Comments on: Help This American Student Navigate the NHS

Question: Help This American Student Navigate the NHS

awesomebrad — Thu, 26 Jul 2007 22:39:20 -0800

NHSFilter: I'm going to be studying in the UK for a year, and I have some questions about my coverage under the NHS.

I'm going to be entering the UK in September for a year-long course of study; I know that because I'm on a student visa and will be in the UK for more than six months, I'm entitled to NHS coverage. I do, however, have some questions.

I've taken several prescription medications to help control acne for the past two years. I know that the general charge for prescriptions is £6.85, and also that there is a list of medications which are not covered. I cannot, however, find this list, and as controlling acne isn't exactly essential to my survival, I need to know whether I'll be able to procure my medications in the UK under the NHS scheme (I don't need to worry about finding a GP to register with, as my school provides one). The medications I use are: Doryx (which is a slightly modified form of doxycycline), Nicomide (nicotinamide/niacinamide prescription vitamin), Retin-a micro, and Brevoxyl 4% creamy wash.

Additionally, I've just had a minor surgical procedure performed, and although it has gone well, it will require follow-up extending into the first part of my stay in the UK (just checks to make sure there's no recurrence). I noticed that the student coverage doesn't cover pre-existing conditions, will this be an issue? And the follow-up should preferably be performed by a specialist: will I/how will I need to go about getting a referral?

I've tried to include everything I can think of, but if you can see any issues here that could crop up and I haven't specifically asked about, I would appreciate it if you could let me know.

Thanks in advance, everyone!

By: essexjan

essexjan — Thu, 26 Jul 2007 23:54:02 -0800

Having checked the patient.co.uk website, I think all the treatments you're currently using for your acne are available in some form or another in the UK - for example doxycycline is available in generic form, not branded as Doryx. I'd suggest you bring enough with you to last a while, and supply your GP with the full info sheets so the nearest match can be found. Very often it'll be the same product you could get in the US, but just under a different brand name.

With regard to the surgery, in the UK you'd normally be referred back to your own GP to follow up minor surgery, or even to the practice nurse. If you wanted to see a specialist, you'd probably need to wait a year or more for the appointment, unless you wanted to pay privately. I'd suggest that when you see your GP about the prescription meds you need, you also say "oh, and I wonder if you could just check that my [whatever] is healing ok." Unless there's tests involved (or anything else that'd result in expense for the surgery) I don't think you'd be charged for a quick examination just to make sure something is healing properly.

By: essexjan

essexjan — Fri, 27 Jul 2007 02:48:24 -0800

or anything else that'd result in expense for the surgery

By this I mean the medical practice, which in the UK is commonly referred to as the surgery, as opposed to actual cutting-you-open-with-scalpel surgery, which we tend to call an operation.

By: srboisvert

srboisvert — Fri, 27 Jul 2007 02:49:43 -0800

Not official or anything but my experience and the experience of several foreign students I know is that the NHS clinics never even check your documentation or status.

Everybody is covered here so they don't seem to want to sweat the paperwork of dealing with international coverage plans. It's probably still smart to be covered in case something major happens but minor prescriptions and such don't seem to merit any insurance paperwork.

By: holgate

holgate — Fri, 27 Jul 2007 03:00:28 -0800

Doryx is called Vibramycin in the UK. It's available on prescription.

By: grouse

grouse — Fri, 27 Jul 2007 03:17:53 -0800

I have an American friend who came here and faced this situation for a different drug originally prescribed in the U.S. This drug was really expensive and the GPs here didn't want to prescribe it. They stopped giving it to her until she saw a specialist, and several months later, the specialist said it wasn't medically necessary. She begs to differ.

If you do manage to get the prescriptions, there are pre-payment certificates that will save you money if you get at least four prescriptions every three months, or at least 14 prescriptions a year.

By: roofus

roofus — Fri, 27 Jul 2007 05:06:46 -0800

You usually don't have to wait longer than 6 weeks for a first appointment with a hospital specialist, and certainly not longer than 18 weeks. I agree though that your GP is very unlikely to refer you back for routine post-op care unless they have specific concerns about something they can't handle.

By: k8t

k8t — Fri, 27 Jul 2007 06:00:04 -0800

I was a student for one year in the UK. I had brought 2-3 months worth of my meds.

One of the first things you'll need to do is register with a GP. My university suggested one near the school (Gower Street Clinic, very popular with all of the university students in Bloomsbury), so I did that before I found housing. Looking back, I would have rather waited and gone to the one around the corner. When I had a bad case of the flu, I would have rather gone there.

I made an appointment right away and I found that the GP was totally okay with "re-prescribing" me everything and she was very helpful with finding the right equivalents. And oh boy was that stuff CHEAP! Fill up while you can.

As far as your surgery follow up, again, speak to the GP.

You may be surprised how the UK system doesn't coddle you like we are accustomed to in the US. You're in, you're out. The GP sits at a desk with a computer. When you have a cold or flu, you talk to the pharmacist about it and s/he prescribes you something right there. Overall I was very happy with the quality of care. I had a friend who discovered that she had menangitis while she was an American student in the UK and she was also satisifed with the care.

By: grouse

grouse — Fri, 27 Jul 2007 06:02:22 -0800

I would have rather waited and gone to the one around the corner.

You can register with a different GP later if you need to.

By: k8t

k8t — Fri, 27 Jul 2007 06:37:34 -0800

Grouse, really? I was told that it was a huge hassle to do that if I in fact didn't move.

By: grouse

grouse — Fri, 27 Jul 2007 06:49:32 -0800

You should have received a medical card when you first registered. On the back, mine says:

If you want to change your doctor

You can do this at any time — you do not have to have a special reason. Just fill in the front of this card and give it to your new doctor.

By: wilko

wilko — Fri, 27 Jul 2007 07:57:07 -0800

What may be a hassle is actually finding another GP with space on their register to take you on. That, or living too far from their area (i.e. for home visits), should really be the only grounds for refusing you. If you want to move from one GP to another, just ring around the surgeries. If at any time you are not registered with any GP at all, your local Primary Care Trust has a duty to help you find one.

By: wayward vagabond

wayward vagabond — Fri, 27 Jul 2007 09:27:33 -0800

you can look up all your local GP surgeries here.

if your local catchment GPs refuse to take you on, the PCT will make them do so. call the NHS direct line 0845 4647 and they'll tell you what to do.

By: holgate

holgate — Fri, 27 Jul 2007 18:16:50 -0800

When you have a cold or flu, you talk to the pharmacist about it and s/he prescribes you something right there.

That's not quite true: there's a class of products that can be sold without a prescription, but only 'behind the counter' at a pharmacy. The pharmacist generally asks a standard set of questions -- e.g. 'have you taken this before?', 'are you taking any other medicines' -- before selling you a BTC product.

In some cases, you'll find medicines that are prescription-only in the US behind the counter in the UK, and the BTC product may also be cheaper than the standard NHS prescription fee: Brevoxyl 4% cream (I don't know if that's identical to the creamy wash) is sold BTC and appears to cost about £6. There may also be a BP (generic) variant that's cheaper still.