Medicine in UK - beyond GP registration
We assume you have already arrived in the UK and registered with a GP. What next? Here is the list of commonly raised issues useful to Ukrainians in the UK.
What is and is not covered by National Health Service (NHS)
● is and is not covered by National Health Service (NHS)
National Health Service offers free-at-the-point-of-contact healthcare in UK. ● NHS is available for free to all people on Ukrainian visas ● NHS is funded out of taxpayer contributions.● NHS covers comprehensive list of medical services, it is easier to say what is *not* included under NHS than what is● There is a small list of services for you will need to pay: eye care, dental care, prescription charge £9.35 (in England only)● There are many people exempt from these charges as well https://services.nhsbsa.nhs.uk/check-my-nhs-exemption/start Services offered by NHS for free: https://www.nrpfnetwork.org.uk/information-and-resources/rights-and-entitlements/nhs-treatment /free-nhs-treatment
NHS is NOT the same as “health insurance”
There is a concept of “health insurance” in UK, this refers to a privately funded health insurance covering costs of private health treatments.
What is not covered under NHS (non-exhaustive list)
● Some drugs & treatments not recommended by NICE
The National Institute for Health and Care Excellence (NICE) is the body responsible for making recommendations and writing guidance on which drugs and other treatments the NHS can use. NICE assesses the clinical effectiveness and cost efficiency of drugs, which means that in some cases, treatments are not available via the NHS. ● accident/sickness insurance certificates, certain travel vaccinations and private medical reports - you may at some point need these to be produced by your GP. You may incur a charge for that.● Cosmetic surgery and cosmetic dental treatments are not available under NHS
Dental Care
In the UK you can receive dental care under the NHS (with low prices or free) or privately. Your treatment can also be a mix of NHS treatment and private options. The same dentist can provide both NHS treatment and private treatment. ● National Health Service (NHS) will provide any clinically necessary treatment needed to keep your mouth, teeth and gums healthy and free of pain.● Your dentist must make clear which treatments can be provided on the NHS and which can only be provided on a private basis, and the costs associated for each. If you decide to choose alternative private options, this should be included in your treatment plan. You'll be asked to sign the plan and be given a copy to keep..● It is important to read and ask questions about your treatment plan.
Example of a treatment that may be very different between Ukraine and United Kingdom - colour of dental fillings. Under NHS, dark colour fillings are offered for back teeth. In contrast it would be unusual for dentists in Ukraine to offer dark fillings.
NHS dental costs
Band 1: £23.80 - Covers an examination, diagnosis and advice. If necessary, it also includes X-rays, a scale and polish, and planning for further treatment.Band 2: £65.20 - Covers all treatment included in Band 1, plus additional treatment, such as fillings, root canal treatment and removing teeth (extractions).Band 3: £282.80 - Covers all treatment included in Bands 1 and 2, plus more complex procedures, such as crowns, dentures and bridges. https://www.nhs.uk/nhs-services/dentists/dental-costs/how-much-will-i-pay-for-nhs-dental-treatment/
Some people are entitled to completely free NHS care. This is the tool to check whether you are exempt from paying NHS chargeshttps://services.nhsbsa.nhs.uk/check-my-nhs-exemption/start
https://www.nhs.uk/nhs-services/dentists/who-is-entitled-to-free-nhs-dental-treatment-in-england/
How to find an NHS dentist
In Scotlandhttps://www.nhsinform.scot/scotlands-service-directory/dental-services In Englandhttps://www.nhs.uk/service-search/find-a-dentistIn Waleshttps://www.wales.nhs.uk/ourservices/findannhsdentistIn Northern Irelandhttp://online.hscni.net/other-hsc-organisations/hsc-service-finder/ Many dentists provide both NHS care and private care. A given dental practice can take on a limited number of NHS patients while remaining sustainable. Currently there is a shortage of NHS dental places and it may be that the first 2, 3, 4, 5 dentists you contact (we recommend doing so by phone) do not have NHS places. Keep trying! If after contacting several dental surgeries you still cannot find a dentist accepting NHS patients, call support services for England, Wales, Scotland or Northern Ireland respectively (contact information also in the links above).
Dental insurance
In UK dental insurance covers routine and emergency dental work, and some policies include worldwide cover. These policies typically work by you paying out for the dental treatment upfront, and then claiming back the money from your insurer. Some policies will cover you for NHS treatment (as explained above, it is NHS treatment is not free though affordable to most) other will cover part of full cost of selection of private treatments. Prices start from £6 per month and usually have different levels of cover to choose from. For example, a basic policy may cover only your NHS treatment and cost £10 per month, while a more comprehensive policy for £20 may cover some private treatment costs. Good resource explaining what is typically covered by a dental insurance policy: https://www.moneysavingexpert.com/insurance/dental-insurance/#accordion-content-03877467 11-0 Many employers offer dental insurance as an employee benefit. Check with your employer if this is offered.
