NHS 111, 999 or A&E — which do you actually need?

Do not weigh this up. Call 999 immediately for: signs of a heart attack, including chest pain or tightness spreading to the arms, back, neck or jaw; signs of a stroke, remembered as FAST — Face drooping, Arm weakness, Speech difficulty, Time to call 999; severe difficulty breathing; heavy bleeding that will not stop; loss of consciousness; a seizure that will not stop or in someone who has not had one before; severe allergic reaction; and serious head injury, burns or suspected spinal injury.

Also 999 for anyone who has taken an overdose or is at immediate risk of taking their own life.

999 is free from any phone including a locked mobile with no credit and no SIM. 112 reaches the same operators and has no additional capability, despite the persistent claim otherwise.

If you cannot speak safely, the silent solution system exists: call 999, and if prompted, press 55 on a mobile to signal to the operator that you need help but cannot talk. Note that pressing 55 alone does not summon police to your location — it prevents the call being disconnected as an accidental dial.

NHS 111 is free, available 24 hours a day, and can be reached by phone or online at 111.nhs.uk. It is not a switchboard — it is a clinical assessment service. Trained advisers work through a symptom assessment, escalating to a clinician where needed.

What it can do surprises people. It can book you a slot at an urgent treatment centre or an out-of-hours GP, arrange an emergency prescription, send an ambulance if the assessment warrants it, direct you to an emergency dentist, and in some areas book you directly into an A&E time slot so you are not waiting from scratch.

The online service is often faster than the phone line for straightforward problems and available in the same 24-hour window. It asks the same questions and produces the same outcomes.

111 covers England, Scotland and Wales. Northern Ireland does not use 111 in the same way — out-of-hours care is accessed through GP out-of-hours services, and the number depends on the trust area.

Urgent treatment centres are GP-led facilities open at least 12 hours a day, equipped to handle most non-life-threatening urgent problems: sprains and strains, suspected broken bones, minor burns and cuts, minor head injuries, insect bites, ear and throat infections, skin infections and rashes, eye problems and abdominal pain. Many have X-ray on site.

They are almost always faster than A&E for these problems, because they are not triaging around cardiac arrests. Find them through NHS 111 or the NHS website's service search.

Community pharmacies now handle far more than they used to. Pharmacy First in England allows pharmacists to assess and supply prescription-only treatment where appropriate for seven conditions: sinusitis, sore throat, earache in children, infected insect bites, impetigo, shingles, and uncomplicated urinary tract infections in women aged 16 to 64. No appointment and no GP referral is needed. Scotland's NHS Pharmacy First and Wales's Common Ailments Service work similarly.

Pharmacists can also advise on medicines, blood pressure checks, emergency contraception and, in many cases, supply an emergency repeat of a regular prescription.

Accident and emergency departments are for serious injury and genuine emergencies: major trauma, suspected heart attack or stroke, severe breathing difficulty, heavy bleeding, severe burns, loss of consciousness, severe allergic reaction and suspected serious infection such as sepsis.

They are also the right place when 111 or a GP directs you there, and for mental health crises where someone is at immediate risk, though many areas now have dedicated crisis lines reachable through 111.

A&E triages by clinical urgency, not by arrival order. Someone who arrives after you with chest pain will be seen before you, and that is the system working correctly rather than failing. Waits for lower-priority presentations regularly run to many hours.

You do not need to be registered with a GP, to have an NHS number, or to prove immigration status to be treated in A&E. Emergency treatment is provided to everyone. Some subsequent hospital care may be chargeable for people not ordinarily resident in the UK, but that never applies to A&E itself or to the treatment of most infectious diseases.

Bring a list of your medications and any allergies if you can. It saves a considerable amount of time.