The NHS as a Whole System

Where to start

• Register with a GP first. No passport, NHS number or proof of address is needed.
• For urgent physical health advice, use the national urgent-care route. A mental health crisis is a different door.
• CAMHS referral routes vary by nation and area. Ask locally, and plan ahead.
• Primary care is your GP: the first point of contact for almost everything that is not urgent. Secondary care is the hospital, reached by referral. CAMHS, the Child and Adolescent Mental Health Service, is the specialist service for children’s mental health. The GP is the usual route in. A school, a health visitor or another professional can often refer, and some services take a referral from the family. Ask locally rather than assuming a single door. A&E is for emergencies, not for what a GP would handle if the surgery were open.
• Two urgent doors exist and they are not the same one. For urgent advice about physical health, out of hours or when you are not sure where to go, the route is the same in three of the four nations. In England, Scotland and Wales, call 111. In Northern Ireland, contact your GP surgery during surgery hours, or your regional GP out-of-hours service when the surgery is closed. For a life-threatening emergency, call 999. A mental health crisis is a separate route, and in Northern Ireland a separate service altogether, because Northern Ireland has no 111 service at all. England, Scotland and Wales: call 111 and choose the mental-health option. Northern Ireland: call Lifeline on 0808 808 8000. Help is free, confidential and available at any hour. Whoever answers may share information to arrange care or keep someone safe. A young person can talk to someone herself, at any hour, without a parent in the room. Childline, 0800 1111. For anyone under 19 in the UK. There is a one-to-one chat online at https://www.childline.org.uk/get-support/1-2-1-counsellor-chat/. Help is free and available at any hour.
• Registering with a GP is free to everyone, whatever your immigration status and however recently you arrived, and a practice cannot refuse to register your family for want of a passport, an NHS number or proof of address. General practice, A&E and urgent mental health care are free at the point of use. Some hospital treatment is chargeable for people who are not ordinarily resident. In England most adults pay a charge for each prescription item; prescriptions are free in Scotland, Wales and Northern Ireland. NHS dental treatment and eye tests are free for children, and charged for most adults. The service is under real pressure and the waits are real, and knowing which door to use is most of what you can control.

It goes with

• The Conversations Parents Avoid. For parents who need to tell their child something hard and don’t know how to start.

The first chapter you open here is free to read in full.

Free on this subject

• General mental health. What to do first, what helps, and who else can help. Free to read and to print.
• Family stress. What to do first, what helps, and who else can help. Free to read and to print.