Looking after your health

What is the National Health Service (NHS)?

This is often shortened to be called the NHS. You are entitled to access health services provided by the NHS if you have made an application for asylum and are receiving support from the Home Office.

You are entitled to access free health services provided by the National Health Service (NHS) such as:

• General Practitioners also known as GPs. You might know them as doctors
• hospitals
• maternity services, which are services for women who are having a baby

The NHS provides services to those who need medical treatment and can also help with areas such as contraception, family planning, healthy eating and mental health.

Your health will not affect your immigration status or affect what NHS services are available to you. None of the people who work for the NHS, including doctors, nurses and interpreters will pass on any information about your health to any other person or organisation outside of the NHS without your permission (except in very exceptional circumstances, such as if the doctor believes you may be of harm to yourself or others).

What are GP services?

GPs are highly skilled doctors who are trained in all aspects of general medicine e.g. child health, adult medicine and mental health. They work in the community, and also provide services such as:

• Antenatal care (care for pregnant women and their unborn children)
• Vaccinations
• Advice on smoking and diet

You need to register with a GP as soon as you can when you arrive so you can access the service when you need to. They can give you support to keep you healthy or if you are unwell.

Visit a GP if it is not an emergency and you need to see a doctor or nurse about your health. It is important however to self-manage where possible if you have a minor illness, or go to a pharmacy for advice (the role of the pharmacy will be explained shortly), before seeing a GP.

Find your local GP surgery

GPs act as gatekeepers for specialist services

This means that they can refer/send you to specialist services that you may need. This can include other doctors or health professionals who specialise in different health issues, such as dietitians, physiotherapists, or for an x-ray. They can also refer your children to any specialist services they may need such as health visitors (who look after the health of children under the age of 5), or paediatricians.

You can only access these specialists through your GP, and cannot approach them directly.

How do I register with a GP?

Go to a local GP practice and ask for a registration form. Ask for help if you need it to fill in the form, as interpreters can be booked if necessary. You have the right to an interpreter.

You will need to give your name, address and telephone number (if you have one).

You may be asked for proof of identity and proof of address, but you cannot be refused registration if you do not have these available. You can take your Mears tenancy agreement as proof of address.

A GP surgery can refuse your application if they have reasonable grounds for doing so, such as if they do not have capacity for new patients, but they must notify you of their decision and reasons behind it, in writing within 14 days of the decision. If this happens, you can either ask your housing manager for advice about identifying an alternative GP to register with or use the find a GP search tool on the NHS website.

After registering with a GP you might be asked to have a health check. It is important to attend this appointment even if you are well.

If you move to a different part of the UK, you will need to register with a new GP.

These phrases could be useful at a GP practice:

‘Please can I register at this GP practice?’

‘I need help to fill in this form’

‘I do not understand this, I need an interpreter’

This is the form which needs to be completed.

It is available at the GP practice or online.

Financial support for health costs

Your HC2 certificate is proof that you are entitled to free health care including; dental costs, eye care costs, travel costs, prescription costs, wig and fabric supports.

You should be given one when you leave initial accommodation. It looks like this. Take it with you to the GP, dentist and optician.

The HC2 certificate is also proof that you are entitled to free travel costs for some hospital appointments. To gain a refund on travel costs you will need to show your bus or train ticket and proof of your appointment.

If you have been charged for treatment it could be a mistake and you can ask for help in checking.

Your HC2 form will be valid for 6 months. Then you need to renew it.

If you do not have an HC2 form or you need to renew it, then you need to complete an HC1 form. It looks like this.

You can order or download these online, or they may be available in the local GP practice or hospital. It is very important to complete this so ask for help if you need it. You will then be sent an HC2 form.

Your HC2 form will be valid for 6 months. Then you need to renew it.

More information on the NHS low income scheme (LIS).

Where to go for medical help

It is important to seek the right medical help if you need it.

For minor issues such as a sore throat or a grazed knee, self-care is most appropriate.

