I have an iPhone 4s and yes, I just switched out the sim. I didn't pay for the first one as I ordered it from H2O, but didn't realize that I could top it up from the UK and let that one expire. Before my next vacation to the US I ordered a bundle of 5 sims from Ebay and paid $1 including postage. (The reason for getting 5 sims is that I needed them for other family members as well). I probably could have ordered them from H2O, just take a look at their website to see their current deal, and if PAYGO would work for you. I top up $10 at a time and use Whatsapp and iChat on 3G to keep in touch, or phone calls at 10c per minute. The rate to call back to the UK is very reasonable too.
You'll need access to the internet to set up the SIM card, and the only slightly tricky thing is getting the settings to access the internet. This should happen automatically but I had to call H2O customer service, and they were very helpful.
Once you are back in the UK you'll have to reset your data settings but that's easy too, once you know how. I hope this helps:)