If you’re thinking of moving to the UK, you’re in for a proper treat. The UK, and in particular London, is one of the most popular expat hotspots for students, professionals and entrepreneurs in the world. It is good to remember that when you travel or move to a new country it is better to be prepared for any inconvenience, including those related to your health. Are expats entitled to NHS treatment? UK healthcare for expats is something you need to familiarise yourself with before you make a move.
So, how many hospitals are there in the UK? What are the best hospitals in the UK for expats? And can non-residents in the UK get free healthcare? Maybe it is worth getting private health insurance instead. Healthcare for expats in the UK can be a complex question, but it doesn’t need to. Find the answers to these questions and more in this guide and understand how the UK’s hospital system works and whether you’re entitled to free health treatment as someone coming from abroad.
- UK is one of the top-ranked countries in the Commonwealth Fund’s index and is well served for medical care.
- There are around 1,250 hospitals in the UK.
- Healthcare costs are going up, with COVID impact contributing.
- Expats in the UK are able to use the public healthcare system managed by the NHS.
- Cromwell, Nuffield and the Wellington are among the best hospitals in the UK for expats
- Many expats want to have private health insurance to help reduce wait times and several other reasons.
- Age, location, medical history and optional extras all influence the private insurance cost.
- On the flipside, American expats abroad often find they pay less for insurance overseas.
UK healthcare for expats. What are the best hospitals in the UK for expats?
In this article, we’ll tell you everything you need to know about healthcare in the UK if you’re a non-citizen with a list of best hospitals in the UK for expats. At the end of the page, you will also find a handy checklist for when you need healthcare in the UK.
How many hospitals are there in the UK?
There are around 1,250 hospitals in the UK. It’s one of the top-ranked countries in the Commonwealth Fund’s index and is well served for medical care.
The UK government plans to deliver 40 new hospitals across the country by 2030 will help us build a better NHS and transform NHS services for local communities. All the new hospitals will benefit from being part of the government’s nationally led programme under the health infrastructure plan, ensuring the programme delivers value for money for use of the limited national public funding available.
Healthcare system for expats in the UK
The United Kingdom boasts of an efficient healthcare system, which is called NHS (National Health Service). It is acknowledged as one of the world’s leading health systems. The standard of care in the UK is excellent, however, there are long waiting periods, especially after the COVID pandemic.
The government-run and funded NHS is designed to cover the various healthcare-related expenses of everyone living in the United Kingdom. It is a residence-based healthcare system launched in 1948 with the idea that medical services of good quality should be accessible by all the residents of the UK. The NHS has become so fundamental to the UK that it is now the country’s largest employer, and the fifth largest employer in the world.
Since the beginning, the medical service has been available to local and foreign nationals, regardless of their social status and income, as long as they are legal residents, pay taxes and contributions to the national health program.
Healthcare in the UK for expats
Although emergency hospital treatment is free for all in the UK, non-citizens must enrol for an NHS number in order to make routine appointments with a general practitioner and get access to the best hospitals in the UK for expats. GPs may refer patients and will be the primary point of contact for most.
Expats should make it their priority to enrol for an NHS number immediately upon arriving in the UK. To enrol, an appointment must first be made, they’ll then be subject to an interview and need to complete some paperwork. They’ll subsequently be assigned an NHS number that will arrive in the mail within a few weeks.
Can I use the NHS as an expat in the UK?
All non-citizens in Britain are eligible for free emergency treatment at NHS UK hospitals. Visitors and expats can access some free treatment via the NHS – emergency treatment, and treatment for infectious diseases, for example. And you won’t be charged for covid vaccinations and treatment, even if you go to one of the best hospitals in the UK for expats.
Otherwise, access to the NHS is based on residence, not nationality. So, if you’re a permanent UK resident, you can access NHS services, most of which are free.
If you are not a UK resident, you will probably be responsible for some costs, determined by where your home country is. People who aren’t eligible for free treatment may be able to get care from the NHS – but they’ll be charged for it.
