How you get a family doctor and health centre (centro de salud)

Terms used

• Centro de salud — The centro de salud is your local public health centre, where your family doctor and nurse see you.
• Zonas básicas de salud — The zonas básicas de salud are the small health areas each region uses to assign people to a health centre.
• Médico de familia — The médico de familia is your family doctor, your first contact in public primary care.
• Cupo — The cupo is the shared list of patients that one doctor and nurse pair look after.

Key rules

• Assignment: Your centre follows your registered home address, so moving house can change it.
• Doctor and nurse: You get a family doctor and a paired nurse who share the same patient list.
• Children: Children usually see a pediatrician and pediatric nurse, generally up to age 14.
• Choice: Free choice of doctor or centre depends on your region and on the doctor having space.

Your health centre depends on your address

Once you hold a health card, the public system gives you a health centre, a family doctor and a nurse based on where you are registered to live. You do not pick them from a list on day one. Your regional health service assigns them.

Spain divides each region into small areas called zonas básicas de salud. Each area has a centro de salud. You are assigned the centre for the area that covers your registered home address. If you move house, the area, and so the centre, can change.

Who you get

You are assigned two people from that centre:

• A médico de familia, your family doctor.
• An enfermero or enfermera, your family nurse.

They work as a pair. They share one list of patients, called a cupo, and you are on it. Children usually have a pediatrician and a pediatric nurse instead, generally up to age 14.

What your doctor does

Your doctor is your first point of contact. They:

• diagnose and treat common and long-term illnesses
• prescribe medicines
• refer you to specialists
• issue sick leave
• handle prevention and follow-up

What your nurse does

Your nurse handles day-to-day nursing care. This includes:

• vaccinations
• wound care
• monitoring long-term conditions, such as blood pressure or diabetes
• health education
• home visits

In some regions nurses can also do limited prescribing and follow-up.

Can you choose a different doctor or centre?

It depends on your region. Most regions assign by area but let you ask for a change. Some regions have formal free-choice rules that let you pick a doctor and centre across the region or a wider area. Even then, the doctor must have room on their list. Madrid, for example, lets you choose across the whole region. Other regions allow choice within their own areas, with different limits.

Ask your regional health service, or the front desk at your centro de salud, what you can do where you live. The choice below the page helps you decide whether to keep your assignment or ask for a change.

Choosing between options

Will you keep the doctor and centro de salud assigned to your address, or ask for a different one?

• Keep the assigned centre and doctor: Your region assigns by address, or you are happy with the health centre of the zone (zona básica de salud) covering your home. The doctor and nurse work as a pair, so you get both.

• Ask to change doctor or centre: Your region assigns by zone but allows a change request. Ask your regional health service, and expect approval to depend on the doctor having space.

• Choose your own doctor and centre: Your region has free-choice rules, as Madrid does, where you can pick a GP and centre across the area. Other regions, such as Galicia, Aragón, Navarra, the Basque Country, Catalonia, Valencia and Andalucía, allow choice within their areas or zones, with different limits.

Once you hold a health card, you are assigned by your registered address. If your region offers free choice, you can pick instead, as long as the doctor has capacity.

Free-choice rules differ by region and change; check the current rules with your regional health service.

Quick answers about seeing a GP in Spain

Is a GP visit free in Spain?

Yes, a GP visit in the public system is free if you are covered by it, with no copayment for consultations. You only pay a share of the price of outpatient prescription medicines, and for some extras such as non-urgent transport. Private care is not covered by this.

Can I go straight to a specialist?

Usually no, because in the public system you need a referral (derivación) from your GP first, except in emergencies. Some regions allow direct access to services such as gynaecology, eye care or mental-health programmes. Private care needs no referral.

Can I use a health centre near my work instead of near home?

Often yes, because you can ask your regional health service to change your centre, and it is usually granted if the chosen doctor has space. Madrid has free choice of centre and doctor. Other regions may limit you to your health area or ask for a reason.