This guide is for internationals who have just moved to England and want to understand how the NHS sorts medical help by urgency. After reading it, you will know what NHS 111, your GP surgery, A&E and 999 each do, and how the official guidance says to move between them.
- Which NHS service does what
- How NHS 111 works in England
- Waiting for a 111 nurse callback
- Where your GP surgery fits in
- A&E and 999
- FAQ
Which NHS service does what
The official NHS pages describe each service by the kind of problem it handles. Taken together, the services run from least urgent to most urgent.
- Your GP surgery is the usual daytime route, and the place for fit notes and referrals.
- NHS 111 is for when you think you need medical help right now but cannot contact your GP, or your GP is closed.
- A&E, also called the emergency department or casualty, is for serious injuries and life-threatening emergencies.
- 999 is the number for emergencies, including signs of a life-threatening illness.
When it is unclear which service is needed, the NHS points people to 111 first, because 111 can check symptoms and send them to the right place.
How NHS 111 works in England
The NHS page on when to use NHS 111 online or call 111 gives two ways to reach the service: 111 online, which is also available in the NHS App, or calling 111. You answer questions about your symptoms and are told what to do next. That could be calling 999 or going to A&E, visiting an urgent treatment centre, seeing an evening and weekend GP, booking a nurse callback, getting urgent dental or mental health support, contacting your own GP, seeing a pharmacist for a minor illness, or looking after yourself safely at home.
Online or by phone
111 online is for people aged 5 and over. For a child under 5, the NHS says to call 111. The NHS also says to call 111 for:
- complex problems caused by an existing medical condition
- people with a care plan from their doctor for their current health problem
- people who need end-of-life care
What 111 online can and cannot do
111 online can request an emergency supply of regularly prescribed medicine for someone of any age. It does not issue a prescription. It asks a local pharmacy for a limited supply until a regular repeat prescription can be organised. It can also help with dental problems, which might mean finding a dentist, or an emergency dentist if there is availability in your area.
It cannot issue fit notes, and it cannot make or cancel appointments in other parts of the NHS. Its feedback form is only used to improve the service, so 111 cannot respond to requests for medical help left there.
Language, accessibility and other nations
You can call 111 and ask for an interpreter. Text relay users can call 18001 111, 24 hours a day, and British Sign Language users can go through signvideo.co.uk/nhs111. This service covers England. Scotland has NHS 24 111 and Wales has NHS 111 Wales. For Northern Ireland, the NHS points to nidirect.
Waiting for a 111 nurse callback
Depending on your symptoms, 111 may offer a callback from a nurse, but you cannot request one. How long you wait depends on the symptoms you reported. People with the most serious symptoms are called first, and the service is usually busier at weekends and on bank holidays.
If you booked the callback online, the confirmation page explains what happens next. If you booked it by phone, you are in a queue and do not need to contact 111 again unless your symptoms have changed or got worse.
A nurse will try to call up to 3 times. If they cannot reach you, they leave a message, but you cannot call them back. You would have to use 111 online or call 111 again and start from the beginning. The call cannot be cancelled, because a nurse needs to check you are ok. If you feel better or have got help elsewhere, the NHS asks you to tell the nurse when they call.
If symptoms get worse while you wait, the guidance is to call 111 for children under 5. Anyone over 5 can check their symptoms online or call 111. For signs of a life-threatening illness, or if someone has tried to end their life, the NHS says to call 999 now.
Where your GP surgery fits in
The other services often lead back to the GP. 111 is there for when you cannot contact your GP during the day or the surgery is closed, and it may direct you to your own GP. Fit notes come from your GP, not from 111 online.
If you are registered with a GP, your surgery is contacted after an A&E visit with an update on why you went and any treatment you received. A&E may also ask you to make an appointment with your GP surgery to request a referral.
The official pages used for this guide do not explain how to register with a GP, what documents a surgery may ask for, or how long registration takes. This guide does not cover those details for that reason.
A&E and 999
The NHS page on when to go to A&E describes it as the service for serious injuries and life-threatening emergencies. A&E departments are open 24 hours a day, every day. For anyone unsure whether they need A&E, the NHS points to 111 first.
Getting there
The NHS advises against driving yourself to A&E. Its guidance is to ask someone to drive you or to call 999 for an ambulance, and to bring any medicines you take.
On arrival
If you walk in, you register at reception and are asked questions such as your name, your address and why you came. If you arrive by ambulance, the crew gives your details to reception and hands you over to clinical staff. You can ask for an interpreter, including for British Sign Language. If you need help because of a physical or mental disability, the NHS asks you to tell staff straight away.
A doctor or nurse assesses every patient before any treatment. This is called triage, and it means the most seriously unwell people are seen first. The NHS says A&E departments are currently very busy and you will likely wait for some time. Some departments have a self-assessment tool at the entrance, which you will not need if you used 111 and the hospital knows you are coming.
After the assessment
Patients who are seriously unwell are seen by an A&E doctor and may be referred to a specialist unit or admitted to a ward. Patients who do not need A&E might be sent to a nearby urgent treatment centre or referred to a GP on site. Some are given a prescription and sent home with instructions.
FAQ
Can I use 111 online for my child?
111 online is for people aged 5 and over, and the NHS says to call 111 for a child under 5. The one exception is an emergency supply of regularly prescribed medicine, which 111 online can request for someone of any age.
Will arriving by ambulance get me seen faster at A&E?
Not always. The NHS says arriving by ambulance does not always mean being seen sooner, because every patient goes through triage and the most seriously unwell people are seen first.
Can I get a fit note from NHS 111?
No. 111 online cannot issue fit notes, and the NHS says you need to contact your GP for one.
Do newcomers have to pay for NHS 111 or A&E?
The two official pages used for this guide do not cover charges or who is eligible, so this guide does not state any. Anyone with a question about how their own immigration status affects NHS care can speak to an immigration adviser regulated by the OISC or a solicitor regulated by the SRA.
Official sources: nhs.uk · nhs.uk
Last verified: 9 October 2026 against the official pages linked above. Rules and fees change; the official page always wins.
This is general information, not legal or immigration advice. Immigration advice in the UK may only be given by advisers regulated by the OISC or by solicitors regulated by the SRA.
Sources
- nhs.uk: When to use NHS 111 online or call 111, accessed 9 October 2026
- nhs.uk: When to go to A&E, accessed 9 October 2026
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