To hesitate to move back from US to UK because of terrible state of NHS

They will.

if she is a British citizen she will need to prove permanent residency before accessing the nhs, but tha’s simply a job, an address etc.

if she needs a visa then an nhs fee will be charged as part of the application to cover any NHS treatment.

Can you just come back though if you have not lived in the UK for many years and not paid into the NHS? your eligibility depends on your residency status on return.

You are not really an ex-pat this usually someone who has moved to another country for work and living there temporary, do you still have citizenship in the UK or a US citizen?

Also, GP appointments are easy. At mine, you do an online consult, then they phone you back with an appointment, usually the same day or within a couple of days. I’ve never waited much longer than a week.

The main problem with the NHS is that it's nationalised, ie entirely state-funded, and a constant flow of taxpayer money is ripe for abuse, so then mismanagement becomes prolific to the point where more money is being spent on managers than doctors, nurses, surgeons etc This all results in heavy rationing, ie long waiting lists.

While the US healthcare system is mostly private, that doesn't make it immune to medical malpractice. Healthcare law and accident lawyers make a killing (no pun intended) from the healthcare industry and medical malpractice claims.

Also, the NHS is so massive (the public sector is in and of itself extremely bloated anyway) that it will become necessary to have health insurance eventually, which I believe is why many (particularly those who worship the NHS) think it's being 'stolen' by the private sector or 'sold off' to the private sector.

If I were in your position, my primary concern would not be the healthcare system.

Spare me the propaganda,

I know what it's for.

And I have seen waiting times for suspected strokes and heart attacks for up to 7 hours.

We're in the SE and can get same day appointments easily, the GP is a polyclinic with loads of services attached and we have several urgent care/walk in centres nearby. We self refer to things like physio.

If it helps, went have family in the US with joint citizenship and the medic is planning on moving back to the UK so they can at least deliver the reproductive healthcare they trained to do. There's lots of misinfo in the US on the NHS.

It is a moot point, OP as you won't be entitled to NHS care for a while.

I had to attend A and E twice recently and was dreading it. But it was empty both times! No waiting, staff twiddling their thumbs. Was seen Immediately both times, sent for an x-ray, waited ten minutes for that. Seen immediately after that. Aftercare has been brilliant for a broken shoulder. A consultant, a specialist nurse and a year’s worth of physiotherapy, hydrotherapy, individual and group sessions. This is at a major London hospital.

I’ve also been treated for cancer twice- very fast. Different hospital in London.

Southern half of the country, but not being more precise than that I'm afraid.

Yes, 7 days a week. We have a walk in GP that's open evenings during the week (till 10pm) and all day at weekends. You just go and wait, and see a GP. So if an appointment with my actual GP practice isn't available or won't work for me, I just pop down to the walk in that evening. They are able to refer on (referred me for a suspicious mole under 2ww, mole was fine), prescribe the same as GP etc. I don't think they are as good for continuing care, but for one off issues, they are fine.

I think this excellent clinic means A&E is less clogged up with unnecessary patients. We've used it for minor injuries, whiplash following a car accident, kids with UTIs, kids with ear infections etc. Last time I was in and out within 20 minutes.

Not all state schools are shit.

All of this.
My DIL is American but lives here in the UK with my son. Her father had cancer. The first time round his insurance paid for treatment and he survived. The cancer came back and that time there was no money for treatment. He didn't tell his family until it was too late for them to insist on selling everything to pay for it. He wanted to leave his wife and daughters with a roof still over their heads. He died 9 years ago. It was horrific

I can see my GP the same day. They even open 6-8pm and weekend mornings. Never had an issue getting an appointment and can choose telephone or face to face

I know people in the USA who have waited >> 4 hours to be seen in Emergency Departments. Their EDs have no 4 hour targets. UK and maybe Sweden are only countries in world with 95% must-be-finished-by target times.

Article about Georgia EDs saying 50% seen within 2.5 hours, so that means plenty waiting much longer. I don't know if that's time to disposition or time to finish waiting.

St. Louis wait times "expected" so I guess that means median, 4-6 hrs.

South Korea used to have typical 20-24 hour waits in their A&Es. MERS put end to that, supposedly.

Wait times in A&E aren't really the biggest problem imho. Wait times for 'elective' tretament are the huge problem linked to social care crisis.

That was a typo for breathing difficulties

yes of course I’m for real. What do you think triage is for? Who do you think is being seen for 10 hours ahead of someone with a heart attack?!

From a quick search:

In England the standard for A&E (accident & emergency) departments is that 95% of patients should be admitted, transferred or discharged within 4 hours of arrival.

However, performance is currently well below that target:

• In recent data, around 73% of patients attending A&E were admitted, transferred or discharged within 4 hours.
• The median time spent in A&E for all patients is around 3 hours in recent years.
• For patients who are admitted to hospital, the median wait in A&E rose to approximately 4 hours 46 minutes in March 2025.

bragging difficulties?

Are you for real?

And no, you do wait for hours.

Are you in the SE? I am and I think it’s more typical here for the in person availability around here.

I need the GP for one of my children when visiting relatives and it was online only.

They’ll have to pay anyway. Isn’t it £3k ish healthcare supplement with the visa before she’ll get visa/ residency?

I’d come to the UK just for this.

Triage does exactly that. If you wait for 10 hours with chest pains and bragging difficulties, it’s because you’re not having a heart attack.

I’m not saying mistakes aren’t made it in triage process but pretending people who need life threatening medical treatment are made to wait 10 hours just because is unfair

You hear the horror stories. You don’t hear all the stories of when the NHS gets the job done well. Over the last year, we’ve had a couple of A&E visits (one for DS, one for me) which have been quick and uneventful. My GP practice is outstanding and far better than the private equivalent.

You want to emigrate from the US because Trump is in charge and he's right wing.

But you're not sure about coming to the UK because it has a left wing health service?

In our family we have had a few instances of dreadful unsafe neglect in a A& E
My Dad missed a chance of being saved through mis-diagnosis and died. Complaints are just fobbed off and they never learn. Maternity services are appalling, figures for still births very bad. Sen provision in crisis social care is also in crisis and reform kicked in the long grass. Prison and justice system in crisis. Most town centres a mixture of banks, betting shops, vape shops, charity shops and little else.
on the good side, you don’t send kids to school fearing a mass shooting, but Knife crime is rife.
we do have some beautiful countryside and beaches..
just come with your eyes open op

OP - do you have any friends and/or family in the UK as it appears you are listening to what's being reported in the USA about, 'socialised,' medicine?