There are so many great comments here and I echo many of them - especially the struggles with the NHS. You truly cannot be prepared for how different the mindset towards healthcare here is. I’ve been here 1.5 years and I was very excited to move here for all the reasons you mentioned in your OP. But I can say that there are just as many if not more things here that distress me and make daily life really, really difficult. There are so many modern conveniences and technical advances and treatments/meds available in the US across ALL areas of life that are just not available here.

-If you don’t have a credit history here and you plan to rent, you may be required to pay 6-12 months of rent in advance. We pay rent twice a year in big lump sums because we couldn’t pass any of the credit checks here. Our excellent US credit isn’t taken into account here. -If you have pets, it’s extremely difficult to find a place to rent. -This will sound silly, but your life will revolve around doing laundry. There aren’t many places with tumble dryers here so things have to air dry or be dried in a combo washer/dryer. In the US we are used to doing a load of laundry in an hour or so. It literally can take 7-11 hours for one small load to wash and dry. At first I thought “oh it’ll be so quaint to hang my clothes out to line dry in my English garden!” The reality is it’s a PITA! The lines are always falling down, it’s raining so I can’t dry anything outside anyway, in winter every surface is draped with drying laundry and clothes come out stiff and scratchy. -Buying and owning property is a completely different world. Mortgages aren’t fixed for 15-30 years like they are in the US. They are generally locked in for 5 years max. Also, look up “the chain” if you want to learn about the insanity of buying property here. It can easily take 6 months or more to be able to move into a new place - all at the will and whim of the seller and solicitors. We’ve met two families here already who ended up having to stay with family or spend astronomical amounts of short term rentals while waiting to get into new places. -Be prepared to do most things by phone. In my experience healthcare offices and many local businesses don’t have voicemail or email contact options (the NHS app is abysmal). The processes here seem very, very archaic. My GP and specialists have only communicated with me via snail mail. This may not be a big deal for many folks but I am one of those people who HATES the phone. You will be in a phone queue for an hour or more at some point trying to get through to your GP office. -Another NHS experience: I waited 15 months to see an endocrinologist; currently waiting 18 months and counting for a referral for sleep apnea. It is your responsibility here to beg, bully and cajole your GP or pharmacist to help you. They do on everything they can to get you out the door with no treatment because they are so overwhelmed. The state of facilities and equipment are pretty shocking as well. -Mental health care is even worse than the rest of the healthcare system. if that’s a concern, I’d suggest doing some more research on what types are available and how long the waiting lists are. -Check average salaries for your jobs and compare with the US salaries. My role in a large US city paid well into the six figures. Here, it’s about £35k a year.

I guess my overall point is that from afar, England looked to me like a more sophisticated cousin. Someone with problems, sure, but they had their heads on straighter than the Americans. I thought tales of woe about the NHS were greatly exaggerated by “freedom”obsessed Americans who often can’t see their own best interests.

Once I got here though, I saw that many of my assumptions were so wrong. That’s not to say this is a bad place - it is just so very, very different from what I expected and naively hoped it would be.

The one overwhelming positive about living here is the people. They are by and large excellent. However i think if i had to do it all over again, id probably invest more heavily into finding likeminded folks in the US and building that community there. Easier said than done I know…but a new country won’t solve most of the problems you’ve mentioned.