Northern Ireland's health system is called Health and Social Care (HSC). While it feels identical to the NHS in the rest of the UK from a patient perspective—care is free at the point of use, and the sexual health firewall protects your privacy—the administrative backend is unique.
🏛️ HSC Trusts
HSC is divided into five regional Health and Social Care Trusts. These trusts manage the hospitals, local clinics, and social services in their geographic area.
The five trusts are:
- Belfast HSC Trust (The primary hub for LGBTQ+ and complex sexual healthcare)
- Northern HSC Trust
- South Eastern HSC Trust
- Southern HSC Trust
- Western HSC Trust
Because sexual health services are commissioned at the Trust level, the speed of access to services like PrEP initiation varies heavily depending on which Trust you live in.
🪪 The Health and Care (H&C) Number
While England and Wales use the 10-digit NHS Number, and Scotland uses the CHI Number, Northern Ireland uses the Health and Care Number (H&C Number). This is a 10-digit number unique to you within the HSC system.
Do you need an H&C Number for sexual healthcare? No. GUM (Genitourinary Medicine) clinics operate under a strict legal exemption. You do not need an H&C Number, and you do not need a GP to be tested, treated for an STI, given PEP, or prescribed PrEP.
How to get an H&C Number: You get an H&C Number by registering with a General Practitioner (GP) in Northern Ireland.
- Find a local GP surgery using the NI Direct directory.
- Ask to register as a patient.
- Once registered, you will be assigned your H&C number.
🔒 The Sexual Health Firewall
Northern Ireland enforces the same strict legal separation between your general medical records (held by your GP) and your sexual health records (held by the GUM clinic).
When you attend a GUM clinic—even if they ask for your H&C Number—they are legally prohibited from sharing your attendance, your HIV status, your PrEP usage, or your STI results with your GP without your explicit, written consent.
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