neighbors, ask around, as it’s vital that you register with a well-run, efficient surgery. I didn’t do this with my first GP surgery (I figured they were all the same, but they’re not). Once I switched to a much better run office, I found it much, much easier to communicate and access care.
Register With A GP
Each GP practice has its own registration system, so check their website to see what you’ll need to do. You’ll have to provide proof of address and proof of UK residence.
If you have an NHS number, you can provide it, but if not, you’ll be assigned one from the surgery.
You’re registering with a practice, and not one specific doctor. You’ll likely be assigned a “primary” doctor, but will not always see the same person for your appointments.
Provide Your Medical History & Documentation
During or after registration, provide your medical history and copies of your medical records.
Each office has slightly different protocols for how they want you to submit documents, so you’ll need to ask reception how to do it.
For children, make sure to provide their vaccination record so the office can check they are up to date according to the UK vaccine schedule.
Set Up the NHS App
Create an NHS account and download the app. The app has everything you need to communicate with your doctor’s office, see test results, request prescriptions, and more.
Some surgeries exclusively use the app for requesting appointments, and some do not. Ask during registration what their process is to request appointments.
Make sure to opt in to text or email alerts so you’re immediately notified of appointments.
Not all surgeries use all the features of the app. Some use their own website or other forms of communication. It varies from practice to practice.
3. How to Use NHS Services
Remember, your GP is always your first point of contact, except in an emergency.
Getting a GP Appointment
Each GP surgery has their preferred method of booking appointments. Some will ask you to submit a request in the app, some will take requests through their website, and some will ask you to phone them.
Same Day Appointments
For same-day appointments, which are hard to come by, you’ll generally need to phone right when the practice opens (usually 8am). You’ll likely be on hold for a while, as everyone who needs same-day appointments is phoning at this time.
If you feel you really need a same-day appointment, they will absolutely do their best to accommodate you. Give them as much information as you can, and communicate as clearly and politely as you can.
If you’re an American, it will feel strange to tell a receptionist your medical problems, but there are no HIPAA laws to contend with here.
Your surgery receptionists are your gatekeepers to appointments, and they’re trying to prioritize the needs of many, many patients to keep everything running efficiently.
Non-Urgent Appointments
For non-urgent matters, contact the GP by their preferred method, and if you need to be seen, you will be assigned an appointment and notified by mail or text.
Unfortunately, you don’t always get to choose the date and time of your appointment.
Employers here are generally understanding of missing work for GP appointments, because they know you can’t choose or change the surgery’s schedule.
Phone Appointments
If you don’t need to be physically seen, you’ll often get a phone appointment to chat about what’s going on. Sometimes reception will tell you that the doctor will phone you “later today,” and sometimes you’ll get an assigned call time.
Surgeries often have unknown or blocked numbers. If you get a call from an unknown number, it’s likely your GP. Try to answer it (I know, I hate answering unknown callers, too).
Follow-Up Appointments
For ongoing care, you’ll be assigned follow-up appointments in advance and notified by mail or text.
Many, many NHS services are overloaded, so your follow-up may be months away, and you won’t get to choose the date and time of your appointment.
Regular Check-Ups
Unlike America, the NHS does not do very many routine or annual checkups. You’ll be notified if you’re due for any check ups or vaccines.
For babies and children, see the regular health visitor schedule here. Children will often receive routine services like vaccinations and eye exams in school.
If you’re over 40, you can get an overall health check every 5 years.
Booking Appointments for Others
If you have children or seniors in your life, you can contact the GP in the same way. If you’re messaging your GP in the app, you can tick the box that says you’re contacting them for help for someone else.
To access your children’s medical records and manage their NHS services, you’ll need to go through your GP surgery to be granted access to their NHS accounts.
4. Referrals
Your GP is always your first point of contact for everything, and you’ll need a referral from your doctor to access specialist care, including mental health treatment.
Say that you need ongoing orthopedic care, for example. Your GP will ask to have an appointment with you, collect all pertinent information, then refer you to the appropriate orthopedic specialist.
After they send the referral, it can take a long time (weeks and even months) to hear from the specialist about an appointment. This is, unfortunately, normal. Always ask for a copy of your referral so you can keep track of dates.
If it’s been a few weeks and you’ve still heard nothing, message your GP to ensure that the referral was sent, or you can phone the specialist to (politely) ensure that your referral was received and is being seen to.
Wait Times for Specialist Treatment
Wait times vary from hospital to hospital and specialist to specialist. For non-urgent treatment, you have the right to be seen within 18 weeks by the specialist you’ve been referred to. In many cases, this doesn’t happen.
