I don’t know which part of the NHS to use. Can you advise me?
The NHS is very large, the biggest employer in Europe. It is so large and complicated, it is hard to know which part of the NHS to use. This page describes the main options, and which is best for which problem. Pros and cons. 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’s get on with how to use the NHS. Find out more now about the range of local options for accessing health advice and treatment. These are the options.
Telephone or Cyber
NHS111
What for: advice (especially for urgent care, if you do not know which bit of NHS to use)
Pros: easy to get through to initially; experienced
Cons: can be frustrating as initially a ‘facilitator’ asks you questions before a health professional rings you back; this can be in an hour or two; will not know your medication or past problems
How to contact: ring 111, or use website
What else can they do: book you appointments; guide you for emergency dental, eye care, or emergency prescriptions
Community-based
GP
What for:
- Mild or moderately severe new problem, with symptoms lasting over 2 days; many problems get better on their own with no treatment (usually within two weeks)
- Deterioration of longterm condition
- Recurrence of an old problem
Pros: know you, your medication and past problems; experienced; can refer you to hospital specialist
Cons: cannot easily get big investigations (e.g. CT scan); general doctor, less specialist knowledge about rarer diseases
How to contact: ring, or email admin address at GP practice. You do not need to be registered to see a GP, you can get care there if you are a visitor to the area
What else can they do: sick (fit) notes, help you get back to work
Note. You can register with a GP of your choice but you must live in their catchment area. It is very important to do this, even if you do not currently have any health issues.
Note. Even though GPs run an out-of-hours service, this is for urgent problems that cannot wait till morning. They will not usually be your normal GP and may not have full access to your medical record or medications. So NHS111 or a Walk-in (or similar) Centre (see below) may be a better option. Please do not use any of these, for things that can wait till morning (e.g. repeat prescriptions).
GP Practice Nurse
What for:
- Monitoring of a long term disease – e.g. diabetes, CKD, high blood pressure (BP), Parkinson’s Disease, epilepsy
- Wound dressing, stitches
- Vaccination
Pros: knows you, your medication and past problems; experienced
Cons: may not be able to prescribe medication
How to contact: ring, or email admin address at GP practice
What else can they do: discuss you with your GP or other specialist nurses
Pharmacist
What for:
- Questions about medication
- Repeat prescription
- Medication review
- Many ailments including colds, flu, headache, upset stomachs, urinary tract or eye infections, rashes, dandruff, insect bites and stings
- Other functions: advice regarding which part of NHS to use (like face-to-face NHS111); vaccination; contraception
Pros: simple being local; no wait; do not need appointment; open late and weekends; experienced
Cons: cannot change current medication without discussion with GP; only your normal pharmacist will have a record of your tablets
How to contact: go to the pharmacy
What else can they do: emergency prescription; some GPs work with a ‘clinical pharmacist’ who has access to your notes and can treat you
Note. Most pharmacies have a private consultation area where you can talk without being overheard. You can speak to the pharmacist in person, or ring them for advice.
What for: nursing issues (e.g. wound dressing, or giving injections) through visits to your home
Pros: a service based in your home (good if you are housebound or frail)
Cons: not many
How to contact: ring them (they should give you a number) or ring GP reception
What else can they do: can discuss your problems with your GP (e.g. take photos)
Midwife
What for: pregnancy, and newborn (up to 10-14 days post birth when they handover to health visitor; see below)
Pros: can discuss with your GP and a hospital obstetrician (pregnancy specialist); experienced
Cons: you are usually not delivered by midwife you know
How to contact: ring them (they should give you a number; or find online at local hospital) or ring GP reception
What else can they do: help you with anxiety or mental health problems
Health Visitor
What for: post delivery, and child health upto 2.5 years
Pros: will visit you in your home; with first visit 10-14 days (taking over from midwife), then every 3-4 weeks; experienced
Cons: do not work at weekends; visit as part of standard plan but difficult to get more frequent visits if you just need support
How to contact: ring them (they should give you a number; or find online at local hospital) or ring GP reception
What else can they do: advice on vaccination
‘First contact MSK (musculoskeletal) physio’
What for: bone, muscle or joint problems (e.g. shoulder, hip, knee or ankle pain)
Pros: may know more than your GP; can organise an MRI or CT; experienced and specialised
Cons: not many
How to contact: can self-refer in many areas (see GP website or Google ‘first contact NHS physio + your area’) or ring GP reception
What else can they do: can get an orthopaedic surgeon to see you, and arrange an operation
Genitourinary Clinic (GUM)
What for: sexually transmitted diseases; emergency post-exposure HIV prevention medication, emergency contraception
Pros: helpful, not judgemental, experienced
Cons: not open at weekends
How to contact: ring or just turn up (you do not need an appointment)
What else can they do: contraceptive advice and supplies of condoms etc
Mental Health
Counselling (IAPT)
What for: mild or moderate mental health problem (e.g. anxiety, depression and panic attacks); relationship issues
Pros: local
Cons: can usually only give one course (e.g. six sessions)
How to contact: you can often self refer; Google ‘IAPT’ + name of your area; or ring GP reception
What else can they do: can discuss your problem with (or get you to see) a Consultant Psychiatrist (mental health doctor)
Mental Health Crisis Team (MHCT) or Consultant Psychiatrist
What for: severe mental health problem
Pros: specialised and experienced
Cons: MHCT often only responds if really unwell and not if becoming really unwell; consultants can be difficult to contact
How to contact: 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 else can they do: can get you admitted to a mental health hospital if you are very unwell
Now we turn to hospital-based care in the NHS, and describe which NHS service shall I use there.
