How do you use the NHS?

How do you use the NHS?

It is hard to know which bit of the NHS to use. This page describes the main options, and which is best for which problem. Yes, it is quite confusing which one to choose.

If you are unwell or injured, it’s important to choose the right service to make sure you get the best treatment as quickly as possible. You may not need to see your GP or go to A&E.

For example, NHS111, Walk-in Centres and Pharmacists are underused. These are especially good options out-of-hours (late and weekends).

Also, you can often refer yourself to a (‘first contact’) physiotherapist or NHS counsellor (IAPT) without going through your GP.

If you’re unsure of where to go for help, start with NHS 111 online.

So, let us get on with describing how to use the NHS, with 10 options.

1. Looking after yourself – stay at home, with support of family and friends – many illnesses get better of their own accord = ‘2 week rule’

What for: many illnesses and injuries can be treated at home – e.g. cough or cold, sore throat, headache, sprain, grazed knee, hangover. Staying at home can also help to stop spreading some viral infections. If in doubt, ring someone. Mums are good
What else: watch TV, have a cup of tea and a biscuit!

Note. ‘Two-week rule’. In other words, sometimes the best way of accessing NHS care is, well, not to access it. Many conditions get better of their own accord. Its often a good idea to wait two weeks and see if it goes away.

2. Telephone or Online advice – good for advice on navigating NHS and can arrange appointments

NHS111 – ring 111, or use website
What for: advice, especially if your GP is closed, and you do not know which bit of NHS to use
What else: book you appointments; guide you for emergency dental, eye care, or emergency prescriptions

NHS website
There is a lot of useful information one the NHS website about how to deal with many illnesses.

NHS app
You can now order tablets, and look at new information about you, written in your GPs’ notes.

3. Local Pharmacist – good for medication review and emergency prescriptions

What for: medication review, repeat prescription, many ailments (including colds, flu, headache, upset stomachs, urinary tract or eye infections, rashes, dandruff, insect bites and stings)
What else: emergency prescription; some GPs work with a ‘clinical pharmacist’ who has access to your notes and can treat you.

Note. They have other functions: advice regarding which part of NHS to use (like face-to-face NHS111); vaccination; contraception

4. Walk-in Centre, Urgent Treatment Centre (UTC), Minor Illness/Injury Unit (MIU) – just turn up, no appointment needed – very good out of hours, including weekends and bank holidays (and for emergency prescriptions)

What for: things you would consult a GP about; they can also deal with a sprain, stitches, minor broken bone, or minor head and eye injury
What else: emergency prescription

5. A&E (Accident and Emergency) – go there or ring 999 (for ambulance, if you cannot get there by any other method) – for major accidents and emergencies only please

What for:

• Severe physical problem – e.g. chest pain, stroke, new confusion, shortness of breath, severe abdominal pain or bleeding, road traffic accidents, major fractures and head injury. MyHSN has a longer list of appropriate conditions in this article: should I go to A&E?
• Severe mental problem – e.g. if you or someone else is having a severe mental health crisis, or are considering suicide

6. Mental Health(MH) – please don’t suffer in silence. We are here to help you. Consdider self-referral to an IAPT (NHS counsellor)

GPs. Some GPs have an interest  in mental health. Ask at the GP reception

Counselling (IAPT) – self refer: Google ‘Talking Therapy’ or ‘IAPT’ + name of your area (or ring GP receptionist)
What for: mild or moderate mental health problem (e.g. anxiety, depression and panic attacks); relationship issues
What else: can discuss your problem with (or get you to see) a Consultant Psychiatrist (mental health doctor)

Mental Health Crisis Team (MHCT) or Consultant Psychiatrist
MHCT: ring them if you have their number, if not, Google ‘urgent mental health helpline or crisis team’ + local area
Consultant psychiatrist (if you have one): ring their secretary (at the hospital they work)

What for: severe mental health problem
What else: can get you admitted to a mental health hospital if you are very unwell

