The National Health Service (NHS) is one of the largest publicly funded healthcare systems in the world. Founded in 1948, the NHS was built on a simple principle:
👉 Healthcare should be free at the point of use, based on clinical need, not ability to pay.
Whether you’re a UK resident, international student, healthcare professional, or new migrant, understanding how the NHS works can help you access the right care at the right time.
What Is the NHS?
The NHS provides healthcare services to people living in the UK. It covers:
- GP (doctor) services
- Hospital treatment
- Emergency care
- Mental health services
- Maternity care
- Community and social care services
Most NHS services are free at the point of delivery, funded through general taxation and National Insurance contributions.
🔗 Official NHS website:
https://www.nhs.uk/
Who Runs the NHS?
The NHS is not a single organisation. It is made up of four separate systems, one for each UK nation:
- NHS England
- NHS Scotland
- NHS Wales
- Health and Social Care (HSC) Northern Ireland
Each system is publicly funded but managed slightly differently.
🔗 NHS England: https://www.england.nhs.uk/
🔗 NHS Scotland: https://www.scot.nhs.uk/
🔗 NHS Wales: https://www.wales.nhs.uk/
🔗 HSC Northern Ireland: https://online.hscni.net/
How Is the NHS Funded?
The NHS is mainly funded by:
✔ General taxation
✔ National Insurance contributions
Patients do not usually pay for:
- GP appointments
- Emergency treatment
- Hospital care
However, some services may have charges, such as:
- Prescriptions (free in Scotland, Wales, NI)
- Dental treatment
- Eye tests
🔗 NHS costs explained:
https://www.nhs.uk/nhs-services/visiting-the-nhs/nhs-costs/
Primary Care: Your First Point of Contact
General Practitioners (GPs)
GPs are usually the first contact for non-emergency health concerns. You must register with a GP surgery to access most NHS services.
GPs can:
- Diagnose and treat common conditions
- Prescribe medication
- Refer patients to specialists or hospitals
🔗 Register with a GP:
https://www.nhs.uk/nhs-services/gps/how-to-register-with-a-gp-surgery/
Secondary Care: Hospitals & Specialists
Secondary care includes services provided by hospitals and specialists, usually after a GP referral.
This includes:
- Consultant appointments
- Surgery
- Diagnostic tests (X-ray, MRI, CT)
- Emergency care (A&E)
Hospitals are managed by NHS Trusts.
Emergency & Urgent Care Services
When to Use Which Service
- 999 – Life-threatening emergencies
- A&E – Serious injuries or illnesses
- NHS 111 – Urgent advice when GP is unavailable
- Urgent Treatment Centres – Minor injuries and illnesses
🔗 NHS urgent care guide:
https://www.nhs.uk/nhs-services/urgent-and-emergency-care/
Mental Health Services
The NHS provides mental health care including:
- Talking therapies (IAPT)
- Community mental health teams
- Crisis services
- Inpatient mental health care
Many services allow self-referral, especially for anxiety and depression.
🔗 NHS mental health services:
https://www.nhs.uk/mental-health/
Community & Social Care
Community healthcare includes:
- District nursing
- Physiotherapy
- Occupational therapy
- Care for older adults and people with disabilities
Social care (e.g. care homes, home carers) is often means-tested and managed by local councils.
Integrated Care Systems (ICS)
England uses Integrated Care Systems (ICSs) to improve coordination between:
- Hospitals
- GPs
- Mental health services
- Local authorities
- Community care
The goal is to provide joined-up, patient-centred care.
🔗 Integrated Care Systems:
https://www.england.nhs.uk/integratedcare/
The NHS Workforce
The NHS employs over 1.3 million staff, including:
- Doctors
- Nurses & midwives
- Paramedics
- Physiotherapists
- Radiographers
- Healthcare assistants
- Managers & support staff
🔗 NHS careers:
https://www.healthcareers.nhs.uk/
NHS Waiting Times
Due to high demand, some services have waiting times, especially for:
- Elective surgery
- Specialist appointments
Patients have the right to choose providers for some treatments.
🔗 NHS waiting times:
https://www.nhs.uk/nhs-services/hospitals/nhs-waiting-times/
NHS vs Private Healthcare
| NHS | Private Healthcare |
|---|---|
| Free at point of use | Paid or insured |
| Longer waiting times | Faster access |
| Universal coverage | Optional |
Many people use both, depending on need.
Healthcare for Migrants & Visitors
Most people living in the UK can access the NHS. Some migrants must pay the Immigration Health Surcharge (IHS) to use NHS services.
🔗 NHS for migrants:
https://www.nhs.uk/nhs-services/visiting-the-nhs/healthcare-for-visitors-to-the-uk/
Strengths & Challenges of the NHS
Strengths
✔ Universal access
✔ Free emergency care
✔ Strong public trust
✔ High clinical standards
Challenges
⚠ Long waiting times
⚠ Workforce shortages
⚠ Rising demand & ageing population
Final Thoughts
The NHS is a cornerstone of life in the UK, providing healthcare to millions every day regardless of income. While it faces challenges, it remains one of the most comprehensive public healthcare systems in the world.
Understanding how the NHS works helps you:
- Access care efficiently
- Make informed health choices
- Navigate services confidently
