How to get NHS care in a place that’s right for you

MOST PEOPLE in England have the legal right to choose where they have their first outpatient appointment. But only one in ten currently does this.

Many people mistakenly assume that they need to go to the hospital closest to their home. But the reality is that you can choose where you receive your care based on what suits you best.

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Maybe you’re waiting for cataract surgery and need to go to a hospital near relatives who can help you recover.

Or it’s time for a hip replacement and you want to choose a clinical provider with great reviews and an excellent rating from the Care Quality Commission.

When you are referred for an appointment, your GP, nurse or referring health professional will provide you with a shortlist of options and will discuss these with you.

To help you make an informed decision, you will also receive information about waiting times, distance and quality of care.

You can arrange your appointment on site. However, if you would like to think about options, discuss them with friends and family, or do further research on your own time, feel free to do so.

When you’re ready, simply book your appointment online or call the national referral hotline.

The aim of the NHS has always been to put patients at the heart of everything it does.

This service is designed to give you the control and flexibility to tailor your appointment to suit your own needs and circumstances.

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Dr. Marjorie Gillespie is a GP based in Essex.

She says, “I always ask my patients what is important to them when opening the list of healthcare providers for referral to a specialist.

“Is it about having the appointment, test or treatment done quickly or close to their home or work?

“Sometimes people choose a place because that’s where their family is.

“Some people have valid reasons why they would prefer not to go to a particular facility – for example, a relative may have recently died there.

“In our practice, a family doctor, a nurse or a physiotherapist can make the specialist referral.”

Dr. Gillespie uses the hypothetical example of a plumber who may have tried everything from painkillers and physical therapy to X-rays to combat knee pain that wakes him up at night and limits his ability to work.

She explains: “We went to the referral service page with them and looked at the options for an orthopedic referral.”

“We would print out a printout of at least five choices – including private healthcare facilities offering NHS care – with a unique number and passcode.

“If the patient feels like they can’t make a choice – maybe they have someone with them and they don’t feel like they can really express their opinion in the consultation – they can go home and book their appointment online. Or they can call the national referral helpline.

“It’s interesting when you talk to people and say: ‘These are all the places you could go’ because everyone thinks their local NHS trust is the only option available.

“Sometimes faster care can be found elsewhere.

“For example, we had a young person who presented with varicose veins and skin deterioration.

“It was a priority for her because it affected her ability to work.

“We opened the e-referral service and found an appointment in another area within two weeks.

“When compiling the shortlist of providers, we consider the distance, the condition, the individual and whether they have comorbidities [more than one disease or condition at the same time] to ensure care is clinically appropriate and tailored.”

Dr. Gillespie gives another example of a vacationer returning from Spain with a broken arm that isn’t healing properly.

She explains: “For example, we would look for an orthopedic surgeon who specializes in the upper limbs and give the patient the opportunity to make an appointment at their preferred hospital.

“The patient may first need to check whether someone is available to drive them so they can choose to make the appointment at home. It works great.

“It has long been known that when patients are given a choice, they are more likely to attend their hospital appointments, be more satisfied and have a positive outcome.”

3 patients, 3 ways

1 Mary, 79, lives with her 80-year-old husband and has family nearby. After suffering from hip pain for a few months, she makes an appointment with her GP to discuss her options for an orthopedic referral.

Mary explains that she needs to be somewhere close to home so she can take a taxi to the hospital and her family can visit her. The shortlist consists of hospitals closest to Mary’s home and she chooses one just three miles away.

The GP makes the referral online while Mary is still in the consultation room and Mary is told that she will receive the appointment details in the post shortly.

2 Youssef, 52, visits his GP after experiencing stomach pains attributed to previously diagnosed gallstones. It is decided that he needs a referral to a gastroenterologist for possible gallbladder removal.

Youssef tells the GP that he would like to travel outside the local area and would like a doctor who could see him quickly as he is currently forced to take repeated sick leave.

An independent industry provider is located 45 miles from Youssef’s home. The family doctor makes the referral immediately and Youssef secures an appointment in three weeks.

3 Six-year-old Anya has been struggling with asthma for two years and her condition is difficult to manage. Her mother and primary care physician agree that it would make sense for her to see a pediatric respiratory consultant.

Anya’s mother asks for some time to search for the best hospital for Anya and confirms that she has a laptop at home to help her with this.

The GP says he will identify some services that are clinically suitable for Anya and provide personal login details so her mother can log in at home and review the information before making her choice.

The referral is made two days later and Anya’s mother receives the appointment details from the hospital in the mail.

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useful information

Once you have chosen a hospital, you can book your first outpatient appointment using the NHS e-Referral service.

This can be done in the following ways:

• Your family doctor can arrange the appointment while you are in the practice
• You can book online using the appointment request letter provided to you by your GP
• You can call the national transfer helpline and they will do this for you

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