NHS vs private insurance in the UK (and pre-authorisation codes)

How the NHS works (your default)

The NHS is free at the point of use and covers you once you’re ordinarily resident. The first move is to register with a GP near you — the GP is the gateway: most specialist care comes through a GP referral, and emergencies go through A&E or 999. Coming from France, the surprise isn’t cost (there’s none upfront) but the referral-and-wait model for non-urgent care.

A genuinely reassuring fact most newcomers don’t know: by law, you do not need ID, proof of address or proof of immigration status to register with a GP surgery — a surgery cannot refuse you for lack of paperwork. You’ll eventually be given an NHS number (a 10-digit patient identifier, the rough equivalent of your French numéro de sécurité sociale within the health system) — useful for finding your records, but not required to register in the first place.

Which door: GP, 111, a walk-in centre, or A&E?

This is the map French movers lack, and it saves both money and wasted hours. For anything non-urgent, book a GP appointment (routine issues, prescriptions, referrals) — expect it to take up to 48 hours. For something urgent but not life-threatening — outside GP hours, or unsure where to go — call or go online to NHS 111 (free, 24/7); it triages you and books you into the right service, sometimes a same-day slot. An Urgent Treatment Centre (UTC) or walk-in centre handles minor injuries and urgent-but-not-emergency issues (cuts, sprains, infections) without an A&E wait — some take walk-ins, others are booked via 111. Reserve A&E or 999 for genuine emergencies: loss of consciousness, chest pain, breathing difficulty, severe bleeding. Using A&E for what a GP or UTC could handle is the single biggest reason for the long waits the NHS is known for.

What private insurance adds

Private medical insurance (Bupa, AXA Health, Vitality and others — often provided by employers) doesn’t replace the NHS; it buys speed and choice for planned, non-emergency care: shorter waits, choosing your consultant, private rooms. For emergencies, you still use the NHS. Whether it’s worth it depends on your needs and whether your employer funds it.

Pre-authorisation codes — the reflex to learn

This is the part French movers most often miss. With most UK private policies, before you see a specialist or have a procedure you must contact your insurer to pre-authorise the treatment. They confirm it’s covered and issue an authorisation (claim) code. The clinic or hospital typically asks for that code before treating you — and without it, your claim can be declined, leaving you with the bill.

The sequence is usually: GP first → referral → call insurer for pre-authorisation → get the code → book the specialist/surgery. Some policies allow direct specialist access (no GP referral needed); others strictly require the GP step. Inpatient surgery almost always needs pre-authorisation. The rule of thumb: nothing private gets booked before the insurer has authorised it and given you a code.

Common mistakes

• Not registering with a GP early — it blocks referrals and routine care.
• Booking a private specialist or surgery without pre-authorisation → refused claim.
• Assuming you can always self-refer — many policies require a GP referral first.
• Ignoring the excess, outpatient limits and pre-existing condition exclusions.
• Thinking private replaces the NHS for emergencies (it doesn’t).

Your plan — a preview, not the full checklist

The principle: register with a GP, keep the NHS as your base, and if you have private cover, learn its pre-authorisation rules before you need them — GP referral, the call to the insurer, the code. The full, dated sequence is what Veia turns into your roadmap, with reminders so a missed authorisation never costs you.