The UK has negotiated reciprocal healthcare agreements among a variety of foreign nations, including New Zealand, Australia, and members of the EU, meaning their citizens are exempt from healthcare payments. And if you’re visiting from an EU country and you have an EHIC, you can access emergency services and some routine treatments that can’t wait until you get home. Read our guide on applying for European Health Insurance Card after Brexit.
Public and private healthcare in the UK for expats
The UK hospital system may be different to that of your home country. While the primary health system in the UK is public and funded by the government, there are many private healthcare insurance providers in the United Kingdom that basically enhance the coverage that is received from the NHS by providing access to private care and hospitals. Healthcare for expats in the UK is of high quality, but private medical insurance can be necessary, too.
You can choose between care at one of the private hospitals in the UK or at one of the public hospitals in the UK. If you are moving to this region for a job assignment, private health insurance can be a part of your remuneration package from your employer.
Historically, expats that enter the UK have considered getting private health insurance a must. That shouldn’t be viewed as an indictment of the system, but rather what expats have come to expect. Employers do not have to provide private insurance to their employees in the UK.
In order to gain access to the NHS system, you must establish legal and permanent residency – officially known in the UK as settlement or indefinite leave to remain (ILR) and pay an immigration health surcharge (IHS) as part of your immigration application.
You might need to pay a healthcare surcharge (called the ‘immigration health surcharge’ or IHS) as part of your immigration application. Whether you need to pay depends on the immigration status you’re applying for.
Who needs to pay a healthcare surcharge
You usually need to pay the healthcare surcharge if you’re applying for a visa or immigration application:
- for more than 6 months, if you’re applying outside the UK
- for any length of time, if you’re applying inside the UK.
You do not need to pay if you’re applying for a visitor visa or to remain in the UK permanently.
You still need to pay even if you have private medical insurance.
When you can start to use the NHS as an expat
You can start using the NHS when both:
- you’ve paid the healthcare surcharge (or are exempt from paying it)
- your visa or immigration application is granted.
You’ll still need to pay for certain types of services, such as prescriptions, dental treatment, eye tests and assisted conception.
When you access healthcare in the UK as an expat, you may need to:
- provide your biometric residence permit, if you have one
- prove your status online using a share code, if you have a digital immigration status.
How much you have to pay
You’ll have to pay:
- £470 per year for a student or Youth Mobility Scheme visa, for example £940 for a 2-year visa
- £470 per year for visa and immigration applicants who are under the age of 18 at time of application
- £624 per year for all other visa and immigration applications, for example £3,120 for a 5-year visa.
Dependants aged 18 or over usually need to pay the same amount as you.
You can pay healthcare surcharge as part of your immigration application here.
What does the NHS cover?
Unfortunately, you can’t get every kind of treatment or medicine from the NHS, although its services are fairly comprehensive. They include:
- Consultations with your doctor/general practitioner (GP)
- Treatment in Accident & Emergency (A&E) – this is what the British call ‘ER’
- Treatment by specialists/consultants (if given a GP referral)
- Sexual health services
- Maternity services
What doesn’t the NHS cover?
On the flip side, here are the medical services that you will have to pay for (either directly or through private health insurance):
- Dental care (£250+ for complex procedures)
- Eye tests (roughly £25 per test, although free for children and over-60s; sometimes it can be paid by your work)
- Physiotherapy (around £50 per appointment – you can get this free via the NHS, but waiting lists are particularly long)
- Tests/scans (can cost £100s – scans are only available via the NHS with a GP referral)
- Chiropractic (approximately £30-£80 per appointment – again, this is free via the NHS, but it’s limited and the waiting lists are long)
- Prescription medicines are also not free under the NHS in England, currently costing £9.15 (roughly US$11.30) per item.
However, certain people can get them for free, including under-16s, over-60s, pregnant women, new mothers (up to 12 months after giving birth), and those suffering from a specific disability.
