If you aren`t from the UK, it might be difficult to think how the scheme really works. Do you just rock up at any physician or hospital when you look like it? What are the criteria? What`s it like being an NHS patient?
The "patient`s perspective" in motion is mine - I was natural and brought up in London, have parents, sisters, a brother, a mate and a 3 yr old son who are all ordinarily resident in the UK and therefore NHS patients.
This article looks at how the National Health Service really works in the United Kingdom - specifically, in England. The NHS is divide into 4 parts, for England, Wales, Scotland, and Northern Ireland. The differences aren`t great, but there are some minor variations.
This hub follows on from two others, the offset is called, The National Health Service in the UK: who pays, and who is covered, and details how the NHS was founded in 1948, who is covered by the system, and how often it all costs.
The second, What the Home Health Service (NHS) in the UK covers, and what costs patients extra is almost what patients pay for medical care, dentistry, and optician`s treatment, under the NHS.
The National Health Service logo
* NHS Choices Homepage - Your health, your choices
The face page for the principal National Health Service website
See all 9 photos
A child about to make a developmental check on the NHS
Accessing the NHS system - the General Pracitioner
Everyone with a good to Home Health Service coverage gets an NHS number. This is allocated to you at birth (if you are innate in the UK) or when you have up permanent, lawful residence here, if that comes later.
This number follows you some from physician to hospital, and keeps your records together. A soul is also allocated a National Health Service Card, but these aren`t terribly important - I can`t remember when I last needed mine, but it can`t have been for a piece as it`s ease in my mother`s "important documents" file at my parents` home.
The General Practitioner is the gateway to the NHS` medical system. In place to access treatment (other than emergency treatment) you want to be registered with a GP`s surgery. There are a lot of them, and they generally hide a small geographical area. An individual patient in a densely-populated area might take the selection of registering at various different surgeries.
A GP`s surgery is, usually, several doctors practising together. My GP`s clinic has 8 GPs based there.
Becoming a GP takes some time - after finishing medical education, a doctor works in a hospital for a bit of days before doing GP training.
When I see an NHS GP, and making appointments
Most of the time, I`m perfectly healthy when I see the GP. Sometimes it might be for booster injections for things such a tetanus or polio.
There are also regularly-scheduled screening programmes, such as smear tests (every 3 years), and breast mammograms for aged women, for example. Every 3 months, in place to regenerate a (free) contraceptive prescription, I want to make my blood pressure and weight checked.
With routine appointments such as these, I usually book them a week or two ahead, as then I can choose exactly what sentence of day will cause me best, and word to see a particular GP if that matters (which it doesn`t, to me, but it matters a lot for some people). My GP`s surgery has appointments from 8.30am to 7.30pm on weekdays, and on Saturday mornings, for routine matters.
If I am unwell, with (say) an ear infection, or a nasty cough, I obviously don`t have an appointment weeks ahead. Instead, I call the operation in the morning, from 8.30am, and a doctor then rings me back to see what is wrong, and if necessary to hold an engagement for me that day. With these last-minute appointments, there is often less choice of precise time and which doctors are available.
A National Health Service (NHS) General Practitioner in Holborn, London WC1
Out of hours GP services
When the operation is closed, there is a 24 hour, 7 day a week come to meet the on-call GP. Consultations can be made over the phone, and the GP might have an out-of-hours house call, or direct you to go to Stroke and Pinch at the hospital (also known as Casualty), or might advise you go the operation the next day.
I`ve just had to call the out-of-hours number once, when my darling then two-year-old son proved that childproof caps on medicine bottles are not childproof, and took a big swig of Calpol (paracetamol liquid for babies). I rang the GP, who looked up toxicity and doses, then rang me backwards and told me that the dose wasn`t something to care about.
