Settling Into London

The GP practice is the front door to the NHS. Almost everything non-emergency runs through it: prescriptions, referrals to specialists, vaccinations, maternity care, mental health services. Register before you need it, not when you need it, because registration takes days and illness does not.

Find practices near your postcode on the NHS website and register with one whose catchment area covers your address — most now accept online registration. Register the whole household including children, and bring what you have: passports, immigration documents, tenancy agreement, a letter to your address. Bring them, but know that you are not legally required to produce them.

NHS guidance is explicit that practices have no contractual duty to seek evidence of identity, immigration status or address, and should not refuse registration because a patient cannot produce such evidence. Practice staff are not immigration officials and are not expected to assess your eligibility. A practice can refuse a registration only on narrow legitimate grounds — you live outside its catchment area and it has not opted into out-of-area registration, its list is formally closed to new patients, or it has documented reasonable grounds such as a history of violence. In practice, some London surgeries still ask for documents they are not entitled to insist on; if you are refused, politely ask for the reason in writing.

Note that GP registration and free hospital treatment are different questions. Primary care with a GP is free to all; some secondary and hospital care is chargeable for people not ordinarily resident in the UK, though most visa holders pay the Immigration Health Surcharge with their visa application and are then treated as if ordinarily resident. Check the migrant health guide for your situation.

• Register the whole family within the first fortnight, before anyone is ill.
• You cannot be refused registration solely for lacking proof of address, identity documents or settled immigration status.
• Bring your passport, immigration documents and tenancy agreement anyway — it makes the appointment shorter.
• If refused, ask for the reason in writing and contact the practice manager or NHS England.
• Register with a practice whose catchment covers where you live, or you will be redirected later.
• GP care is free to everyone; hospital care may be chargeable if you are not ordinarily resident and have not paid the Immigration Health Surcharge.

Most families arriving in prime central London end up using both systems, and there is nothing contradictory about that. Understanding the division of labour saves money and time.

The NHS is free at the point of use, provides all emergency and major acute care, and is where you will be treated for anything genuinely serious — the major trauma centres, intensive care and specialist cancer services are NHS. Its weakness is waiting times for non-urgent referrals and routine appointments.

Private healthcare in London buys speed, appointment convenience and continuity of consultant, mostly for outpatient diagnostics, elective procedures and routine GP access. It does not buy better emergency care: if a child has a serious accident, the ambulance takes you to an NHS emergency department, and that is where you want to be.

A common and sensible arrangement is to register with an NHS GP for the family's baseline and continuity, and hold private insurance or use private GP services for speed on non-urgent matters. Dentistry and optical care are largely paid-for in practice even within the NHS, so budget separately.

• Register with an NHS GP even if you intend to use private care — it is your route into NHS specialist services and your medical record.
• Emergency and major trauma care is NHS regardless of insurance.
• Private cover is most useful for outpatient waiting times, diagnostics and elective procedures.
• Check whether your private policy requires a GP referral — most do.
• NHS dentistry is limited in central London; arrange dental care early and expect to pay.
• Prescriptions in England carry a standard charge per item, with exemptions including under-16s, and are free in Scotland and Wales.

London has three tiers of unplanned care and using the wrong one costs hours.

Accident and Emergency, universally called A&E, is for genuine emergencies and life-threatening conditions: loss of consciousness, chest pain, breathing difficulty, severe bleeding, serious head injury, stroke symptoms, severe allergic reaction, major trauma. Call 999 for an ambulance in those cases. Urgent Treatment Centres and walk-in centres handle the large middle ground — sprains, minor fractures, cuts needing stitches, infections, high fever without red-flag symptoms — usually much faster than A&E. NHS 111, free by phone or online, triages anything you are unsure about, around the clock, and will direct you to the right service or send an ambulance if needed.

