Health

Overview

Health care in the UK is good, and for most visitors the health side of a trip comes down to a pharmacy visit for a cold or blisters. The country's National Health Service (NHS) is publicly funded and free for residents, and visitors get more free care than most Americans expect: emergency treatment in A&E (the British term for the ER), the NHS 111 advice line and urgent treatment centers cost you nothing.

The catch comes if you are admitted. Once you are on a ward or booked for follow-up treatment, NHS hospitals in England bill overseas visitors at 150% of the NHS rate, and an unpaid bill can follow you into future visa and travel applications. US health insurance rarely pays a British hospital directly, and Original Medicare pays nothing at all. Travel medical insurance is the fix.

This page covers what is free and what is billed, where to go for each kind of problem, British pharmacies and what they sell, bringing your medicines, insurance and Medicare, vaccines, food and water, and the outdoor hazards: ticks, midges, sun and cold. For crime, emergencies and the police, see Safety.

What the NHS charges visitors

The UK has four health services, one each for England, Scotland, Wales and Northern Ireland, and each sets its own charging rules. The broad picture is the same everywhere: emergency care is free at the point of use, and planned or inpatient hospital care is chargeable for tourists. England's rules are the most detailed and are set out below.

Free for every visitor in England

• Treatment in A&E itself, including emergency treatment at walk-in centers, urgent treatment centers and minor injury units.
• A 999 ambulance to the hospital.
• NHS 111 advice by phone and online.
• A GP (family doctor) appointment, if a practice agrees to see you as a temporary patient.
• Family planning (excluding abortion and fertility treatment), and diagnosis and treatment of sexually transmitted infections and most other infectious diseases.

Charged

• Hospital treatment after A&E: if you are admitted to a ward, or given an outpatient appointment to come back, the hospital will charge you at 150% of the national NHS rate (the NHS tariff). This includes surgery, scans and tests booked after the emergency stage, and maternity care.
• Prescriptions: £9.90 (about $13) an item in England, the same as most residents pay. NHS prescriptions are free in Scotland, Wales and Northern Ireland for patients there, but a prescription from a private doctor is always paid for, so ask before you assume.
• Dental treatment and eye tests: charged, as they are for residents.

A short hospital stay with scans and tests can easily run to several thousand pounds, and anything involving surgery or intensive care far more. Each hospital has an overseas visitors team that checks eligibility and issues the bill; expect to be asked for your passport and travel insurance details, and possibly for a deposit. Hospitals never delay urgent or immediately necessary treatment for payment; they treat first and bill afterward. For non-urgent treatment, they can ask for payment in full before they start.

Scotland, Wales and Northern Ireland

In Scotland, emergency treatment is free until you are stabilized, and a GP who registers you as a temporary resident will not charge for the visit; other care can be billed, and NHS Scotland advises visitors to carry travel insurance with medical cover. Wales and Northern Ireland also provide emergency treatment free and charge non-resident visitors for most other hospital care, with their own rates and rules. Wherever you are, assume an A&E visit is free and anything after admission is not.

Where to go when you are sick or hurt

NHS 111

Call 111 from any phone, free, at any hour, or use the online service. A trained adviser asks about your symptoms and tells you what to do: look after it yourself, see a pharmacist, go to an urgent treatment center (often with a booked arrival time, which saves hours of waiting), see a GP or go to A&E. They can also call an ambulance. In Scotland the same number reaches NHS 24, and in Wales NHS 111 Wales. Northern Ireland's system is different: for urgent problems out of hours, use the GP out-of-hours service or a minor injuries unit, and check nidirect for local options.

Urgent treatment centers and walk-in centers

These are the closest thing to US urgent care. They handle sprains, suspected broken bones, cuts, burns, infections and similar problems, usually with X-rays on site, and they are open at least 12 hours a day, often longer. Names vary: urgent treatment center (UTC), minor injury unit (MIU) and walk-in center all appear. Waits are generally shorter than at A&E. Search "urgent treatment centre" on the NHS website or ask 111 for the nearest one.

GPs

GPs (general practitioners) are the family doctors of the NHS, working from "surgeries" or "practices". In England, a visitor staying more than 24 hours and less than three months can ask to be seen as a temporary patient, and treatment is free, but each practice decides whether to accept you, and many are busy. Call in the morning when appointment lines open.

Private doctors

Private GP clinics in London, Edinburgh, Manchester and other cities see visitors quickly, often the same day, and can write UK prescriptions. Fees are posted on their websites; expect a price similar to an uninsured US urgent-care visit or more. Many hotels keep a list of doctors who will visit. Your travel insurer's assistance line can also direct you to one, and some insurers pay private clinics directly.

