NHS

About the National Health Service (NHS)

Since its foundation in 1948, the NHS has grown rapidly and is now the largest and one of the most well-respected state-funded health services in the world. The NHS provides care for millions of people each year, with a huge range of services available to UK citizens free of charge. The NHS is also one of the world’s biggest employers, with over 1.7 million employees currently on the books. The NHS was founded on the principle that everyone should be entitled to healthcare, regardless of their financial situation or social status; this principle has remained intact but the original aims of the NHS have evolved and now include the provision of a wide range of services, the promotion of good health and the prevention of illnesses and serious health conditions; the NHS is now focused on education, as well as treatment.

How is the NHS run?

The NHS is funded by British taxpayers and is managed by the Department of Health. The annual budget determines the amount of money ploughed into public services, with the National Health Service often one of the primary recipients of state and taxpayer’s money. Money is divided between local Primary Care Trusts, who decide where and how the money is spent. NHS services in Wales, Scotland and Northern Ireland are all managed independently of the NHS in England.

What services does the NHS offer?

The range of services offered by the NHS is vast and far more wide-reaching than most people realise; the most popular services and NHS run institutions are outlined below:

• Hospitals
• GPs
• Midwives and health visitors
• Social care
• Dentistry
• Emergency medical care (the ambulance service)
• Ophthalmology
• Mental health
• Pharmacists
• NHS Direct (this is a telephone line which patients can use to discuss any symptoms or problems they may have with trained professionals, the service is also available online)
• NHS walk-in centres (this is a surgery which is open to all members of the general public; no appointment is necessary and the patient can receive advice from a trained professional)
• Smokefree services (these are designed to help people stop smoking)
• Drugs and alcohol abuse services (these help people with dependencies to get back on track and live a healthier lifestyle)
• Educational services

Access to NHS services

One of the most important founding principles of the NHS back in 1948 was the ability to provide a high standard of care to all those who needed it. Today, the NHS is committed to delivering excellent healthcare to every single UK citizen that needs it. In terms of accessing services, the majority of UK citizens should find themselves in a position to receive the treatment they need without having to travel very far; the regions covered by Primary Care Trusts have been divided up to ensure services are readily available for patients.

Local services usually include GPs, social care services, community healthcare services, ambulance services, dentistry and ophthalmic services. Most towns have a hospital, although some may have a limited range of specialist wards and it may be necessary to travel slightly further for treatment for some health conditions.

In some cases, where specialist treatment is needed, patients may have to travel slightly further afield to ensure they get the best treatment possible; certain hospitals specialise in the care and treatment of certain conditions so your consultant may refer you to one of the specialist units.

What if I can’t find a GP or a dentist in my area?

The NHS is currently working to reduce the number of people that struggle to register with an NHS dentist; recently, waiting lists have increased in size and NHS practices have become over-subscribed. If you can’t find a dentist in your local area, you should contact your local Primary Care Trust; they will be able to check for places in your local area; if they cannot locate any, you may be eligible for private treatment funded by the NHS, but usually, there are places available. Usually, it is easier to find a GP in your local area, but if you are having trouble finding one that is taking on new patients, don’t hesitate to contact your Primary Care Trust; they will usually be able to find you a GP quickly and easily.

What choices do I have about the care I receive?

Nowadays, the patient has more choice than ever before and can play a large part in determining what kind of treatment they have and where they have it. Patients can now choose which hospital they want to go to and which GP they want to register with (this is limited to the GP’s catchment area) as well as being able to play an active role in the decisions made regarding their treatment. New legislation announced in 2009 enabled a greater choice for the patient, which has enabled people to take on a more active role with reference to their healthcare.

How do I choose a GP?

There are many things to consider when choosing a GP and it can be a very important choice as you will probably have more contact with your GP than any other health professional. Firstly, although you have a choice of GP, you must live within their catchment area in order to be able to register; this ensures doctors can make house calls as well as meaning the surgery is a convenient distance from patients. If you are new to an area, ask local people about which GP they go to and ask for recommendations. Have a look at the information provided on the NHS website about the GPs working in your local area and the services offered by the local practices; if you have a child with asthma, for example, it may be beneficial to choose a practice than offers additional support for asthma sufferers.

Female patients may feel more comfortable seeing a female GP so it is beneficial to do a bit of research to find out if there any female GPs in your area; you can find this information on the NHS website. Also, have a look at which practices are currently taking on new patients, as some may be over-subscribed.

Some patients may have a preference regarding the age and cultural background of their GP so it may be beneficial to ascertain this information when choosing a GP.

If you have troubles getting around because you don’t drive or live in a rural setting, check out the location of the surgery and research how easy it would be to get there; this involves checking out trains or buses and having a look at how much a taxi would cost, for example.

Will I have to wait to see a GP?

Some GP’s have very busy surgeries where patients struggle to get an appointment, while others often have free appointments. Most surgeries have introduced an appointment system where the appointment is made on the day you wish to see the doctor; in many cases, this involves patients ringing the surgery first thing to secure an appointment. Other practices offer a system where you can make appointments a few days in advance; you should find out the system your practice uses when you register. GP’s will often arrange appointments for minor surgical procedures or more complex queries well in advance.

Many surgeries have a number of different GP’s which may be advantageous if you don’t mind which doctor you see but could be a disadvantage if there is one particular doctor that you want to see or there is one doctor that happens to be more popular than the others; if this is the case, you may have to wait to see your GP or you could consider seeing a different one.