NHS 111 is free to phone for advice on medical problems and you are not sure what to do. Phone 111 on your phone, it is available 24 hours a day, 7 days a week, and you can ask for a translator if you need one. Depending on the situation you will:

• find out what local service can help you
• be connected to a nurse, emergency dentist, pharmacist or GP
• get a face to face appointment if you need one
• be told how to get any medicine you need
• get self-care advice

The pharmacist can give advice and help with issues such as diarrhoea, runny nose and headache. They can advise you on the best medication to take if that is required, however you may have to pay for some of these. The role of the pharmacy will be explained in more detail shortly.

As explained, visit a GP if it is not an emergency and you need to see a doctor or nurse about your health. You should however seek to manage by self-care and advice from the pharmacy first. Only go to the GP if you need to.

Go to Accident and Emergency (A&E) or phone 999 in an emergency situation such as choking, severe bleeding, chest pain or blacking out.

Emergency services

As mentioned, if you have a serious accident or sudden serious illness, you should go to your nearest hospital with an A&E department. Do not use A&E for minor medical problems.

If it is an extreme emergency then call 999, and ask for an ambulance.

It is free to access A&E services and call an ambulance.

Remember to call 111 for urgent medical advice in a non-life threatening situation.

Urgent and emergency care info on the NHS website

GP appointments

To see a GP you must make an appointment. Many require you to make an appointment by telephone or online. Some will also make an appointment if you visit their surgery. Ask your GP practice what the process is.

You may have to wait a few days for a non-urgent appointment. This is normal for everyone. If you think it is urgent, then tell the receptionist when you make an appointment, and you may be seen on the same day if it is appropriate. But important to remember you cannot expect to be seen without making an appointment first.

It is important to arrive on time for appointments and cancel if you cannot attend. If you do not arrive on time you may lose your appointment.

You can ask to see a male or female GP, and your GP surgery will do their best to accommodate this.

You must make a separate appointment for each family member as the GP will only be able to see one patient in each appointment. Appointments are usually only 10 minutes long.

The majority of GP practices have electronic screens in reception, where you check in for your appointment. Sit in the waiting area after checking in.

Interpreters

If you need an interpreter then tell the receptionist when you make the appointment. You are entitled to an interpreter, and it is important for you and the doctor to understand each other.

If you cannot understand your interpreter, you have the right to let them know, and get another. You can also request a male or female interpreter.

You will not be charged for an interpreter and this may be face to face or over the phone.

Everything discussed in the appointment is confidential, including anything discussed in the presence of an interpreter.

How do I access medication?

After your appointment, your GP may want you to take medication and they will write you a prescription. This is a document which says what medication is needed, and how to take it. Take the prescription to the pharmacy, which is where medicines are prepared and sold. Remember that if you have a HC2 form, prescriptions are free.

Many pharmacies are open until late and on weekends, and you can get some medicines from the pharmacy without a prescription, however you will have to pay for them. Some pharmacies offer a ‘pharmacy first’ scheme. This is available for children and adults who need medication for a number of common ailments. All you need to do is give the pharmacist your NHS number, or your child’s NHS number to receive advice and where appropriate, medicines free of charge.

Ask your GP about their process for getting repeat prescriptions if they are necessary. Repeat prescriptions can be ordered online, but you need to collect the medication from a pharmacy of your choice.

Here is an example of a prescription form. As you will be eligible for free prescriptions after receiving your HC2 form, remember to mark a line in the box in row ‘L’ which says ‘HC2 (full help) certificate’.

When you get a prescription, it is important to understand how to take it.

Number 1 describes the medication, such as its name, strength and quantity in the prescription. 

Number 2 provides instructions on taking the medication, such as when and how many. 

Number 3 provides warnings on side-effects and interactions.

In the UK, self-care is important for minor issues such as colds. We treat these with products such as paracetamol, and calpol for children. You can find these in the supermarket, which may be the cheapest place. 

Antibiotics are not routinely given due to concerns about antibiotic resistance – this means that if you take them when you do not need them, they may not work for you in future when you do need them. Many conditions will get better on their own without using antibiotics so follow advice from your pharmacist or doctor regarding whether you need them or not. 

