Understanding healthcare
The range of organisations, services and bodies which form the National Health Service (NHS) can make the health system in England a confusing one. Healthwatch Surrey exist to provide information and advice to the residents of Surrey on how to access healthcare – and to signpost to the relevant parts of the system – to hopefully make things a little clearer.
Primary care
Primary care services provide the first point of contact in the healthcare system, acting as the ‘front door’ of the NHS. Primary care includes general practice, community pharmacy, dental, and optometry (eye health) services.
General practice
The doctors and other health professionals at your GP practice can offer medical advice, provide a diagnosis and prescribe medicines, and they are also responsible for coordinating and managing your long term healthcare. They will refer you to more specialised services if needed.
Pharmacy
Pharmacists can offer advice and over the counter (OTC) medicines for a range of minor illnesses, such as coughs, colds, sore throats, tummy trouble and aches and pains. There are now a range of conditions that certain pharmacists can diagnose and prescribe treatments for too, though the pharmacist will always let you know if you need to visit a doctor. There’s more information on this Pharmacy First service on the Surrey Heartlands website (pharmacies). You can also buy medicines for minor illnesses or first-aid supplies in a pharmacy.
Dentists and opticians
Dentists and opticians look after your teeth and eye health, including regular check ups and advice on specific issues or problems.
Secondary care
In secondary care you will be taken care of by someone who has particular expertise in a certain area. It is typically your second contact when you have a health problem which can’t be dealt with in primary care because it needs more specialised knowledge, skills or equipment than the GP practice have at their disposal. It is often provided in a hospital setting. A cardiologist, for example, is a doctor specifically trained to look after people who have a range of different heart conditions. With the more specialist equipment available in hospitals they can conduct a range of tests such as echocardiograms and ECGs to help to diagnose and treat their patients.
Community health services and self-referral
Some specialised health services are accessed in the community, not in hospitals. These include mental health, child health and antenatal services and sexual health and family planning clinics.
NHS 111
Use NHS 111 if you think you need medical help right now but it is not a medical emergency. They can direct you to the best place if you are unable to contact your GP during the day, or when your GP is closed. You can contact them online (NHS 111), via the NHS App or by calling 111. Further information on NHS 111 is available on the NHS website (NHS 111).
Emergency care – 999 and A&E
Call 999 if someone is seriously ill or injured and their life is at risk. An ambulance may be sent to provide treatment or transport the patient to hospital. You can find more information on what is classed as a life-threatening emergency on the NHS website (999).
Hospital Accident and Emergency (A&E) departments are open 24 hours every day of the year and you can access these services directly and without an appointment.
Urgent care
Urgent Treatment Centres, Minor Injury Units and Walk-in Centres are available if you need urgent medical attention, but it’s not a life-threatening situation.
NHS Choices: what rights do I have?
The government is committed to giving patients greater choice and control over how they receive their healthcare.
This commitment is reflected in the NHS Constitution for England, a framework which sets out some of the nationally set choices available to you in the NHS. In some circumstances you have legal rights to choice and you must be given these choices by law. In other circumstances you do not have a legal right to choice but you should be offered choice about your care, depending on what is available locally.
Further help and advice
Further information can be found on the NHS website (NHS framework).
The Healthwatch Surrey Helpdesk is also here to provide information and signposting to local people about health and social care services.
It’s also the place to share your experiences of health and social care. Whether it’s good or bad, big or small, we welcome your feedback and act on it to help improve care where you live.
The National Health Service explained
The National Health Service (NHS) was established in 1948 with the overarching aim to provide healthcare services that are free for all at the point of delivery.
NHS England is the national body for the NHS in England. The Department of Health and Social Care sets out what the NHS is expected to deliver with the money it gets from central Government.
When it was first established the NHS focussed on treating single conditions or illnesses. Since then, our health and social care needs have changed; more of us are living longer, and have multiple conditions that require regular, ongoing care. This led to the development of a structure made up of a patchwork of organisations working independently of each other, which was difficult to navigate.
Recent changes have seen the NHS and its partners working to try to change this and to bring organisations closer together; primary care, secondary care, social care and mental health services have been seeking to partner with each other in different ways, to ensure we can receive the care we need, when and where we need it.
Integrated Care Systems (ICSs) have been set up to make this happen. The 42 ICSs in England are local partnerships that bring health and care organisations together to develop shared plans and joined-up services. ICSs are made up of Integrated Care Boards (ICBs – responsible for planning health services for their local population) and Integrated Care Partnerships (ICPs – a broad alliance of partners who all have a role in improving local health, care and wellbeing. They may also include social care providers, the voluntary, community and social enterprise sector and others with a role in improving health and wellbeing for local people such as education, housing, employment or police and fire services).
At a very local level, GPs have come together to form Primary Care Networks (PCNS) – groups of practices working together and sharing resources so they can provide a wider range of services than a single GP surgery could provide.