The one thing every family should establish in week one is which hospital has their nearest 24-hour A&E, and specifically which has a children's A&E. Central London is well served: Chelsea and Westminster Hospital on Fulham Road covers Chelsea, South Kensington and Fulham and runs a 24-hour A&E with a separate children's A&E; St Mary's Hospital in Paddington covers Bayswater, Marylebone and much of west London with a 24-hour A&E and is a designated major trauma centre; St Thomas' Hospital on Westminster Bridge Road runs a 24-hour emergency department serving Westminster and the South Bank. These are the fixed points worth knowing, but check what is actually nearest to your specific address — a few hundred metres can change the answer.

Confirm the current position for any hospital on the NHS website before you rely on it, and put the address into your phone now rather than looking it up at two in the morning.

• 999 for life-threatening emergencies; 111 for everything you are unsure about, free and 24 hours.
• Urgent Treatment Centres handle minor injuries and illness far faster than A&E — use them.
• Chelsea and Westminster Hospital, Fulham Road SW10 — 24-hour A&E and a separate children's A&E.
• St Mary's Hospital, Paddington W2 — 24-hour A&E and a major trauma centre.
• St Thomas' Hospital, Westminster Bridge Road SE1 — 24-hour emergency department.
• Save your nearest A&E address, your GP's number and 111 in every family member's phone in week one.

Council tax is an annual charge on residential property, payable to your borough, and it funds local services. It is normally the occupier's liability — so as a tenant you usually pay it, not your landlord, unless the tenancy says otherwise.

Tell the council you have moved in as soon as you arrive; every borough has an online form. You will be billed for the remainder of the financial year, usually over ten monthly instalments, and the amount depends on the property's valuation band and the borough's rate. Central London boroughs differ substantially from one another, so check the band and the borough's charge before you sign a tenancy or agree a purchase — it is a real and recurring cost, not a rounding error.

Registering also produces something useful: a council tax bill in your name at your address is one of the most widely accepted proofs of address in the UK, needed for everything from school applications to bank accounts and library cards. Discounts exist — a 25 per cent single-person discount, and exemptions where all occupants are full-time students — and are not applied automatically. You must claim them.

Registering to vote is separate from council tax and depends on nationality; being on the electoral roll also helps establish a UK credit footprint, so check your eligibility.

• Register with the borough as soon as you move in; the liability starts on the day you move in, not the day you register.
• Tenants normally pay council tax; check what your tenancy agreement says.
• Check the property's council tax band and the borough's rate before committing to an address.
• Claim the 25 per cent single-occupant discount or student exemption if it applies — it is not automatic.
• Your council tax bill is a widely accepted proof of address; keep the first one.
• Check separately whether your nationality allows you to register to vote — it also builds your UK credit footprint.

A TV licence is a legal requirement to watch or record live television on any channel or service, or to use BBC iPlayer at all. It is not a subscription to the BBC's channels only, and it applies whether you watch on a television, laptop, tablet or phone. Streaming on-demand from other services does not require one. Enforcement is real; buy it online when you move in.

Utilities depend on tenure. In a rented flat you usually inherit the existing supplier and must notify them with a meter reading on the day you move in — take a photograph of the meter with the date. In a purchase, do the same on completion day. Water in London is not a market you can switch, and it may be metered or charged by rateable value.

Broadband is the item most likely to derail your first weeks, because installation slots in central London can be weeks out and period buildings and mansion blocks sometimes need freeholder consent for new cabling. Order it before you move in, not after. Ask what technology actually reaches the building — full fibre availability in prime central London is inconsistent, and a Victorian conversion two streets from a fibre-served block may be on much older infrastructure.

Mobile service is straightforward and cheap by international standards. A pay-as-you-go SIM or eSIM requires no credit check and can be bought on arrival; a monthly contract usually does require a credit check, which you will fail in your first months. Start on prepaid, switch to a contract later once you have a UK footprint. Number portability between networks is standard.