Meanwhile, prescription medicines are free in Wales, Scotland, and Northern Ireland.
We’ve compiled some of your most common questions around healthcare for expats below:
Coronavirus (COVID-19) in the UK
The COVID-19 pandemic has been a difficult time for everyone. Many expats find themselves separated from family and loved ones in their home countries and experience mental health difficulties. As a foreigner, it is also sometimes difficult to find critical information regarding coronavirus infection rates, local measures and restrictions, and now, thankfully, vaccinations.
Overseas visitors to England, including anyone living in the UK without permission, will not be charged for:
- testing for coronavirus (even if the test shows you do not have coronavirus)
- treatment for coronavirus – including for a related problem that affects some children called multisystem inflammatory syndrome
- vaccination against coronavirus
- No immigration checks are needed.
For general coronavirus health information in the UK, including vaccination schedules and locations, visit the NHS Coronavirus (COVID-19) website. For official COVID-19 measures, rules, and restrictions in the UK, visit the UK government Coronavirus (COVID-19) website.
Read our guide on expats and Covid passports.
Hospital treatment is free of charge for people who are ordinarily resident in the UK. This does not depend on nationality, payment of UK taxes, National Insurance contributions, being registered with a GP, having an NHS number, or owning property in the UK.
To be considered ordinarily resident, you must be living in the UK on a lawful and properly settled basis for the time being.
To get an appointment at an NHS hospital, you need a referral from your GP – the local doctor you’re registered with. A GP can also refer you to a private hospital, or you can refer yourself. If you’re coming to live in the UK, it’s important to register with a GP and get an NHS number.Find a GP on the NHS website
Emergency treatment is free at NHS hospitals. To call an ambulance, dial 999. If your situation is urgent but not critical, you can go to the nearest accident and emergency (A&E) department.
Some private hospitals also offer urgent care, but if you’re not insured you’ll need to pay.
No. There are charges for prescriptions, and dentistry is not free.
In order to make use of the public healthcare system, you will need to be registered with the NHS and obtain your unique 10-digit code. In order to do this, you need to set up an initial appointment with a general practitioner who accepts NHS patients on the NHS website. After the appointment, you will receive your assigned NHS number by post within a couple of weeks.
You can only be registered to one GP in the UK and it has to be near your residential address. Once you have registered, you can only go to that clinic. You may change clinics but first, you will need to unregister from the first one. Most clinics are open 8am-6pm, Mon-Fri, and most of them don’t accept appointments in advance which means that you’ll have to call in first thing in the morning and check their availability.
A nice thing about the NHS website is that you can check the reviews of other patients before choosing your preferred clinic. Doctors are also ranked by a scoring system that is easily available on the same website.
Generally speaking, if you’re no longer a UK resident you’re not entitled to NHS treatment. But there are exceptions. These include:
• UK state pensioners living in the EU who have a residual S1 certificate
• UK nationals who moved to Norway, Ireland, Liechtenstein or Switzerland on or before 31 December 2020
If you are an EU citizen living in the United Kingdom, you would be covered by the European Health Insurance Card (EHIC). The terms and conditions for medical or health-related expenses would be the same as the costs charged for British nationals. You will have to get in touch with your national healthcare service provider in case you don’t have the EHIC before moving to the United Kingdom.
Expats from countries outside the EU will need an NHS number to avail healthcare services. You just have to fill an application form at a local health center and wait for a few days to get the NHS number, which should be sent to you by post.
Short-term visitors from the EU can continue to access medically necessary healthcare through the European Health Insurance Card (EHIC) scheme, or planned healthcare through the S2 funding route.
Short-term visitors from the EU who are not covered by the new UK-EU agreement on reciprocal healthcare (including former UK residents) may be charged for NHS treatment.
There are no changes to the healthcare entitlements of short-term visitors who are covered by bilateral healthcare agreements between the UK and countries outside the EU, including Norway, Iceland, Liechtenstein and Switzerland.Applying for European Health Insurance Card after Brexit
What types of hospitals are in the UK?
