HEALTHCARE

Healthcare in the United Kingdom is mainly provided by four publicly-funded health care systems to all UK permanent residents that is free at the point of need and paid for from general taxation in the United Kingdom.

Each of the four countries of the United Kingdom has a separate but co-operating National Health Service (NHS) (1): the National Health Service of England, NHS Scotland, NHS Wales and Health and Social Care in Northern Ireland. They provide free physician and hospital services to all permanent residents of the United Kingdom, funded from general taxation. Most of the expenditure of The Department of Health (£98.6 billion in 2008-9) is spent on the NHS.

Services

common to the whole of the United Kingdom

1 General practitioners

2 Health Centres and Clinics

3 Hospitals

4 Advice services

5 Ambulance services

6 Cost recovery in exceptional circumstances

7 Dentistry

1 General practitioners

Each NHS system uses General Practitioners (GPs) to provide primary healthcare for patients and to make referrals to services as necessary, whether for tests or treatments. GPs are qualified doctors, typically working in business practices that deal exclusively with NHS patients and receive fees based on the number of patients and the different services provided by the practice under the GP contract. All people are eligible for registration with a GP, usually of the patient's choosing, though the GP must be local to the area in which the person lives. GPs can only reject patients in exceptional circumstances. There are no fees payable for the services of a general practitioner.

2 Health Centres and Clinics

Health Centres close to residential areas are provided as part of the free public health service. They typically provide care that is considered more routine and less invasive than the type of surgeries and procedures that take place in the hospital. Ophthalmology, dentistry, wound dressings re-dressing, infant check-ups and vaccinations, are typical areas of practice to be found in such places. Medical services are typically provided by nurse practitioners and visiting specialist doctors. Health centres do not make a charge for their services.

3 Hospitals

Hospitals have specialist diagnostic equipment that is not generally available in GP surgeries or in health centres. They also perform surgical procedures. The median wait time for a consultant led first appointment in English hospitals is a little over 3 weeks. Patients can be seen by the hospital as out-patients or in-patients, with the latter involving overnight stay. The speed of in-patient admission is based on medical need and time waiting with more urgent cases faster though all cases will be dealt with eventually. Patient can ask for a private hospital referral at any time which may provide earlier treatment but at full cost to the patient. Access to hospital services is via referral from a general practitioner.

Some hospitals have Accident and Emergency departments providing trauma care and no referral is needed to access A&E services. Emergency Departments try to treat patients within 4 hours as part of NHS targets for emergency care. The Emergency Department is always attached to an NHS general hospital. All services in UK hospitals are free of charge to the patient.

4 Advice services

Each NHS system runs 24 hour confidential advisory services: NHS Direct provides a telephone-based service for England, NHS Direct Wales provides a similar service in Wales while Scotland has NHS24.

5 Ambulance services

Each public healthcare system provides free ambulance services for patients facing life-threatening emergencies or if ordered by hospitals or GPs when patients need the specialist transport only available from ambulance crews or are not fit to be sent home by car or public transport. In some areas these services are supplemented when necessary by the voluntary ambulance services (British Red Cross, St John Ambulance and the St Andrews Ambulance Association).