Categories
Self-organization

How to choose an nhs consultant

The NHS Constitution gives people living in England the right to choose where to receive treatment.

You have the right to:

  • choose your GP surgery, unless there are reasonable grounds to refuse (for example, you live outside the area that the surgery covers)
  • make choices about your NHS care, and to receive information to support these choices

This also means you can choose the organisation that provides your NHS care when you’re referred for your first appointment with a consultant.

So if your GP recommends that you see a specialist, you can choose where and when to see them.

NHS e-Referral Service

The NHS e-Referral Service is an electronic booking service for people living in England.

It allows you to choose from different hospitals and clinics across England (including some private hospitals).

Finding a hospital

If you’re unsure about which hospital or clinic to choose, your GP can advise you on what might be the best choice for you.

Find and choose hospitals is the most sophisticated hospital comparison system in the UK.

It allows you to compare hospitals using a wide range of factors, including:

  • overall quality of service (judged by the regulator)
  • other patients’ views
  • waiting times

When choice is limited

There are some exceptions that may limit your choice – for example, not all hospitals are able to treat every condition, and a hospital must meet NHS conditions on standards and costs.

You also can’t choose when and what services to use in cases where speed of access to diagnosis and treatment is particularly important, such as:

  • emergency services
  • Rapid Access Chest Pain Clinics, where you must be seen within the 2-week maximum waiting time
  • cancer services, where you must be seen within the 2-week maximum waiting time
  • maternity services
  • mental health services

The following people can’t choose where to receive treatment:

  • people held under the Mental Health Act 1983
  • military personnel
  • prisoners (including prisoners on temporary release)

For more on choosing treatments, see Your choices in the NHS.

Further information:

  • Can I choose to see a male or female GP?
  • How long will I have to wait to see a consultant?
  • Consent to treatment
  • Choosing a hospital

Page last reviewed: 3 January 2017
Next review due: 3 January 2020

Non-Covid services are still badly behind despite the pandemic peaking more than four months ago

Patients with life-threatening conditions are being told they must wait until 2022 for a telephone consultation with a specialist, due to the impact of coronavirus.

Charities last night called for urgent action after it emerged that a pensioner with swelling of the blood vessels in his head had an appointment to discuss his drugs regimen postponed indefinitely, and a post-operative consultation delayed for 14 months.

Martyn Lincoln, who was diagnosed in May with giant cell arteritis (GCA), risks diabetes, cataracts and hair-loss unless he can reduce the daily dose of the steroids he takes to control the disease.

Yet despite hospital admissions for coronavirus peaking in mid-April, the 67-year-old’s local NHS trust can offer him no means of safely lowering his dose “in view of Covid-19 pressures”.

It comes amid warnings that the list of people waiting for NHS treatment could double to more than 10 million by the end of the year.

Despite this, senior doctors have said in recent days that their wards resemble a “medical version of the Mary Celeste” because so few face-to-face clinics have been restored.

Writing in today’s Telegraph, Mr Lincoln, formerly a fit and active garden centre manager from Buckinghamshire, says: “The Government tells us the NHS is open as usual and trusts are getting back to normal service.

“As a patient with ongoing health issues I am now deemed sufficiently well enough (despite being decidedly unwell) to have to wait 14 months for a phone call from the consultant or junior.”

He adds: “If this is the new normal it’s disgraceful.

“This government won’t be getting my vote for causing this mess, no matter how well intentioned.”

A regular side-effect of Mr Lincoln’s steroids is to reduce his vision to a degree whereby he is unable to drive.

In a statement, Buckinghamshire Healthcare NHS Trust suggested Mr Lincoln had received the “urgent” care he required.

However, John Mills, from Vasculitis UK, which represents GCA patients, said prolonged use of steroids can induce serious side-effects, such as diabetes, cataracts and brittle bone disease, as well as major weight gain, mood swings, sleeplessness and hair loss.

“The consensus opinion amongst medical professionals is that, wherever possible, prolonged use of steroids, especially in high doses, should be avoided,” he said.

“Martyn’s case should be reviewed urgently by his consultant, to review both the progress of the treatment and any untoward consequences.

“This should be quite feasible as a telephone consultation.”

Matt Hancock, the Health and Social Care Secretary, warned in July that getting the NHS back to normal was “a long way off”.

Even before Covid struck, certain waiting times had reached their worse levels since modern records began.

