MOST PEOPLE in England have a legal right to choose where they have their first outpatient appointment. But only one in ten currently does so.
Many wrongly assume they must attend the hospital closest to where they live, but in fact you can select where you receive your care based on what suits you best.
Perhaps you’re waiting for a cataract op and need to be in a hospital near relatives who can help you with your recovery.
Or the time has come for a hip replacement and you want to select a clinical provider with outstanding reviews and an excellent Care Quality Commission rating.
When you are referred for an appointment, your GP, nurse practitioner or referring health professional will give you a shortlist of options and discuss them with you.
Information on waiting times, distance and care quality will also be provided in order to help you make an informed decision.
Your appointment can be made on the spot. But if you’d like to mull over options, discuss them with friends and family or do extra research in your own time, you’re free to do so.
When you’re ready, simply book your appointment online or by calling the national referral helpline.
The goal 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 make your appointment work for you based on your own needs and circumstances.
Dr Marjorie Gillespie is a GP based in Essex.
She says: “I always ask my patients about what is important to them whenever I open up the list of healthcare provider options for specialist referrals.
“Is it getting 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 poignant reasons why they would prefer not to go to a particular facility – a relative may have recently passed away there, for example.
“At our practice, a GP, nurse practitioner or physiotherapist can make the specialist referral.”
Dr Gillespie uses the hypothetical example of a plumber who might have tried everything, from painkillers and physio treatments to X-rays, to address knee pain that is waking them up at night and limiting their ability to work.
She explains: “We would go on to the referral service page with them and look at the options for an orthopaedic referral.
“We’d give a printout of a minimum of five choices – which might include private healthcare settings that provide NHS care – with a unique number and a pass code.
“If the patient felt that they couldn’t make a choice – perhaps they have got somebody with them and they don’t feel that they can really express their views in the consultation – they can go home and book their appointment online. Or they can phone the national referral helpline.
“It’s interesting when you talk to people and say, ‘These are all the places that you could go,’ because everybody imagines their local NHS trust is the only option available.
“Sometimes quicker care can be found in a different location.
“For example, we had a young person presenting with varicose veins and skin deterioration.
“It was a priority to her because it was interfering with 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 person 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 holidaymaker returning from Spain with a broken arm that isn’t healing properly.
She explains: “We’d search for an orthopaedic surgeon who specialises in upper limbs, for example, and give the patient the appointment options at their preferred hospital.
“The patient may need to first check whether someone is available to drive them, so they might choose to book the appointment at home. It works brilliantly.
“It’s been recognised for a long time that if you give patients choice, they are more likely to attend their hospital appointment, be 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 experiencing hip pain for a few months, she books an appointment with her GP, who talks her through options for an orthopaedic referral.
Mary explains she needs to be somewhere close to home, so she can take a taxi to hospital and her family can visit. The shortlist is made up of hospitals closest to Mary’s home and she settles on one that is only three miles away.
The GP makes the referral online while Mary is still in the consulting room, and Mary is told she’ll receive the appointment details shortly through the post.
2 Youssef, 52, sees his GP following a bout of stomach pains related to previously diagnosed gallstones. It’s decided he needs a gastroenterologist referral for possible gallbladder removal.
Youssef tells the GP he is happy to travel outside of the local area and would like a provider who can see him quickly, as he’s currently forced to take repeated sick leave from work.
An independent sector provider is found 45 miles from Youssef’s home. The GP makes the referral straightaway and Youssef secures an appointment in three weeks’ time.
3 Six-year-old Anya has been struggling with asthma for two years and her condition is difficult to manage. Her mum and GP agree it would be sensible for her to see a paediatric respiratory consultant.
Anya’s mum asks for some time to research the best hospital for Anya and confirms she has a laptop at home to help with this.
The GP says they will identify a few services that are clinically appropriate for Anya and provide personal login details so her mum can log in at home and review the information before making her choice.
The referral is completed two days later and Anya’s mum will receive the appointment details from the hospital in the post.
Useful information
Once you have decided on a hospital, you can book your first outpatient appointment through the NHS e-Referral Service.
This can happen in the following ways:
- Your GP can book the appointment while you’re at the surgery
- You can book online using the appointment request letter your GP gives you
- You can phone the national referral helpline and they will do it for you
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