Pharmacies and over-the-counter medicines

British pharmacies (also called chemists) are the first stop for minor illness, and pharmacists are trained to assess symptoms, advise you and tell you if you need a doctor, all free and without an appointment. Look for a green cross sign. The big chains are Boots and Superdrug, with branches on almost every high street, in big rail stations and at airports; large supermarkets such as Tesco and Asda often have pharmacy counters; and there are thousands of independent pharmacies. In cities, at least one pharmacy in each area is usually open late or on Sunday; NHS 111 can tell you which.

In England, the Pharmacy First service lets pharmacists treat seven common conditions and prescribe medicine, including antibiotics, where needed, without a GP: sinusitis, sore throat, earache (children 1–17), infected insect bites, impetigo, shingles, and urinary tract infections in women aged 16–64. It is an NHS service designed for residents, so ask whether they can see you and what it will cost; many pharmacies also offer private consultations.

Three kinds of medicine

• General sale: on open shelves in supermarkets, convenience stores and gas stations. Packs of painkillers are kept small (16 tablets) by law.
• Pharmacy medicines: sold only in a pharmacy, from behind the counter, after a few questions from the staff or the pharmacist.
• Prescription-only: need a prescription from a UK prescriber. UK pharmacies cannot fill a US prescription.

Bringing prescriptions and controlled drugs

Bring enough of every regular medicine for your whole trip plus a few extra days, in the original pharmacy packaging with your name on the label, in your carry-on. A US prescription cannot be filled in a British pharmacy, and replacing medicine means seeing a UK doctor. NHS Scotland notes that a pharmacist may agree to sell a small emergency supply at full price in some cases, but do not count on it with a US prescription. Mailing medicine to yourself in the UK is slow and parcels can be held or seized.

Controlled drugs

Many common US prescriptions are "controlled drugs" under UK law. That includes ADHD stimulants such as Adderall, Vyvanse and Ritalin; opioid painkillers such as oxycodone, hydrocodone and tramadol; benzodiazepines such as Xanax, Valium and Klonopin; sleeping pills such as Ambien; gabapentin and pregabalin (Lyrica); and testosterone. You can bring them for personal use if you follow GOV.UK's rules:

• Bring no more than three months' supply. Anything over that, whether carried or posted, will be confiscated unless you have a Home Office personal licence, which is only for exceptional cases.
• Carry the medicine in your hand luggage, not checked bags.
• Carry a letter from your prescriber giving your name, your travel dates, a list of your medicines with quantities, doses and strengths, and the prescriber's signature.
• Keep everything in the original packaging. Officials can confiscate medicine if you cannot show it was prescribed to you.

Adderall itself is not licensed in the UK, which is why the letter matters: a British doctor cannot simply write you a refill, though related medicines exist. For questions, the Home Office's Drug and Firearms Licensing Unit has guidance on GOV.UK.

Other medicines and devices

• Injectables: insulin, GLP-1 pens such as Ozempic or Mounjaro, and EpiPens are fine in carry-on with the prescription label and a doctor's note. Carry two EpiPens if you use them; UK pharmacies cannot replace them without a UK prescription.
• CPAP machines work on UK 230-volt power with the right plug adapter, since most power supplies are dual-voltage. Check the label, and see Staying connected for plugs.
• Glasses and contacts: pack a spare pair of glasses and your prescription. High-street opticians such as Specsavers and Boots Opticians can test eyes and make glasses quickly, for a fee.

Travel insurance

The NHS itself advises visitors staying under six months to have personal medical insurance, and the State Department recommends coverage for medical evacuation as well. For most Americans, a travel medical policy is the single most important health purchase for a UK trip. Check three things first:

1. Your own US plan. Many employer and marketplace plans cover emergencies abroad as out-of-network care, but usually you pay the hospital and claim later, and they rarely cover medical evacuation. Call and ask what applies in the UK, and get the answer in writing.
2. Your credit card. Premium cards often include trip cancellation, delay, baggage and rental car cover, but rarely emergency medical care. Read the benefits guide rather than assuming.
3. A travel medical policy. If the first two leave gaps, buy a policy that covers emergency medical treatment, hospital stays and medical evacuation or repatriation to the US, and that has a 24-hour assistance line. Many travelers choose medical limits of at least $100,000 and higher for evacuation.