7. Community Nursing – nursescan visit you at home

District Nurse – often referral needed and only for housebound patients
What for: nursing issues (e.g. wound dressing, or giving injections) through visits to your home – largely for housebound patients
What else: can discuss your problems with your GP (e.g. take photos)

Midwife – ring them (they should give you a number; or find online at local hospital) – no referral needed
What for: pregnancy, and newborn (from 14 days post birth when they handover to health visitor; see below)
What else: help you with anxiety or mental health problems

Health Visitor – ring them (they should give you a number; or find online at local hospital) – no referral needed
What for: post delivery, and newborn/child health (from 14 days to 2.5 years)
What else: advice on vaccination

8. GP Surgery – ring, or book online (via website) or via NHS111 – or self-refer to ‘MSK physiotherapist’ for pains in shoulders, hips, knees etc

What for:

• Mild or moderately severe new problem, with symptoms lasting over 2 days;
• Deterioration of long-term condition
• Recurrence of an old problem

What else: sick (fit) notes, help you get back to work

Just remember, you may see other healthcare professionals that are as good or better than a GP.  This could be a Physician Associate, Advanced Nurse Practitioner, Clinical Pharmacist, First Contact Physiotherapist, as well as your GP.

There will also be specific clinics for contraception, health checks, chronic disease monitoring for asthma reviews, hypertension checks etc. But there may also be minor operations, wound clinics and vaccinations.

9. See a hospital consultant– contact via their secretary or specialist nurse

Hospital Consultant – ring their secretary (or their specialist nurse, see below) if already seen
Note. In the UK, you cannot refer yourself directly to a consultant. You have to go through your GP (or GP’s physio etc)

What for: serious or rare disease, or specialist investigation or treatments (e.g. endoscopy, operation, chemotherapy, dialysis)
What else: write a letter to your employer if you need your work pattern changing

Note. You may see his/her deputy called a registrar or specialist nurse (see below). They will be very experienced.

Hospital Specialist Nurse (works with Hospital Consultant) – ring them
What for: knows a lot about their specialist area; experienced
What else: get a message through to your consultant

10. Other services – sexual healthclinics good for contraception and pregnancy advice

Genitourinary Clinic (GUM; sexual health) – ring or just turn up (you do not need an appointment)
What for: sexually transmitted diseases; emergency post-exposure HIV prevention medication, emergency contraception
What else: contraceptive advice and supplies of condoms etc

Dentist – ring up
What for: dental and mouth problems
What else: prescribe antibiotics etc if needed; talk to dental surgeons at local hospital if the procedure required is safer done at a hospital

Optometrist (optician) – ring and make an appointment or just visit
What for: eye problems
What else: some also do hearing tests and aids

Note. If you have a serious eye problem (e.g. blindness, loss of vision or severe pain), it is best to go to an A&E department that has an ‘eye casualty’ (i.e. eye doctors).

Dietitian – ring them if you have their number (get it when you first see them). Referral might be needed
What for: weight loss or gain, or other dietary advice
What else: can also help with fluid restriction, if your doctor has asked you to follow one; refer you for bariatric surgery if ‘natural weight loss’ is not working

Podiatrist – ring and make an appointment, but not all conditions funded
What for: foot or toe problems
What else: if you have diabetes, can work with your diabetic team, to prevent gangrene etc

Social prescriber – Google ‘social prescriber + local area’ (or ring GP reception)
What for: help with life problem, loneliness, or practical issue (e.g. shopping)
What else: help you with visiting doctors and nurses

Social worker – ring your local council
What for: life, financial, work and social problems; can help you organise a nursing or residential home
What else: help you with benefits and housing

Summary

Yes it is confusing. We hope this article has helped you understand how to use the NHS better, and made your options a little clearer. Remember the NHS is here to help you. We know it aint great at the moment in some areas of our work. We are very sorry. But please keep contacting us. Be politely persistent, and with our help, you will get what you need.

Other resources

How the NHS works for migrants