How the NHS works

It is common for people working in the health system to use the terms 'primary care' and 'secondary care' and most health services fall into one of these categories.

Primary care is the first point of contact for most people with the health system. GPs (general practitioners or family doctors), practice and community nurses, dentists, pharmacists and opticians all provide primary care. It focuses on the treatment of common illness and injuries as well as preventive services like helping people quit smoking. Another important role GPs play is to refer people on to more specialist care if they need it, including secondary care.Secondary care includes most of the services provided in a hospital. Services can either be inpatient (you stay overnight) or outpatient (you come to the hospital during the day).

Secondary care includes most of the services provided in a hospital. Services can either be inpatient (you stay overnight) or outpatient (you come to the hospital during the day).

Specialist HIV out-patient clinics are located in hospitals. Unlike many other secondary care services, you don’t normally need a referral from someone working in primary care to access an HIV clinic.

For people who have HIV, it’s best to be in contact both with a general practitioner and with an HIV clinic. For many health issues, the GP will be the best person to go to, but for things related to HIV, you should go to the HIV clinic.

Most NHS services are free of charge for most people. But even if you are entitled, you may need to pay for some prescriptions other than for your HIV medication and for dental and optical treatment. Help with these costs is available in some circumstances. You can find out more about this on the NHS Choices website.

Also, NHS treatment is not automatically free of charge to people from other countries. It depends on your immigration status and on the kind of treatment required.

From October 2012, HIV treatment is free to anyone who needs it, regardless of your immigration status.

Some other treatments are also free of charge to anyone in need. These include treatment at an Accident & Emergency department or emergency treatment at a walk-in centre, or treatment for tuberculosis (TB), hepatitis and some other infectious diseases.

Treatment for life-threatening conditions (including HIV) must be provided, even if a person is unable to pay for it. Our Immigration section has further details.