The NHS can feel like a maze when you first arrive: who can use it, what is free, how you get seen, and what the letters like GP, A&E and 111 actually mean. This guide is the map. It explains how UK healthcare works for newcomers, the few things you do pay for, and how to get care the right way, then links to a detailed walkthrough for each step. Everything here is based on NHS and official guidance and covers England, where charges differ from Scotland, Wales and Northern Ireland. It is general information, not medical advice.
How the NHS works
The NHS provides most healthcare free at the point of use, funded through taxation. If you are on a visa, you usually pay towards it in advance through the Immigration Health Surcharge, which gives you broadly the same access as a resident. Once you are here, care is organised around your GP, a local family doctor who is your first point of contact for most health needs.
The structure is the part that surprises newcomers most. In many countries you choose a specialist and book them directly. In the NHS you generally cannot. Your GP assesses you and refers you on, which makes registering with one the step everything else depends on. The narrow exceptions are A&E and sexual health clinics, which you can walk into without a referral, and a handful of services you can refer yourself to, such as antenatal care, talking therapies, and drug and alcohol support.
Your first step: register with a GP
Registering with a GP surgery is the single most important thing to do for your health after arriving, and it is free. You do not need ID, proof of address, or proof of immigration status to register. Doing this also gets you into the NHS system and triggers your NHS number. If a surgery refuses you, it has to write to you within 14 days explaining why, and only a few reasons are valid.
Do it in your first week, while you are still doing admin. The common mistake is waiting until you are ill, at which point you are trying to register and get seen at the same time. Read the full walkthrough: How to register with a GP.
Your NHS number
An NHS number is your unique 10-digit reference across the health service. Most newcomers get one automatically when they first register with a GP. It is free and stays with you for life. There is no card and nothing arrives in the post, which is why many people do not realise they already have one. It is not the same as a National Insurance number, which is for tax and work. Read the full walkthrough: How to get an NHS number.
What you pay for
Seeing a GP and hospital treatment are free. A few everyday services carry a fixed charge in England, and many people are exempt from those too:
| Service | What you pay in England |
|---|---|
| GP appointment | Free |
| Hospital treatment and A&E | Free |
| Prescription | £9.90 per item |
| NHS dental treatment | £27.90, £76.60 or £332.10 per course |
| Sight test | Free for many groups, otherwise around £22.50 to £25 |
Prescriptions are free for everyone in Scotland, Wales and Northern Ireland. The charge only exists in England, which matters if you move between UK nations. Read the full walkthrough: NHS costs explained: prescriptions, dental and eye care.
How to get care when you need it
The NHS has different services for different needs, and using the right one saves you time. A pharmacy handles minor illness, your GP handles ongoing and non-urgent care, NHS 111 advises when you are unsure, and A&E or 999 is for emergencies only.
The pharmacy is the step newcomers skip most often. Under Pharmacy First in England, a pharmacist can assess and treat seven common conditions without you seeing a GP at all, within set age ranges. NHS 111 is free to call, runs 24 hours a day, and is the right number when your question is really where am I supposed to go. Read the full walkthrough: How to use the NHS: GP, pharmacy, 111 and A&E.
What to expect that may be different
Three things catch newcomers out, none of which mean anything has gone wrong:
- You may not see a doctor. GP practices are teams. Depending on your problem you may be booked with a practice nurse, a clinical pharmacist, a physiotherapist or a mental health practitioner.
- A&E is not first come, first served. Patients are sorted by clinical urgency, so someone who arrives after you with a more serious problem is seen first. If your symptoms get worse while you wait, tell the staff so they can reassess you.
- NHS dentists are hard to find, not expensive. The prices are fixed and modest. The difficulty is finding a practice taking new NHS patients, so start looking when you arrive rather than when something hurts.
Frequently asked questions
Can I use the NHS as soon as I arrive?
Yes. If you paid the Immigration Health Surcharge with your visa, you have access to NHS care. Your first step is to register with a local GP.
Do I need documents to register with a GP?
No. You do not need ID, proof of address or proof of immigration status. A surgery cannot refuse you for lacking these, and if it refuses you it must write to you within 14 days with its reason.
Is NHS treatment free?
GP appointments, hospital treatment and A&E are free. Prescriptions, dental care and some eye care carry fixed charges in England, and many people are exempt from those.
Can I book a hospital specialist myself?
Generally no. Your GP refers you. The main walk-in exceptions are A&E and sexual health clinics.
What do I do if I am ill at the weekend?
Use a pharmacy for minor illness, or call NHS 111, which runs 24 hours a day, seven days a week. Use 999 or A&E only for life-threatening emergencies.
Does the NHS work the same across the UK?
The core principle does, but charges do not. This guide covers England. Prescriptions are free in Scotland, Wales and Northern Ireland.
Next steps: start with registering with a GP, then read how to use the NHS. For the wider picture of settling in, see the first 30 days guide and the money guide for newcomers.