St. Thomas` NHS hospital central London
King`s College Hospital, an NHS hosptial in south London
Referral to a hospital doctor or clinic
If the GP thinks it is necessary, he can either refer you to a specific specialist doctor at the hospital, or place you to a clinic at the hospital. You can`t go straight to a specialist hospital doctor on the National Health Service, the GP has to cite you.
Depending on what character of trouble it is, you will either be told to go home and expect an engagement letter, or given a letter there and so and sent off to the relevant clinic with it.
My son suffered from horrible reflux as a newborn baby, and when we took him to the GP when he was roughly 5 weeks old, the GP reckoned he was dehydrated. We were sent to a paediatric clinic at the nearest tertiary-level hospital, where Isaac was seen first by a junior doctor, then a consultant (the most senior level) and as a consequence of those examinations, he was admitted to the paediatric ward for 3 years to be put on a trickle and given various ultrasound scans, blood tests, and other nasty procedures.
The children`s wards have small rooms attached, so that a raise or protector can rest in the hospital overnight and be about the child.
Once referred to a specialist, you might easily get further appointments and tests, if necessary, made directly with the hospital. You don`t want to be referred each time. So Isaac saw a paediatrician regularly at the hospital until he was ended the whip of the reflux, at which period he was discharged back to the GP`s care.
Any notes, tests, examinations and so forth are copied to the GP, so your medical file at the GP is a perfect health history.
A newborn baby (my son) in a cot in an National Health Service hospital maternity and neo-natal ward
Newborn baby (12 hours old) with his proud grandmother in the same ward
* Choosing where to access care after the birth
National Health Service guide to wish for mothers and newborn babies
Midwives, ante-natal care and maternity
How this is organised will bet on the Local Health Authority. In a lot of cases, community midwives (those who do routine pre and post pregnancy care) are based at a GP`s surgery. In other cases, they have a freestanding clinic several years a week.
Pregnancy care is organised through the midwife. It consists of a long (2-3 hour) booking-in appointment early in pregnancy, where health histories of the woman, her partner, and her close family are taken, blood tests organised, height and weight checked, and a care plan devised.
After that, you see a midwife approximately 10 times done the pregnancy, more frequently later on, to stop the baby`s movement, heart-beat and size, the mother`s general health, and to check the mother`s blood pressure, sugar and protein levels. At any time, the midwife can name a charwoman to the ante-natal unit at the hospital, if she thinks that is necessary.
In addition, in a normal, healthy pregnancy, there are ultrasound scans at around 12 and 20 weeks, and an engagement with the doctor at the ante-natal clinic at around 30 weeks. If the mother has health or pregnancy problems, she will pass a lot more time with the midwife and the ante-natal clinic.
The National Health Service also runs ante-natal classes, and tours of the pregnancy and neo-natal wards, so that the father can select between natural childbirth (midwife-led care) and more medical childbirth (doctor-led care) and which hospital she wants to establish birth in.
It`s also possible to make an NHS home birth, where two midwives come to the mother`s home when she is in labour.
My son and I were fired from hospital when he was 3 years old. A community midwife visited us at home every day for a week, then every other day for another week.
Great Ormand Street Hospital for Sick Children, a National Health Service hospital in London WC1. This shows the primary building.
Great Ormand Street Hospital ambulance entrance
Health visitors
Each fry is assigned to a Health Visitor, or team of health visitors, from birth.
The inaugural visit at least (and much subsequent ones, it depends on the way the clinic runs) are at the baby`s home, when he is a few years old.
health visitors` clinic is also where a child and child has regular developmental checks with a paediatrician, checking all sorts of things from fine motor movement through listening to speech, as appropriate at different ages.
Isaac was offered developmental checks at 6 weeks, 3, 6, 9, 12, and 18 months, and 2 and 3 days old. He has another upcoming at 4 years old.
Other health professionals
There are loads of early health professionals, often connected to GP`s surgeries, who share with mass in the community. They include Community Psychiatric Nurses, who provide support to the mentally ill, and District Nurses, who do home visits for things such as changing dressings. Fazia khan -
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