Children's health

It is important to keep your child vaccinated. You will usually be contacted by your GP surgery when your child is due for a routine vaccination. This could be a letter, text, phone call or email. If you know your child is due for a vaccination, it is best to speak to your GP surgery to book the appointment. You do not need to wait to hear from them. It could be at your GP practice or a local child health clinic.

You can get support and advice from a health visitor if your child is between 0 and 5 years old. Health Visitors support all pregnant women and young children up to the age of 5 with a range of health checks at key points in their early life.  This includes an antenatal check and continues up until 2 ½ years old.  This is to make sure that children are growing well and meeting the expected milestones, supported by their parents. Where necessary help and advice is provided including: forming a bond with your child, breastfeeding and healthy eating, keeping a ‘happy head’, and any immunisation requirements. These visits are usually in the home, but the health visitor may invite you to join groups, clinics and networks run by the health visiting team or colleagues who work with them such as: nursery nurses, children centre staff, voluntary organisations or community mothers.

When you first learn that you are pregnant, book an appointment with your GP to let them know, so that you can receive all of the necessary support.

More information on NHS vaccinations and when to have them.

Dental care

A dentist is an expert in oral health.

Regular check ups allow your dentist to see if you have any dental problems, and help keep your mouth healthy.

In addition to registering with a GP, you will need to register with a dental practice. Find a dentist.

Dental practices provide both private and NHS care. Register at a dental practice as an NHS patient. They may not have capacity to take on new NHS patients, so you may have to join a waiting list, or look for a different dentist who is taking on new NHS patients. Cosmetic dental treatment is not free.

Eye care

Your eyes rarely hurt when something is wrong with them, so having regular eye tests is important to help detect potentially harmful conditions. The NHS recommends that you should have your eyes tested every 2 years.

Go to an optician, they will test your eyes for any abnormalities or conditions, and can prescribe and fit glasses and contact lenses. Find an optician.

Opticians will register you as an NHS patient so eye tests and essential treatment is free of charge.

Screening programmes

There are screening programmes in the UK to detect different conditions such as cervical, breast and bowel cancers. You will be automatically offered screening by receiving a letter, when you are the appropriate age for a certain test.

You do not have to undergo screening if you do not wish, however detection of a problem earlier means that treatment is more effective and can reduce the risk of death from certain conditions.

Contraception

Contraception is also known as ‘birth control’ and ‘family planning’.

Contraception is free on the NHS.

You can get contraception and advice from the GP surgery, pharmacy, or sexual health clinic.

Sexual health clinics

These are also known as GUM clinics. As well as contraception they provide other services such as testing and treatment for sexually transmitted infections (STIs), advice and information about sexual health, HIV testing including rapid tests that give results in about 30 minutes and counselling for people who are HIV-positive, and PEP (post-exposure prophylaxis) – medication that can help prevent people from developing HIV if they have been exposed to it.

Not every clinic will provide all of the services, and you may have to book an appointment rather than ‘drop-in’, so check your local clinic. More information on what sexual health clinics provide.

Keeping a 'happy head'

It is important to understand how the traumatic experiences you have been through in your home country, and on the journey to the UK can affect you.

Most asylum seekers have experienced trauma, fear and loss. Feeling stressed, anxious and worried is normal when you are waiting for a decision on your asylum case, which may take a very long time.

You may also struggle to sleep, lack energy and be sad/tearful. This is normal in these circumstances.

It is important to talk about how you feel and get help if you need it. This can be to a friend not just a professional.

If you have suffered with symptoms for a few weeks and/or they are affecting your daily life then make an appointment to speak with your doctor.

How we feel in our head, whether that is happy or sad is called ‘mental health’ in the UK. This does not mean someone is ‘mad’ or ‘crazy’.

Anxiety, post-traumatic stress disorder, which is also known as PTSD, and depression are common.

Advice is also available on the NHS website, to support you to feel better. It also gives you details of support organisations and their helplines that you can contact for help and advice.

It is important not to remain isolated and inactive whilst waiting for your decision, otherwise these feelings may get worse.

