NHS vs private
healthcare
How NHS and private healthcare differ in terms of cost, choice, waiting times and facilities, and how they can work together.
The basics
What is the difference between NHS and private healthcare?
The National Health Service (NHS) was launched in 1948. It provides everything from GP appointments to emergency and specialist hospital care, and is funded mainly through taxation. It is generally free at the point of use for people who are eligible.
Private healthcare is privately funded care. It can take place in independent hospitals and clinics, or in private units within NHS hospitals.
For information about eligibility for free NHS treatment, see the GOV.UK guidance on NHS entitlements.
At a glance
A summary of the main differences
This summary highlights the main differences. The sections below explain them in more detail.
| Topic | NHS | Private healthcare |
|---|---|---|
| Who pays | Funded mainly through taxation. Generally free at the point of use for people who are eligible. | You pay the hospital, clinic or specialist yourself. A health insurance policy could help you meet some or all of the costs, depending on its terms and conditions. |
| Choosing where you are treated | In England, you can generally choose which hospital or provider you are referred to, with some exceptions. | You can generally choose your hospital and specialist. |
| When you are treated | In England, you generally have the right to start non-urgent consultant-led treatment within 18 weeks of referral, although actual waiting times can be longer. | May offer more flexibility over treatment dates, depending on availability. |
| Your room | A shared ward or a single room, depending on availability and clinical need. | You may have a private room, often with an en suite bathroom. |
| Emergencies | Accident and emergency departments and emergency care. | Most private hospitals do not have accident and emergency departments. NHS emergency services are generally the first point of contact in a medical emergency. |
| Long-term conditions | Ongoing care is provided. | Private treatment may be available if the provider offers it, but private medical insurance often excludes or limits ongoing treatment. |
NHS rights on choice and waiting times apply in England only. Scotland, Wales and Northern Ireland have their own rules. Sources: NHS guide to waiting times in England and Your choices in the NHS.
Waiting times
How do waiting times and choice compare?
On the NHS in England, you have certain rights about where and when you are treated. Private healthcare can give you more choice over your hospital, specialist and treatment dates.
On the NHS
You usually start by seeing your NHS GP. In England, patients generally have the right to start non-urgent consultant-led treatment within 18 weeks of referral, subject to certain exceptions. This does not necessarily mean completing treatment within 18 weeks, and actual waiting times can be longer. Read the NHS guide to waiting times.
In England, you can generally choose which hospital or provider you are referred to. This includes some independent private hospitals providing NHS-funded services. Read about your choices in the NHS.
Waiting times vary by specialty and region, and urgent conditions are prioritised. Scotland, Wales and Northern Ireland run their own NHS services, with their own waiting time standards and rules on choice.
With private healthcare
Private healthcare can give you more choice over your hospital and specialist, and more flexibility over treatment dates, depending on availability. Private GP appointments are also available for a fee.
If you use private medical insurance, your choice may depend on the terms of your policy.
Facilities
What are the facilities like?
Facilities and care arrangements vary between hospitals, both NHS and private.
In an NHS hospital
NHS hospital facilities vary. Patients may be accommodated in shared wards or single rooms, depending on availability and clinical needs. Visiting arrangements vary between hospitals, and care is generally provided by a consultant-led clinical team.
In a private hospital
- A private roomYou may have a private room, often with an en suite bathroom and television.
- Choice of foodThere may be a wider choice of meals.
- Flexible visitingThere may be fewer restrictions on visiting hours.
- Your consultantYour chosen consultant may oversee your care, supported by the hospital's clinical team.
Intensive care and complications
Hospital facilities vary, and not all private hospitals have intensive care units or facilities to manage serious complications. Some patients may need to be transferred to an NHS hospital if more specialist care is required. If this is important to you, ask the hospital about its facilities and arrangements before treatment.
Treatment
Are the same treatments and medicines available?
Not always. The treatments and medicines available through the NHS and private healthcare can differ.
Some treatments may be available privately but not routinely funded by the NHS. Others may only be available through specialist NHS services, and are not provided in private healthcare facilities.
Private healthcare may offer access to different treatments, but this does not necessarily mean better or more comprehensive treatment than the NHS provides.
If you use private medical insurance
Whether private medical insurance covers a particular treatment depends on the terms and conditions of the policy. A policy does not necessarily cover every treatment available privately.
Policies commonly include restrictions on certain treatments, medicines, experimental procedures, and ongoing care for long-term conditions. The exact exclusions and limits vary between insurers and policies. Before treatment, check the policy terms and whether prior approval is required.
Cost
How do NHS and private healthcare costs compare?
NHS treatment is generally free at the point of use for people who are eligible. Private treatment involves a charge, and the cost can vary considerably depending on the treatment and the provider.
What private treatment costs can include
The cost of private treatment can include:
- Consultations. Fees for appointments with a specialist, including follow-ups.
- Tests and scans. Such as blood tests, X-rays and MRI scans.
- Hospital charges. Such as your room, the operating theatre and nursing care.
- Specialist fees. Such as the surgeon's and anaesthetist's fees.
Some hospitals offer a fixed-price package for a procedure. Always ask for a written quotation that clearly sets out what is included. Private units in NHS hospitals may cost less than independent private hospitals.
The Private Healthcare Information Network
You can find independent information about the quality and the cost of private treatment available from doctors and hospitals from the Private Healthcare Information Network.
Ways to pay for private treatment
Paying the hospital, clinic or specialist directly is known as self-pay. Private medical insurance is another way to help fund eligible treatment.
Policies work in different ways. Some pay eligible treatment costs directly to the healthcare provider, or reimburse eligible costs you have paid yourself. Others pay a fixed cash benefit towards qualifying treatment, which may be more or less than the actual cost.
Insurance benefits are subject to policy limits, excesses, exclusions and underwriting terms. This means you may still have to meet some treatment costs yourself.
Ways to manage the cost of a policy
- Choose the cover you needYour premium depends on the benefits and level of cover you choose.
- Choose a higher excessAn excess is the amount you pay towards a claim. Choosing a higher excess can reduce your premium, but means agreeing to pay a greater share of eligible treatment costs yourself.
Working together
Can you use the NHS and private healthcare together?
Yes. Private healthcare works alongside the NHS rather than replacing it. Having private treatment, whether you pay yourself or use insurance, does not affect your right to NHS treatment.
When the NHS is usually the right place
- EmergenciesMost independent private hospitals do not have accident and emergency departments. NHS emergency services are generally the right choice in a medical emergency.
- Long-term conditionsThe NHS usually provides ongoing care for long-term conditions. Private treatment may also be available, but many private medical insurance policies exclude or restrict cover for ongoing management of long-term conditions. Read about chronic conditions.
Moving between NHS and private care
You can have a private consultation and then NHS treatment, or move from NHS to private care. NHS treatment remains subject to its usual referral requirements and waiting times.
Referrals
Many private specialists ask for a referral from a GP before a consultation. Some private hospitals and clinics accept self-referrals for certain services. Check with the hospital or clinic before you book.
NHS cash benefits
Some private medical insurance policies offer a cash benefit when you receive qualifying treatment through the NHS rather than using your private insurance. The availability and amount of any benefit depend on the policy's terms and conditions.
Next steps
Find out more about private healthcare
Explore our guide to accessing and paying for private healthcare. For advice on private medical insurance, speak to a broker or adviser. If you have a question about our policies, contact our team.
This page contains general information about NHS and private healthcare, and private medical insurance. It is not medical advice, and it does not constitute a personal recommendation or advice about the suitability of any policy. NHS rights on choice and waiting times described here apply in England. Calls may be recorded and monitored for training and quality purposes.