Hospital-based
A&E
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, head injury, severe burns and collapse. MyHSN has a longer list of reasons to 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
Pros: best place to go if seriously unwell; can get emergency investigation (e.g. CT scan) or have emergency operation; open 24h a day, 7 days a week
Cons: can wait a long time; may be seen by non-specialised junior doctor
How to contact: go there; ring 999 (for ambulance) only if cannot get there by other method
What else can they do: good place to go, if have severe mental health problem (can get a mental health nurse or doctor to see you)
Note. If you have a more minor ailment, you may get a bad experience. It is NOT what they are for. Many quite bad things, are better dealt with by NHS111 or Walk-in and similar centres
Walk-in Centre, Urgent Treatment Centre (UTC), Minor Illness/Injury Unit (MIU)
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
Pros: open out of hours (e.g. 7 days, 8am-8pm); often do not wait long; often at or near a hospital (so can get you seen there if needed, or take their advice); can do x-rays
Cons: MIU may not have a doctor
How to contact: just turn up, no appointment needed
What else can they do: emergency prescription
Hospital Consultant
What for:
- Serious or rare disease
- Specialist treatments (e.g. operation, chemotherapy, dialysis)
Pros: knows a lot about their specialist area; you may see their deputy (called a registrar); both will be experienced
Cons: can be hard to contact; may not know much about other health issues
How to contact: ring their secretary (or their specialist nurse, see below)
What else can they do: write a letter to your employer if you need your work pattern changing; ring your GP to discuss your problems
Hospital Specialist Nurse (works with Hospital Consultant)
What for: knows a lot about their specialist area; experienced
Pros: often easier to contact than consultant; can talk to other specialist nurses
Cons: may not know much about other health issues
How to contact: ring them (they should give you a number)
What else can they do: get a message through to your consultant
Dietitian
What for: weight loss or gain, or other dietary advice
Pros: know a lot about nutrition; can help with diabetic control (and even get rid of diabetes)
Cons: hard to contact
How to contact: ring them if you have their number (get it when you first see them)
What else can they do: 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
Social Care and Help
Social prescriber
What for: help with life problem, loneliness, or practical issue (e.g. shopping)
Pros: can help with a wide range of problems, especially for the elderly
Cons: only some areas have them
How to contact: Google ‘social prescriber + local area’, or ring GP reception
What else can they do: help you with visiting doctors and nurses
Social Worker
What for: life, financial, work and social problems; can help you organise a nursing or residential home, rehabilitation, support workers in the home; rest for carers
Pros: local
Cons: may have limited ability to discuss with your doctors and nurses; no access to your medical record
How to contact: ring your local council
What else can they do: help you with benefits and housing
Other
Dentist
What for: dental and mouth problems
Pros: local
Cons: not open at weekends; may have to pay
How to contact: ring up, or just visit
What else can they do: prescribe antibiotics etc if needed; talk to dental surgeons at local hospital if the procedure required is safer done at a hospital
Note. If you have a serious dental problem at weekends, ring NHS111 and they will guide you to an emergency dentist; you may have to travel some distance to see them
Optometrist (optician)
What for: eye problems
Pros: local
Cons: not open on Sundays; only free on NHS for some people
How to contact: ring and make an appointment or just visit
What else can they do: 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). NHS111 or an internet search can guide you to nearest one. You may have to travel as it may not be your local A&E
Podiatrist
What for: foot or toe problems
Pros: local
Cons: only free on NHS for a few people
How to contact: ring and make an appointment
What else can they do: if you have diabetes, can work with your diabetic team, to prevent gangrene etc
Looking after yourself
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.
Pros: (very) local!
Cons: not many
How to contact: ask yourself and family
What else can they do: watch TV, have a cup of tea and a biscuit
Ensure your medicine cabinet is stocked with things like paracetamol, aspirin, plasters, gauze, rehydration mixture, a thermometer and indigestion remedy.
Summary
Yes it is confusing. We understand that you don’t know which part of the NHS to use. We hope the options are a little clearer now.