Orthodontics
For kids:NHS orthodontic treatment is free for people under the age of 18 with a clear health need for treatment. But because of high demand, there can be a long waiting list.
A rating system called the Index of Orthodontic Treatment Need (IOTN) is used to assess eligibility for NHS treatment. NHS treatment is available for grade 4 and grade 5 cases. Grade 3 cases are usually judged on an individual basis. NHS treatment may also be available if the appearance of your teeth, jaw or face is of concern. For adults: Orthodontic treatment is not usually available on the NHS for adults. Most adults have private treatment. Private TreatmentIf you do not qualify for free NHS treatment, or you do not want to wait for treatment to start, you may choose to have private treatment.
Private orthodontic treatment is widely available, but expensive. The fee can range from £2,000 to £6,000, depending on the complexity of the treatment and the type of appliances used, but fees can be higher.
After an initial assessment, a private orthodontist will talk to you about a possible treatment plan, how much it will cost and any alternative options you have.
Continuing existing work started in UkraineYou may come across orthodontists declining to take on your case, even privately, as the treatment was started by another specialist. Do continue searching both online and via your personal network and asking other Ukrainians in UK.
Emergency care under NHS
999 - life threatening emergencies Go to A&E - life threatening emergencies111 - when you have an urgent medical issue and you are not sure what to doGo to an urgent treatment center (walk-in center, minor injury unit) - if you have an urgent but not life-threatening case
CALL 999 for life-threatening emergencies and accidents
Any condition which you suspect to have serious threat to life, for example serious bleeding, chest pain, burns, breathing difficulties, reduced alert levels, allergic reactions, stroke symptoms or serious injuries etc. More details: https://www.nhs.uk/nhs-services/urgent-and-emergency-care-services/when-to-call-999/ What happens when you call 999:This number is for all emergency services initially you will have to ask for which service you require, fire department/police or ambulance. You will be asked questions about where you are, what happened. Ambulance crew will be dispatched if it is a life threatening emergency. You will most likely be taken to A and E or will be dealt with at the scene.
Calling 999 does not mean ambulance crew will be dispatched by default.
More details on what happens next:https://www.nhs.uk/nhs-services/urgent-and-emergency-care-services/when-to-call-999/
Go to A&E aka emergency department - go there for life-threatening situations
Not all hospitals have an A&E department. Use this link to find an A&E nearest to you https://www.nhs.uk/service-search/other-services/Accident-and-emergency-services/LocationSearch/428. What happens at A&E?A&E departments offer access 24 hours a day, 365 days a year. A&E staff compromises of the wider healthcare team including doctors and nurses. Medical staff are highly trained in all aspects of emergency medicine and will be able to help you with your problem or know who to refer you to if needed. 1. RegisterIf you arrive by ambulance, the ambulance crew will provide the relevant details to reception and hand you over to the clinical staff.
If you're not in a life-threatening or serious condition, you'll be prioritized by the A&E hospital team along with other patients waiting to be seen, this wait can often be hours long– arriving by ambulance does not necessarily mean you'll be seen sooner than if you had walked in to A&E.
If you go to A&E by yourself, you'll need to register when you arrive. You'll be asked a few questions such as name and address but also why you're visiting A&E. If you've been to the hospital before, the reception staff will also have access to your health records. Once you've registered, you'll be asked to wait until you're called for your assessment. 2. Assessment – triageOnce you've registered you'll generally be pre-assessed by a nurse before further actions are taken. This is called triage. The process is carried out on all patients attending A&E. Triage ensures people with the most serious conditions are seen first. 3. Treatment, transfer or dischargeWhat happens next depends on the results of your assessment. Sometimes further tests need to be arranged before a course of action can be decided. If the nurse or doctor feels your situation is not a serious accident or emergency, you may be sent to a nearby urgent treatment centre, minor injuries unit or referred to a GP on site.
Call 111 - when you have an urgent medical problem and you are not sure what to do
What happens when you call 111.You answer questions about your symptoms on the website, or by speaking to a fully trained adviser on the phone.
You can ask for a translator if you need one.