If something serious comes up instead, you should head to the hospital. Your GP may refer you to see a specialist there and since you are covered by the NHS you won’t have to pay anything for a visit or an operation. In fact, hospital treatment is free to people classed as ordinarily residents in the UK which means that if you are legally allowed to be living in London you’re covered.
There are two types of hospitals in the UK:
- NHS hospitals – these are run by the National Health Service and funded by the state through taxation. Some, but not all, NHS hospitals have accident and emergency departments (emergency rooms), sometimes referred to as casualty departments, which offer urgent care. The larger hospitals offer a full range of services, including maternity services and specialisms. There are also specialist hospitals – for paediatrics, orthopaedics and dentistry, for example. NHS treatment is free for UK residents.
- Private hospitals – these are run by health insurance companies – BUPA and Nuffield Health are a couple of the big names – other private companies, and charities. Many of them are specialist hospitals. You can access treatment in a private hospital if you have private health insurance – your policy may set out which hospitals you can be treated in. Alternatively, you can simply pay for treatment. This is sometimes called ‘self pay’ and is expensive.
Some NHS hospitals have private beds and wards, and some private hospitals provide treatment for NHS patients.
Walk-in clinics in the UK if you’re an expat
If you encounter a minor injury or illness while away from home or during the weekend, you can go to a walk-in clinic. At these centres, you don’t need to book an appointment but be prepared to wait a couple of hours.
Emergency in the UK if you’re an expat
The A&E (Accident & Emergency Services) is the Emergency section of the hospital. If you are ever in real pain or something big is going on, you should head to the A&E. Waiting times depend on your condition and one of the other patients and emergencies.
Dental in the UK if you’re an expat
Dental care is another matter in the UK. Definitely, an NHS dental clinic will be cheaper than a private clinic (or even free if you qualify for free care), but they tend to be of poorer quality. It is quite common for Londoners to treat their main issues through the NHS but deal privately for their dental health. If you are employed in London and you have private medical insurance, check if dental care is included which means that you can claim some/all of your dental back.
What are the NHS waiting times?
The NHS is exceedingly popular in the UK – both in the sense that it is loved by the public, but also in extremely high demand. This pressure on the service has gradually reduced its effectiveness since it came into being in 1948, and relatively tight funding over the past few years hasn’t helped either.
Non-urgent treatment by consultants/specialists18 weeks
|Type of treatment by the NHS||NHS official waiting time|
|Treatment after being admitted into A&E||4 hours|
|Treatment after an urgent cancer referral||62 days|
Are private hospitals better than NHS?
Standards of medical care don’t depend on whether a hospital is NHS or private – most NHS consultants do private work, so the same treatment is available from them however you access it. But one of the main advantages of private healthcare is that you can get the treatment you want and need without waiting. There’s huge demand for NHS services and there can be long waiting times for non-urgent care.
In July 2021, the survey of more than 4,000 UK nationals found that the NHS makes people proud to be British but one in five has been forced to go private. It also found:
- 21% had been forced to go private because NHS treatment was unavailable
- 25% said waiting times had harmed their mental health
- 28% felt they had to fight for treatment.
Prof Stephen Powis, national medical director for NHS England
told BBC in July 2021
Additionally, the number of people on the NHS waiting list for elective surgery has grown exponentially over the past few years. Basically, people are being added to the list quicker than the NHS is capable of dealing with it. For example, back in April 2010, there were 2.5 million people on the list. By the end of 2019, there were 4.5 million.
Recently NHS emergency hospital waiting times hit the worst level since NHS records began. Given these realities, it’s not surprising that so many expats want private insurance.
Is it worth having international health insurance to access the best hospitals in the UK for expats?
International health insurance is a product designed to offer cross-border coverage. The NHS is an impressive healthcare system founded on honourable principles, but it is becoming increasingly strained as the UK population grows.