Other people who have lived through this experience strongly recommend you take action to break this circle and protect your emotional wellbeing.  Although asylum seekers are not allowed to work in the UK and could be waiting for many months for a decision, there are still ways you can pass the time meaningfully and positively. This will keep you feeling stronger.

They recommend you take action by being proactive and regaining some control over your life such as by:

Connecting to other people

Do not sit in your room alone. Find out where there is a local drop in for asylum seekers, or a community centre, or a group of people from your community. You will meet lots of other people this way – both people going through the same experience as you and English people who want to help. You can find out further information through the services directory.

Its important to talk about how you feel rather than keep how you feel to yourself and suffer in silence. Talking to others breaks this isolation. It can be therapeutic.

You can also get professional help if you need it by talking to your GP and asking to be referred to talking therapies.

Getting involved in activities

Many of these local community groups run a range of activities such as conversational English, vegetable gardening, cooking, singing, visits to local sites, and sport like football.  These can keep you active and you can learn new things.

After 6 months you will be eligible to study some courses for free at a local further education college

And you can Volunteer with local groups.  Volunteering is unpaid, but is a very good way of practicing and improving your English, of learning how things work in the UK, widening your connections and knowledge, learning new things, and giving back. Being a Volunteer can also provide you with references and experience which will be useful for future employment.

Being active

Adults should aim for at least 150 minutes of physical activity per week, and children should aim for at least 1 hour per day. This can be spread out over the week and does not have to cost money, you can go for a walk in your local area such as a park alone or with family or friends.

Healthy living

Our lifestyle has a big impact on our health.

Smoking is extremely damaging to health and increases your risk of cancers, heart attacks and strokes.

It is the biggest cause of preventable death worldwide.

Second-hand smoking is also damaging to health, and increases your risk of getting the same health conditions as smokers. Children are extremely vulnerable to the effects of second-hand smoking, such as having a higher risk of developing chest infections and meningitis.

Smoking or passive smoking in pregnancy increases risk of miscarriage, premature birth and stillbirth.

You can ask for advice at the pharmacy or GP practice, and access a specialist service to help you quit.

Drinking too much alcohol can damage our health, increasing risk of certain cancers, liver disease and stroke.

There is no safe amount of alcohol to drink, but it is advised to drink no more than 14 ‘units’ per week.

Spread your drinking over 3 days or more, and have several drink free days every week.

Alcohol can be addictive and it is a poor coping mechanism, so do not rely on it to get through difficult times.

Talk to someone about how you are feeling if you do not have a ‘happy head’, and get help if you need it.

Our diet is important when staying healthy. You should think about how your energy balance may change.

You may be less active than when you were back home whilst you are waiting for a decision. If you eat the same as before, but are less active, you will put weight on. If you put weight on you may become overweight and be more at risk of heart disease, type 2 diabetes and some cancers.

Healthy living

Eating too much sugar is bad for health as it can be very easy to gain weight, and bad for teeth. Cheap, convenience foods such as certain cereals or chocolate bars contain lots of sugar, and are low in nutritional quality. You should avoid adding too much sugar to drinks such as tea and coffee. Fizzy drinks are often high in sugar, and also contain caffeine, which can affect children’s attention and behaviour.

Eating too much salt is also bad for health as it can raise blood pressure and increase risk of heart attacks and strokes. Lots of salt may be hidden in some foods, particularly cheap convenience foods such as pizzas, tinned food and ready meals. You should avoid adding salt to your meals.

Eating too much fat can be bad for your health, as it can raise your cholesterol which increases risk of heart attacks and strokes. Avoid using too much oil/butter etc. when preparing and cooking food. Convenience foods can also be high in fat, such as chocolate, biscuits and cakes.

Fast food may contain too much sugar, salt and fat. It is of low nutritional quality, so should not be eaten regularly.

Physical activity can reduce risk of major illnesses such as cancer, type 2 diabetes and heart disease.

Adults should aim for at least 150 minutes of physical activity per week, and children should aim for at least 1 hour per day.

Any activity where your heart rate raises, you breathe faster and feel warmer counts. You do not have to take part in a sport, or join a club.