Unfortunately, the longest wait times right now (in my personal experience) are for children. The autism diagnosis wait list in London is pushing 5 years, and the ADHD diagnosis wait list is over 3 years.
The Prime Minister has set out a plan to help with the backlog by partnering with private healthcare providers. Hopefully it works.
You can always book private healthcare, and though you’ll have to pay, it’s still much cheaper than dealing with insurance in America.
5. Understanding Emergency and Urgent Care
Outside of GP hours, or in an urgent situation, you have a few different options for care depending on your circumstances.
When to Use A&E (Accident & Emergency)
In the UK, the Emergency Room is called A&E. If you’re in a life threatening situation, call 999, or take yourself to A&E if it is safe for you to do so.
At A&E, you’ll be triaged at the front desk, then sent to the waiting room (or taken straight back if it’s a life-threatening emergency).
Wait times vary dramatically based on how busy the hospital is. It’s hard, but try to be patient – they are all working as fast and efficiently as they can.
Ambulance services are stretched to their limit in many metropolitan areas of the UK, so if you can safely take yourself to A&E, it may be faster.
Unsure? Dial 111
If it’s outside of GP hours, or if you’re not sure if you need immediate medical attention, dial 111. You’ll immediately be connected with medical specialists who can talk through your symptoms and situation, and tell you what to do next.
If they want you to go to your nearest A&E, they will phone the hospital to tell them you are coming.
If it’s not an emergency but you’re worried – and it’s out-of-hours for your GP practice – you can always phone 111, 24 hours a day.
I have always found this helpline to be incredibly helpful, and I wish we had something similar in America.
Alternatives to A&E
For things like sprains, minor injuries, high fevers and stomach viruses – things that aren’t an emergency, but you need help with fast – visit your nearest Urgent Treatment Centre.
These are staffed by nurses who can help you, and it will likely be faster than A&E.
Find out if they can help in your situation and locate your nearest Urgent Treatment Centre here.
6. Prescriptions
How To Get And Collect Prescriptions
If your doctor has prescribed medication, they’ll send it electronically to your preferred pharmacy (also called a “chemist”).
In the NHS App, you can nominate a preferred pharmacy where your GP can send your medications. You can only select one nominated pharmacy for your GP to use.
High Street vs. Mail Order Pharmacies
High street pharmacies – either chains like Boots & Superdrug, or small independent chemists – vary in quality and helpfulness. Once you find a pharmacy you like, and fills your medications on time and without hassle, stick with them.
Mail order pharmacies are a double-edged sword: they will request refills for you and automatically send you your medications every month.
However, if you need a one-off medication like antibiotics, make sure your GP sends it to a local pharmacy so you can get it right away. If not, it will be stuck in the mail for several days while you’re suffering.
You may have to switch nominated pharmacies in the app for this to happen, then switch back for your regular monthly medications.
It may take some trial and error to figure out a prescription system that works for you.
Prescription Refills
Unlike America, in the UK you’ll need to request a refill from your doctor and not your pharmacy, even if it’s not a controlled substance.
In the NHS App, you can request prescription refills and track the progress of your requests (if your GP uses this feature).
If it’s “approved,” that means they have sent it to the pharmacy, and you can call the chemist to ensure they have the stock to fill it.
In-person pharmacies are generally much faster in filling prescriptions than American pharmacies, since most medications come in blister packs or pre-filled bottles. I’ve never waited over 10 minutes to get a prescription filled here.
Prescription Charges And Exemption Criteria
Most NHS-issued prescriptions for adults costs £9.90 each as of 2025.
Children and other exempt individuals get prescriptions for free. Check your exemption status here.
If you get more than one prescription per month, it’s worth getting a Prescription Prepayment Certificate, which pays for 3 months, 6 months, or a year’s worth of prescriptions for much, much cheaper.
Present your certificate to your pharmacist, and remember to renew it before it expires (or else you’ll be fined). It’s up to you to make sure your prepayment certificate is up to date; it’s not the pharmacy’s responsibility.
7. Additional NHS Services
Mental Health Services
Your first point of contact for mental health services – for children and adults alike – is always your GP. They can refer you to specialists, talking therapies, and discuss medication.
For under 18’s mental health, services (including prescriptions) are run through CAMHS (Childhood & Adolescent Mental Health Services). Ask your GP to refer your child to CAMHS.