Is all NHS healthcare free?

The vast majority of treatment you receive on the NHS will be free of charge but there are a few exceptions. Dental costs are subsidised by the NHS but there is still a fee system in place; treatments are banded according to their complexity and range from around £15 to £300 (private dental treatment can cost thousands of pounds so this is a radically reduced rate). Some eye care is also chargeable; it is best to check details of this with your optician before you have an appointment. Most prescription medications are also not free; currently, each item of medication costs £7.20 and a twelve month pre-paid certificate is £104 (this covers a 12 month supply of your prescription medication). Some people are exempt from paying for prescription medications; these include:

• People aged over 60
• Children aged between 0 and 16
• Children aged between 16 and 18 that are in full-time education
• Pregnant women and women on maternity leave that have a valid maternity exemption certificate
• People with specific medical conditions, limited mobility or a physical disability (these must be verified and the patient must have a valid medical exemption certificate)
• People with a war pension
• People who are in receipt of Government benefits (restrictions apply)

Prescription medications are free of charge if they are given to patients in a hospital, NHS walk-in centre, during an appointment with the GP or at a local Primary Care Trust. Medications including contraceptives and treatments for sexually transmitted infections and tuberculosis are also free of charge.

Which treatments are not covered by the NHS?

Although NHS healthcare is comprehensive, there are a number of treatments and procedures that are not covered by the NHS. Mostly, these treatments are non-essential, but some may also not be available because of cost or a lack of widespread availability. Some of the procedures and treatments excluded by the NHS are listed below:

• Cosmetic surgery: cosmetic surgery is available in some cases, but the majority of procedures are not covered by the NHS; this is mainly due to the fact that people have cosmetic surgery to make themselves look and feel better, rather than for medical reasons.
• Cosmetic dentistry: cosmetic dentistry is usually carried out for aesthetic reasons, rather than to address medical issues and is therefore not covered by the NHS.
• Immunisations: certain immunisations aren’t covered by the NHS; you should ask your GP or practice nurse for details of which immunisations are covered and which aren’t.
• Dental treatments: certain dental treatments are not available on the NHS; usually, this is because they are not essential; for example, white fillings are not available on the NHS because they are more expensive than silver amalgam fillings but they do the same job; patients choose to have white fillings because they look more attractive.
• Fertility treatment: there are strict regulations for NHS fertility treatment which take into account a number of different factors including age, weight and lifestyle. A certain amount of fertility treatment is available on the NHS for those couples that meet the criteria; however, if the treatment is not successful after the set amount of cycles, they will not be offered further treatment on the NHS.

How do I choose a hospital?

Due to changes made last year, patients now have the right to choose which hospital they go to; obviously, in the event of an emergency the patient will usually be taken to nearest accident and emergency unit to ensure they get treatment as quickly as possible. For non-emergency treatment, however, patients now have a choice of hospitals. In many cases, the patient can choose where they want to go, but in cases of serious health conditions, where complex treatment is needed quickly, the GP will refer the patient to the hospital they believe can deliver treatment quickest.

If you have no idea about your local hospitals and don’t know where to start with regard to choosing one for your treatment, ask your GP; the chances are that they have had a lot of experience with dealing with specific hospitals and specialists and they will be able to advise you which one would best suit your individual case. You may also find it beneficial to talk to relatives, friends or colleagues that may have more experience of healthcare in the local area, although you should take care not to be heavily reliant on hearsay.

In some cases, your GP may recommend a certain hospital or specialist because they have a good reputation or are geared up to deal with a certain health condition; although you don’t have to go with their recommendation, you should consider it carefully as it will ensure you get the best treatment possible; sometimes this might mean you have to travel a bit further but your health is extremely important and a little extra effort could reap huge rewards.

Will I have to wait for NHS treatment?

The answer to this question is reliant upon a number of different factors, including the type of treatment you need, the area you live in and your general health. In some cases, there may be a very short period of time between being referred and getting treatment; however, in other cases, there may be a fairly lengthy wait for treatment.

The NHS has pledged to cut waiting lists in a bid to improve patient care and waiting lists are now at all-time low; however, some departments have failed to satisfy targets (these include trauma and orthopaedics and neurosurgery). The target set out in January 2009 championed a maximum waiting time of 18 weeks and the vast majority of patients have received treatment within this period of time in the last twelve months. On average, patients are receiving treatment within 9 weeks of their initial referral. Some departments are more stretched than others so waiting times may be longer than in other departments; your GP should be able to give you a rough idea of the time you can expect to wait for treatment when they refer you.

You may be able to avoid longer waiting lists by choosing a hospital slightly further away from where you live; usually your GP will be able to explore all the options open to you.

The NHS and preventive measures

The NHS spends millions of pounds each year on treating preventable illnesses; making a few positive lifestyle changes can have a significant influence on people’s health and the NHS is keen to promote healthy living in a bid to improve national standards of health and cut costs in the future. There are several ways the NHS are encouraging preventive medicine; these include:

• Stop smoking campaigns
• Drink aware campaigns
• Healthy eating and exercise campaigns
• Screening programmes
• Education campaigns (this includes TV, internet and radio advertising, posters and promotional leaflets)

These measures can provide people with the knowledge and information they need to make an informed decision on how they live their life; children are particularly important for the future health of the nation and the NHS is putting efforts into encouraging children to exercise regularly, eat well and look after their bodies by broadcasting child-friendly adverts and putting leaflets and posters in schools, hospitals and GP’s surgeries.