What to check in the policy

• Pre-existing conditions: many policies exclude them unless you buy within a set number of days of your first trip payment.
• Activities: hill walking, scrambling, winter mountaineering, skiing in Scotland, cycling and water sports may need an add-on.
• Direct billing: whether the insurer pays the hospital directly or you pay and claim.
• Age limits and pricing for travelers over 70.
• Theft cover for phones and cameras, if the policy also covers belongings.

An air ambulance back to the US can cost tens of thousands of dollars, and a commercial flight with a medical escort is not cheap either. Long-stay students and workers are a different case: they pay the Immigration Health Surcharge with their visa and use the NHS much like residents; see Long stays.

Medicare and Medicare Advantage abroad

Original Medicare (Parts A and B) does not cover care in the UK. Its narrow foreign exceptions involve Canada, Mexico and ships near US ports, none of which apply to a British trip. Part D drug coverage stops at the US border too.

Medigap (Medicare Supplement) Plans C, D, F, G, M and N include a foreign travel emergency benefit, as do the older E, H, I and J plans still held by people who bought them before June 2010. It works like this:

• It covers emergency care that begins during the first 60 days of a trip outside the US.
• You pay a $250 deductible each year, then the plan pays 80% of the cost.
• There is a lifetime maximum of $50,000 for foreign travel emergencies.
• It does not cover a medical flight home, routine or non-emergency care, or prescription drugs bought outside the hospital.

Medicare Advantage (Part C) plans vary. Many include worldwide emergency and urgent care as an extra benefit, often with an annual cap, and some include no foreign coverage at all. Call your plan before you book, ask about limits, whether you must pay up front, and how to claim, and get the answer in writing.

Vaccines and CDC guidance

The UK needs no special travel vaccines, and there is no malaria, yellow fever, dengue or Zika risk. The CDC's advice for American travelers to the UK centers on being up to date on routine vaccines: measles, mumps and rubella (MMR), tetanus and diphtheria, chickenpox, polio, flu in season and COVID-19. Depending on your plans and history, CDC may also suggest hepatitis A and hepatitis B vaccines for travelers who have not had them, and rabies shots only for people whose work or activities bring them into contact with bats. Check the CDC's UK destination page before you go, because the lists are updated.

Measles

England has had measles outbreaks in recent years. CDC recommends that every international traveler be fully protected against measles, with two doses of MMR at least two weeks before departure for anyone without evidence of immunity. Babies aged 6 to 11 months should get an early dose before an international trip, then continue the regular schedule. Adults born before 1957 are considered immune.

The UK has no entry health requirements, no COVID-19 rules and no vaccination checks at the border. Home COVID-19 tests are sold in pharmacies and supermarkets if you need one.

Water, food and allergies

Tap water is safe to drink everywhere in the UK. It is hard (high in minerals) in London and much of southern and eastern England, and soft in Scotland, Wales and the north; some Highland water is faintly brown from peat and still safe. In England, Wales and Scotland, pubs, bars and restaurants licensed to sell alcohol must give you free tap water if you ask. A few remote cottages draw water from a private supply; the owner should tell you whether to drink it. Do not drink untreated water from streams and lochs in the hills, however clear, because sheep and deer graze upstream; boil, filter or treat it.

Food safety standards are high. In England, Wales and Northern Ireland, restaurants, cafés and takeaways get a food hygiene rating from 0 to 5, often shown as a green sticker in the window (display is required by law in Wales and Northern Ireland). Scotland uses a Pass or Improvement Required scheme. You can look up any business on the Food Standards Agency ratings site.

Food allergies

UK law requires restaurants and food businesses to tell you if a dish contains any of 14 major allergens, including peanuts, tree nuts, milk, eggs, gluten, fish, shellfish, sesame, soy, celery and mustard. Food made and packaged on the premises, such as sandwiches in a café, must carry a full ingredient label. Ask staff directly; most menus say "please ask about allergens" and servers are trained to check with the kitchen. Carry your own epinephrine.

See Food for what to eat and Pubs for drinking; remember a British pint is 20 fluid ounces (568 ml), and many ciders are strong.

Ticks, Lyme disease, midges and other bites

Ticks and Lyme disease

Ticks that can carry Lyme disease live across the UK in long grass, bracken and woodland, and occasionally in parks and gardens. The NHS names grassy and wooded parts of southern England and the Scottish Highlands as higher-risk areas; the New Forest, Exmoor, the Lake District and the Highlands and islands are classic tick country, along with anywhere with deer and sheep.

