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Navigating the NHS

NHS differences across the UK

It may be the National Health Service but there are some variations in services depending on where you live in the UK.

The NHS has been around since 1948 based on the principle that good healthcare should be available to everyone.

Our NHS is the envy of other countries around the world for its expertise and for the fact that, with a few exceptions, it’s free to the 60 million plus people who live in the UK.

It’s funded centrally from our taxes but NHS services in England, Wales, Scotland and Northern Ireland are managed separately, the latter three countries by their devolved administrations.

Health services are organised separately on the Isle of Man, Guernsey and Jersey.

Prescription charges

In England people pay prescription charges. If you live in Wales, Scotland and Northern Ireland prescriptions are free.

There are many exemptions in England though. The Department of Health estimates only 10% of prescriptions in England are actually paid for by the individual.

Those who do not have to pay include people receiving certain benefits, over 60s, under 16s, 16-18 year olds in full-time education and those with a medical exemption certificate, such as people with diabetes.

NHS medicines and technologies

Different parts of the UK may have different medicines and technologies approved for NHS funding, or different timescales for assessing them.

The National Institute for Health and Care Excellence (NICE) makes recommendations on medicines and medical technologies for NHS funding for England and Wales based on clinical and cost-effectiveness. The Scottish Medicines Consortium (SMC) carries out that role in Scotland. The Department of Health Social Services and Public Safety (DHSSPNI) adapts NICE guidance for Northern Ireland.

Screening intervals

The arrangements for some screening tests may vary between the different countries of the UK. For example, the age ranges and screening intervals differ for cervical cancer smear tests.

Hospital waiting lists

It’s difficult to compare statistics from England, Wales, Scotland and Northern Ireland. In some cases the statistics can’t be compared like-for-like.

Waiting times vary between individual hospitals and according to what treatment is needed. People can often choose which hospital to be referred to if the waiting list is shorter elsewhere.

It is not unusual to see fluctuations in waiting times, for example due to patient case mix, the number of working days in the month, or because of periods of bad weather that prevents patients and staff from attending appointments.

According to the NHS Constitution in England, once you have seen your GP and he or she has referred you to a specialist, you should have the right to start your consultant-led non-emergency treatment within a maximum of 18 weeks.

You have the right to be seen by a specialist within a maximum of two weeks from GP referral, for urgent referrals where cancer is suspected.

Hospital car parking charges

Most UK hospital car parks are free outside of England.

NHS car parking charges were abolished in Scotland 2008, but remain at three hospital car parks operated under the private finance initiative (PFI).

WebMD Medical Reference

Medically Reviewed by Dr Rob Hicks on March 17, 2015

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