Depending on the situation you will:● find out what local service can help you● be connected to a nurse, emergency dentist, pharmacist or GP● get a face-to-face appointment if you need one● be given an arrival time if you need to go to A&E – this might mean you spend less time in A&E● be told how to get any medicine you need● get self-care advice More information: https://www.nhs.uk/nhs-services/urgent-and-emergency-care-services/when-to-use-111/
Go to an urgent treatment center (walk-in, minor injury unit)
You can go to an urgent treatment center (UTC) if you need urgent medical attention, but it's not a life-threatening situation. UTCs are open at least 12 hours a day, every day. Conditions that can be treated at an urgent treatment center include sprains, bites, minor burns, coughs and colds, vomiting, and emergency contraception. Often 111 services can refer you to an UTC. Alternatively, these conditions can be managed by booking an appointment with your GP (primary care doctor).
Seeing a medical specialist in UK
This section covers non-emergency cases. If you need emergency care, whether you walked into an A&E or were brought in by ambulance, you will be seen by the appropriate specialists based on medical needs.
Under the NHS, you can see a medical specialist based on a referral from your GP. Your GP will provide a referral if they feel it is medically necessary to do so.
There are a number of exceptions, some services do not require a GP referral:● Sexual health clinics● Maternity care - if you are pregnant, you can self refer to a hospital of your choice to start your maternity care● Talking therapies● A&E treatment
Seeing specialist under NHS
If you wish to be referred to a specialist in a particular field, such as a surgeon or a gynaecologist, you should see the GP you're registered with. A specialist will only see you with a letter of referral from your GP. Once you have been referred - you will receive a letter to book your first appointment through the NHS e-Referral Service.
This can happen in the following ways:● your GP can book it while you're at the surgery● you can book it online using the appointment request letter your GP gives you● you can phone the NHS e-Referral Service line on 0345 608 8888 (open Monday to Friday, 8am to 8pm, and on weekends and bank holidays from 8am to 4pm)
Useful information (only in English) https://assets.nhs.uk/prod/documents/Print-ready_PatientReferral_PRINT.pdf
Currently, there are long waiting times for non-urgent appointments (exceeding 3-4 months) to see many of the medical specialists. Although target waiting time is 18 weeks (under NHS England) this may not be met in your case. If your condition is suspected to be a cancer or oncology diagnosis you will be seen in 2 weeks from the point of referral by the GP, this doesn’t necessarily mean that you have a diagnosis of cancer but that you will be assessed within around 2 weeks by the specialist in that field.
Seeing specialist privately
You can see a specialist outside the NHS, in private care you will frequently be seen within 1-2 weeks of requesting an appointment. Private care is paid for out-of-pocket (“self-funding”) or covered by a private health insurance.
Many employers provide private health insurance, check with yours if you have this benefit available and how it works.
To see a private specialist (also referred to as consultant) you can ask your GP for a referral, explain this is to see a private specialist. Requesting GP referral is not mandatory, but many private specialists will require you to have a GP referral.
Important! Quality of the National Health Service in the UK is very high. Accessing private care is more commonly a way to cut waiting time (for diagnosis as well as treatment), rather than higher quality medical services.
Costs: a private specialist appointment will cost between £100-£500 depending on speciality and location, any tests would be additional to this. Private surgical procedures are often £5000+
While 1-2 specialist visits may be an affordable way to cut waiting time to a diagnosis requiring a simple prescription, treatments and tests may add up to tens of thousands of pounds. Costs of some of private healthcare can be covered with private health insurance.
Read more about private health insurance here:https://www.moneysavingexpert.com/insurance/cheap-health-insurance/
Contraception
Contraception is free under NHS. Depending on your method of contraception, you can access it through your GP, sexual health clinic and pharmacy.https://www.nhs.uk/conditions/contraception/where-can-i-get-contraception/
Получение противозачаточных средств в Великобритании не является проблемой, вам никогда не придется ввозить их из-за границы или вообще платить за доступ к ним! Вам не нужно платить рецептурный сбор за контрацепцию!
Find sexual health clinic:
in England https://www.nhs.uk/service-search/sexual-health/find-a-sexual-health-clinicIn Scotland https://www.sexualhealthscotland.co.uk/get-help/sexual-health-service-finderIn Wales: https://phw.nhs.wales/services-and-teams/cervical-screening-wales/what-is-cervical-screening/sexual-health-clinics-in-wales/In Northern Ireland: https://www.sexualhealthni.info/gum-clinics-northern-ireland
Pill / hormonal contraception:
● You can get progesterone only pill without prescription at the pharmacy, directly https://www.gov.uk/government/news/first-progesterone-only-contraceptive-pills-to-be-available-to-purchase-from-pharmacies● You can get other types of pill prescribed by GP● If getting an appointment at your GP will take a long time, private prescriptions for contraceptive pill are available (use search engine or ask at your local pharmacy)● Find your local sexual health clinic - appointments are usually available much quicker than current GP waiting times