Getting medication (antidepressants, stimulants, et al) for children & adolescents is much more difficult than in America, and it will take some time. If you can afford it, it’s absolutely worth it to go private for your child’s mental health (speaking from too much personal experience).
Dental Care
There are two types of dentistry practices in the UK: NHS dentists and private dentists.
NHS dental services, however, are not free. Some people are entitled to free dental treatment, but others pay on a scale based on what treatment you need.
A cleaning, for example, will cost £26.80, while a root canal will cost £73.50.
Private dentists charge roughly twice as much, but you can often be seen much faster.
In either case, dental treatment in the UK is not as comprehensive as in America, and it’s usually a la carte. You won’t be seen by a dentist at a regular cleaning unless you have also booked a check-up.
Dental care is, however, a lot cheaper in the UK, even if you have to pay separately for multiple services.
Find an NHS dentist here, though not all have room for new patients.
Optical Care
Optical care, like dentistry, isn’t free within the NHS, but it’s still a lot cheaper than in America.
Check if you’re eligible for a free eye test here, though many, many high street opticians offer free or cheap eye exams that are just as good as your eye doctor in America.
Glasses and contact lenses are also cheaper than in America, and you may be entitled to an optical voucher to offset the cost, depending on your situation.
I get my eye exams and glasses from a high street optician, and even with my very complex prescription, I’ve never paid over £200 for glasses.
8. Tips for Navigating the NHS as a Newcomer
If you’ve just arrived in the UK, the whole socialized healthcare system can seem daunting and cryptic. I had to learn the hard way how to navigate this complex system, so here are my best tips if you’re just starting out on your NHS journey.
✅ Be Proactive
In America, healthcare chases you: tests, physicals, & blood work are all done regularly, whether they’re necessary or not. Why? It’s a machine built to profit off of your healthcare.
Here in the UK, you have to chase healthcare. No one will message you to remind you to get your thyroid checked; you’ll have to ask. Your pharmacy won’t refill your prescriptions for you, you have to request it from your doctor on your own.
Preventative care is not huge here, so you’ll have to learn to look after your own healthcare and be assertive in what you need.
✅ Find a Good GP
Your GP is the gatekeeper to accessing everything within the NHS, so finding a great GP surgery is essential.
A brusque or rude receptionist is not always an indicator of how the practice is run. How responsive they are to your messages and requests is. (side note: GP receptionists are goddesses and have the patience of Sisyphus, and they – and everyone within the NHS – all deserve a big fat raise).
With my very first GP in the UK, I lost all hope for the NHS. But as it turns out, I just had a really poorly run surgery that was impossible to communicate with.
Coming from America, every doctor’s office will seem strange and terrible. They’re not; it’s just a different system that’s not for profit.
✅ Be Persistent but Patient
It takes much more time and energy to get what you need within the NHS. Remember, you’re learning an entirely new system, and it’s a system that’s already overloaded and underfunded.
But the people that work within the NHS, I’ve found, actually care, and though it may take a bit more effort, you can absolutely get what you need if you are polite but persistent. Learn to advocate for yourself in the nicest way possible.
Ask questions if you don’t know what’s going on, and it’s totally okay to admit if you’re confused. The language and procedures are all foreign.
It’s a learning curve, but it’s a system you can learn to navigate with time and experience.
✅ Document Everything
You won’t be handed a visit summary when you walk out of your appointment. Take note of what you discussed, note next steps, and follow up on any referrals if you haven’t heard anything.
If you can’t access your medical records in the app, ask your surgery. It’s very easy to lose track of what’s going on, especially if you have multiple family members who all need different things.
Final Thoughts: You CAN Do This
I hope this quick rundown of the NHS has been helpful; I’ve tried to cover everything I wished I knew when I first arrived.
It may seem overwhelming right now, but remember, you CAN do this. It’s much harder to navigate medical care in the UK, but you’ll also never go bankrupt if you get in an accident or get sick.
All that time you used to spend on the phone with your insurance company? You’ll now spend that time waiting for an appointment, or waiting to hear about an appointment. But when you finally get to see that specialist, you won’t be denied coverage or get a surprise bill in the mail.
There are pluses and minuses to the NHS, but if you remember to be polite, persistent, and communicate clearly, you’ll become a pro in no time. And though this system has its faults, I think it’s amazing that everyone – no matter their situation – can get the treatment they need.
Read More: Moving to London & The UK
How to Set Up Your New Life in the UK
Types of visas available for living and working in the UK
Complete London Neighborhood Guide
Finding Short Term Accommodation In London
How to Rent a Property in London
