If you asked anyone who knows me for a description of me, I think most would say I'm complicated, especially when it comes to anything (and everything) medical. We knew that in coming here the medical system would be completely and drastically different from anything previously experienced, starting with the reality of a National Health Service (NHS). Imagine having almost everything to do with the body included within one system that does not require separate and expensive insurance policies. As a citizen of the UK, a person is automatically included in the program and care is provided at no cost (except for some prescription and dental charges). As guests here my husband and I had to pay for access, as part of our visa fees. Once we did that, though, all of my GP visits, psych team visits, and hospital testing and stays are included. So far I have more than gotten my money's worth with the care I've received and it's only been since September.
To be seen by a GP you must register with their practice. Once registered, a primary GP is assigned to you even though you may or may not see them most of the time (seems to be a NHS requirement). Most GP surgeries (offices) have multiple doctors of varying levels and specialties, and many have nurse practitioners that can be seen as well. The GP acts very much like a primary care doctor does in the United States. They are the hub for all of the specialists to work through, and they approve or send in referrals, and handle/manage the prescriptions. The practice I'm a part of has more than 13 GPs (spread over two locations) and has a few Nurse Practitioners as well. There are also 2 pharmacists that work with the doctors and patients to manage medications but they can also prescribe medications when appropriate. There is an online portal that can be used to request appointments and medication refills, and it also allows you to see who has accessed your medical records. If you are really adventurous you can also request an e-consult. By answering some basic questions they decide what to do and promise to call back within 24 hours to tell you if you need to be seen, get a prescription, or just follow their advice. Because the number of patients is so high and appointments are at a premium, they are scheduled in 10 minute intervals and if more than one topic needs to be discussed you must request a double time slot. So far I have not run afoul of the time limit but I have not had too many appointments with a GP yet. Routine appointments may be scheduled a few weeks out, but the staff have the ability to triage you into a sooner appointment if your condition warrants it. Treatment by the GP is fully covered by the NHS so no copays are required. Most of the time the appointments are right on time or very slightly late. The only exception seems to be if you come into the office and request a same day appointment then the wait can be quite long because they will be slotting you in when a break in the schedule allows it.
Included in the building that holds my GP surgery is a walk-in clinic that can be used if you are experiencing something very basic that can be treated by either an advanced practice nurse or their equivalent. This sure beats going to an A&E (ER) and waiting for a really long time to get the same treatment. Like any government service, the NHS is underfunded and overwhelmed but it also has better service than I experienced in the United States. Universal healthcare seems to be a dirty phrase in the US but so far the advantages far outweigh any drawbacks.
I have had a quick 1 day/2 night hospital stay relating to my mental health that required me to be monitored while IV medications were given. Because of the NHS all of this was done at no cost to me, including a chest CT, many vials of blood, constant monitoring of heart rhythm and blood pressure. The results of my ECGs were abnormal and because I had been experiencing intermittent chest pain a cardiologist was called in and decided to do further testing on my heart. Within a couple of weeks of my discharge I received a letter telling me to report to one of the many hospitals in the area and have an echocardiogram done. Later that week another letter came with an appointment set up for more specific CT's of my heart and the vessels leading into and out of it. Both rounds of testing have been completed at this point and again all of this was done at no cost to me (other than the Uber to get to and from the hospitals). Fortunately all tests look great and I can be done worrying about my heart and just worry more about other things. My tests were completed at Freeman Hospital, and my original stay was at The Royal Victoria Infirmary (RVI). It seems that with multiple hospitals in a relatively small area they specialise in certain things instead of having all of them doing the same things. So for an emergency I was taken by ambulance to RVI because of it's A&E, but the testing on my heart was done at Freeman because they have a specialised cardiothoracic centre. I know if it becomes necessary to have an inpatient psychiatric stay that will be at another hospital. This is so much better than having multiple hospitals in an area all doing the same things and trying to one up each other instead of focusing on what they do best and working together. So for both inpatient and outpatient treatment I have had amazing experiences, and the waits are no longer than what it would take to be seen by most US specialists.
My next big encounter with medicine will be at my evaluation by the Pain Clinic at RVI in mid-March. I've been counting down to this appointment pretty much since we received a letter saying where and when to show up and a packets of papers to complete before the appointment. In our corner of Colorado there were no pain specialists and my various doctors did their best to help me cope with chronic pain from multiple sources. I hope I'm not putting too much hope for answers and treatments into this centre.
I'm happy to keep my experiencing of the hospitals in this area to the three I've been to or know about. The other six that are technically in the area but are a little farther afield can stay unvisited, although we've passed one of them multiple times walking up from Quayside. (It's a hospital in name only, but has an amazing history if you want to look into the Holy Jesus Hospital).
The practice of medicine is pretty universal, but the culture from which that practice originates can make all the changes in the world. It's been good for me and I think I will find answers to questions I've been asking for a very long time.
Cheers!
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