Here are some reasons you should consider taking out private medical cover in the UK before your move:
- You might require regular treatment for something the NHS doesn’t cover (or doesn’t cover very extensively), such as dental care, eye care, physiotherapy, or very specialist medicine
- You normally would like to have second opinions and additional scans for peace of mind
- You aren’t used to waiting very long for treatment in your home country
- You consider being able to choose your hospital and doctor a priority
- You value having a private room in a hospital.
How much does health insurance cost in the UK?
How much you’ll pay for health insurance isn’t a number you can guess. It’s affected by many factors, few of which you control.
Here are a few examples of our members and how much they pay for their plan.*
|The busy family||The young couple||The solo nomad|
|A family of four who wants their routine dental care covered but don’t need the additional the coverage our Gold plan would provide.||A couple who are planning on starting a family and want to ensure they have great maternity cover when they are living abroad.||A frequent traveller and digital nomad who wants to have medical evacuation and a good level of cover without a huge premium.|
|Country of Nationality||UK||USA||Norway|
|Country of residence||Vietnam||Indonesia||Thailand|
|Age(s)||35, 40, 5, 2||29, 34||34|
|Excess (per annum)||US$255||US$255||US$255|
*Based on personal health plans with worldwide cover issued in 2021 by William Russell.
- Doctor visits, consultations, hospital care and mental health treatment in multiple overseas territories (depending on the plan you choose).
- Up to US$100,000 for unexpected elective medical care and $250,000 in emergency treatment costs during short visits back to US soil, for reassurance when you visit family or head home for the holidays (if you have picked USA-45 add-on).
Finding best hospitals in the UK for expats
To find the best hospitals in the UK, there are a few ratings and rankings systems you can check:
- for the whole of the UK, you can check the world hospital ranking list which has a list of hospitals in the UK. The current highest ranked hospital in the UK is the Royal Berkshire NHS Hospital, ranked at 67 in the world.
- you can check the inspection ratings of the Care Quality Commission (CQC) who are the independent regulator of health and social care in England.
See below for a list of best hospitals in England, Scotland, Wales and Northern Ireland.
Which are the best private hospitals?
The best hospital will depend on your location and your needs, but these are some of the big names:
- Cromwell Hospital
- Bupa Health Centres
- Nuffield Hospitals
- Spire Hospitals
- St John and Elizabeth Hospital London
- The Wellington Hospital
Which are the best NHS hospitals?
According to a research by Newsweek, top NHS hospitals include:
- Freeman Hospital
- Glasgow Royal Infirmary
- Queen Elizabeth Hospital Birmingham
- St Richard’s Hospital
- St Thomas’ Hospital
- Salford Royal
- University College Hospital
- Worthing Hospital
- University Hospital of Wales
You can check the ratings of hospitals in England on the Care Quality Commission website.
International health insurance is a popular alternative for expats living overseas. With William Russell, English-speaking customer service representatives handle every stage of your claim from our UK offices, so you’re in safe hands.
Your handy “how to get healthcare in the UK” checklist
If you’re not sure how to get the help you need when you move to the UK, use this checklist to guide you.
- ☐ Call NHS 111 if you urgently need medical help or advice but it’s not a life-threatening situation. You can also call NHS 111 if you’re not sure which NHS service you need.
- ☐ Call 999 if someone is seriously ill or injured and their life is at risk.
- ☐ Go to a walk-in centre, minor injuries unit or urgent treatment centre, if you have a minor illness or injury (cuts, sprains or rashes) and it cannot wait until your GP surgery is open.
- ☐ Ask a local pharmacist for advice – a pharmacist can give you advice about many common minor illnesses, such as diarrhoea, minor infections, headaches, sore throats, or travel health.
- ☐ Make an appointment with your GP if you’re feeling unwell and it’s not an emergency.
You will need to pay for some things such as eye tests, dental treatment and prescriptions, just like people who live in England.