• Wear long pants tucked into socks, use a repellent containing DEET, and stick to paths where you can.
• Light-colored clothing makes ticks easier to spot.
• Check yourself, children and dogs every evening after a walk, including the scalp, behind the knees and in skin folds.
• Remove a tick with fine tweezers or a tick tool (sold at pharmacies and outdoor stores): grip it close to the skin and pull up slowly without crushing it, then clean the bite.

The tell-tale sign of Lyme disease is a circular or oval rash around the bite, sometimes with a lighter or darker center, which usually appears one to four weeks after the bite but can take up to three months. Flu-like symptoms may come with it. If you develop either within three months of being in tick country, contact a GP or NHS 111 in the UK, or your doctor at home, and say where you have been. Lyme disease is easily treated with antibiotics when caught early.

Midges

The Highland midge is a tiny biting fly that swarms in the Scottish Highlands and islands, especially along the west coast, from late May to September, with the worst of it in June, July and August. Midges carry no disease, but on a still, damp, cloudy evening they can make a lochside picnic unbearable. They are worst at dawn and dusk and give up in a breeze or bright sun.

• Smidge, a repellent made for midges and sold all over Scotland, works well; DEET products do too.
• A head net (a few pounds in outdoor and gift shops) is a lifesaver for camping and evening walks.
• Plan picnics for breezy, exposed spots, and keep windows closed or screened at dusk.
• Check the Scottish midge forecast online in summer.

See The Highlands and Scottish islands for more on timing a trip.

Other things that bite and sting

• Adders, Britain's only venomous snake, live on heaths and moors. Bites are rare and very rarely fatal, but go to A&E if bitten.
• Horseflies ("clegs" in Scotland) give painful bites in summer, and wasps are aggressive in late summer.
• Weever fish hide in the sand on some beaches in the south and west; stepping on one is very painful. Wear water shoes, and soak a sting in water as hot as you can comfortably bear.
• Jellyfish wash up on beaches in summer; most stings are mild.
• Rabies is not found in British land animals. A very small number of bats carry a related virus, so do not handle bats.

Hay fever

If you have allergies at home, the British grass pollen season, roughly late May to July, may surprise you. Antihistamines are cheap at any pharmacy, and the Met Office publishes a daily pollen forecast.

Sun, cold and weather in the hills

Sun

Britain's mild temperatures fool people into sunburn. In June and July the sun is high and strong, the UV index in southern England can reach high levels on clear days, and Scotland's long summer days (close to 18 hours of daylight in the north around the solstice) mean many hours of exposure on a hill or a boat. Wear sunscreen even on cool, breezy days, especially at the beach and on mountain tops.

Heat

Heat waves are now a regular part of British summers; in July 2022 the UK recorded 104.5°F (40.3°C) for the first time. Most homes, many hotels and older trains and Tube lines have no air conditioning, so a hot spell can be harder to cope with than the number suggests. Ask about air conditioning or fans when you book a summer stay, carry water and plan indoor time in the afternoon.

Cold, wet and wind

The bigger risk is cold. On the summits of Ben Nevis, Yr Wyddfa (Snowdon) or the Lake District fells, it can be near freezing with driving rain and gale-force wind while the valley is pleasant, and wet clothes in wind cause hypothermia surprisingly fast, even in summer. Snow can lie on the highest Scottish summits into early summer, and in winter Britain's mountains need ice axes, crampons and experience.

• Check the mountain forecast the evening before and the morning of your walk.
• Pack a waterproof jacket and pants, a warm layer, hat and gloves, even in August.
• Turn back if the cloud drops, the wind rises or you are behind schedule.
• Know the signs of hypothermia (shivering, clumsiness, confusion) and get the person warm and out of the wind.

For emergencies on hills and coasts, call 999 and ask for police, then mountain rescue, or the coastguard. Routes, gear and safety are covered on our Outdoors and Safety pages, and the seasons on When to go.

Health checklist for your trip

• Buy travel medical insurance with evacuation cover, or confirm in writing what your US plan, Medigap or Medicare Advantage plan covers in the UK.
• Check you are up to date on MMR and other routine vaccines at least two weeks before you fly.
• Pack every regular medicine for the whole trip plus extra, in original packaging, in your carry-on.
• Get a prescriber's letter for any controlled drugs, and keep to three months' supply.
• Bring melatonin, if you use it, and a small kit: plasters (Band-Aids), blister pads, your usual painkiller and antihistamine.
• Pack DEET or Smidge and a tick tool for the Highlands and countryside in summer.
• Save 999 and 111 in your phone, and the insurer's 24-hour assistance number.
• Pay or pass to your insurer any NHS bill before you leave.