• TV licence: required for live TV on any channel and for any BBC iPlayer use. Buy it online on arrival.
• Take a dated photograph of gas, electricity and water meters on the day you move in.
• Order broadband before you move in; central London installation lead times are long and older buildings can need freeholder consent.
• Ask what broadband technology actually serves the building, not the postcode.
• Start with a prepaid SIM or eSIM — no credit check — and move to a contract after a few months.
• Keep every bill from the first six months; they are your proof-of-address evidence base.

The rules here are genuinely nuanced and depend on where your licence was issued, so treat this as orientation and confirm your own position with the DVLA tool on GOV.UK before you drive.

The general rule for a full car licence issued outside the EU or EEA is that you may drive in Great Britain for twelve months from the date you become resident. After that you need a GB licence. If your licence was issued in a country designated for exchange, you can apply to exchange it for a GB licence without retaking a test, subject to the normal age and medical requirements. Designated territories include Australia, Canada, Japan, New Zealand, South Korea, Hong Kong, Monaco, the United Arab Emirates and Ukraine among others — the list changes, so check it rather than assume. If your licence is not from a designated country, you must pass the GB theory and practical tests to continue driving after the twelve months.

EU and EEA licences are treated differently: a holder who becomes resident in Great Britain can generally continue to drive on that licence until age 70, or for three years after becoming resident, whichever is later. Exchange is available but not immediately compulsory.

Two practical notes. There are time limits on applying to exchange after you become resident, so do not leave it to month eleven. And for many central London households a car is genuinely optional — congestion and Ultra Low Emission Zone charges, parking permit costs and scarcity, and the quality of public transport mean plenty of our clients sell the car within a year.

• Non-EU/EEA full car licence: generally twelve months from becoming resident, then you need a GB licence.
• Licence from a designated country: exchange without a test, subject to age and medical requirements — check the current list.
• Licence not from a designated country: pass the GB theory and practical tests before the twelve months expire.
• EU/EEA licence: generally valid until age 70 or three years after becoming resident, whichever is later.
• Use the GOV.UK 'Driving in Great Britain on a non-GB licence' tool for your exact position — do not rely on summaries, including this one.
• Before buying a car, price the Congestion Charge, ULEZ, a resident parking permit and off-street parking in your borough.

The problem is circular and every new arrival meets it: banks want proof of address, proof of address comes from bills, and bills want a bank account. It is solvable, but plan around it rather than being surprised by it.

The fastest route is usually to open with a digital bank that accepts a passport plus a document trail rather than a long UK address history, and use it for day-to-day spending while a mainstream current account is arranged. If you already bank with an international institution that has a UK presence, ask about an international or premier account opened from your home country before you fly — this is often the smoothest path and can be started weeks in advance.

Then build a UK credit footprint deliberately: council tax and utilities in your name, the electoral roll if you are eligible, a mobile contract once you can pass a check, and consistent address details across every account. A UK credit file takes months to become useful, which matters if you intend to borrow — mortgage lending to a recently arrived non-resident is a specialist market with its own products, larger deposit expectations and slower timelines.

Do not assume a large overseas balance substitutes for a UK file. It does not, in either lettings referencing or mortgage underwriting, and discovering that during a purchase is the wrong time.

• Start the account before you arrive if your existing bank has a UK arm — it is usually the least painful route.
• Digital banks accept passport-based onboarding and get you functioning quickly.
• Build the file deliberately: council tax, utilities, electoral roll where eligible, consistent address details everywhere.
• Expect a mainstream current account with full facilities to take weeks, not days.
• If you will need a mortgage, speak to a broker who works with non-resident and newly-resident applicants early.
• Keep original documents and certified translations in one folder — you will be asked for the same set repeatedly.

The guidance below is the basis for the statements on this page and is current as at August 2026. Services and hospital provision change — confirm on the official source before relying on any detail.

• NHS — How to register with a GP surgery
• GOV.UK — NHS entitlements: migrant health guide
• NHS — When to go to A&E
• GOV.UK — Council Tax
• GOV.UK — TV licensing
• GOV.UK — Driving in Great Britain on a non-GB licence
• GOV.UK — Exchange a non-GB driving licence
• GOV.UK — Find your local council