Hospitals are hampered to a degree by the heightened needs for infection control demanded by the virus, and the requirement to keep adequate bed capacity free to cope with a resurgence of cases, which is considered more likely as winter approaches.

A spokesperson for Buckinghamshire Healthcare NHS Trust said: “Our doctors, nurses and other staff have worked incredibly hard over the last few months to make sure that all patients who needed urgent care have been able to receive it, which has been the case for Mr Lincoln.

“While there has been an inevitable impact on less urgent appointments, our teams are increasingly bringing these back, prioritising those in greatest need, and we are incredibly grateful for the support and understanding of patients during what we know is an anxious time for many.”

You’ll usually need a GP referral to access hospital treatment, except in an emergency.

Is hospital care free on the NHS?

Hospital treatment is free if you’re ordinarily resident in the UK.

If you’re visiting England or recently moved to England, look up the relevant information about accessing the NHS, as charges may occur.

The services and treatments listed below are free to all in NHS hospitals in England, including overseas visitors:.

  • A&E services – but not emergency treatment once you’ve been admitted to hospital
  • family planning services – but not termination of pregnancy or infertility treatment
  • treatment for most infectious diseases, including sexually transmitted infections (STIs)
  • treatment required for a physical or mental condition caused by torture, female genital mutilation, domestic violence or sexual violence – this does not apply if you’ve come to England to seek this treatment unless you’ve applied for, or have been granted, asylum status

Choosing a hospital or consultant

If you’re referred for your first outpatient appointment, in most cases you’ve the right to choose which hospital in England to go to.

This will include many private and NHS hospitals that provide services to the NHS.

You’re also able to choose which consultant-led team will be in charge of your treatment, as long as that team provides the treatment you require.

If you wish to be treated by a particular consultant for a procedure, you can choose to have your first outpatient appointment at the hospital where the consultant works and be treated by that consultant’s team.

But this does not necessarily mean you’ll be seen by the consultant themselves.

This choice is a legal right. If you’re not offered a choice at the point of referral, ask your doctor why and say that you wish to go through your options.

If you’re still not offered a choice or are refused, contact your local clincal commissioning group (CCG).

CCGs are NHS bodies responsible for the planning and commissioning of health care services for your local area.

If a GP wants to refer you for a service or treatment that they think is best for you but is not routinely offered by the NHS, the process is different.

The GP will have to submit an Individual Funding Request (IFR) to your CCG and provide details of where they want you to go.

CCGs will publish information about individual funding requests on their website.

You do not have a legal right to choice if:

  • you need urgent or emergency treatment
  • you’re serving in the armed forces
  • you’re accessing maternity services
  • you’re detained under the Mental Health Act
  • you’re detained in or on temporary release from prison, in court, an immigration removal centre or a secure children’s home
  • you’re referred to high-security psychiatric services or drug and alcohol misuse services provided by local authorities

How the NHS website can help you choose

On this site, you can compare different hospitals according to what matters most to you, such as waiting times, patient safety, complaints or quality of food.

Use the services near you search tool to find your nearest hospital.

You can also read what other patients have said about the hospital or leave your own feedback.

Simply select the “Leave review” option provided on each hospital profile to record your experiences about the treatment you received.

You can also find out how a consultant performs for a particular procedure or compare consultants from different hospitals before you make your choice for your first outpatient appointment.

Use our consultant search tool to try it out.

For some specialties, you’ll also be able to see how many times a consultant has performed a particular procedure, including quality measures such as complication rates, adverse events and mortality rates.

You’ll also be able to compare the information to other consultants for this particular specialty in England.

How to book your appointment

Once you’ve decided on a hospital, you can book your first outpatient appointment through the NHS e-Referral Service.

How long do I have to wait for my appointment?

If your referral is for non-urgent care, you’ve the right to start treatment led by a consultant within 18 weeks of being referred, unless you want to wait longer or waiting longer is clinically right for you.

Letters about your care

When doctors write to each other about your care, they should aim to give you a copy of their letters or emails.

If you do not get a copy, you can ask for one.

Page last reviewed: 11 April 2019
Next review due: 11 April 2022

Did you know that in many cases you have the legal right to choose where you have your NHS treatment? The NHS is offering more and more options to enable you to make choices that best suit your circumstances, giving you greater control of your care, and hopefully better results.

You can view what choices are currently available to NHS patients in the NHS Choice Framework. Here you’ll also find information about when you cannot choose – for example, if you need emergency care or you’re a member of the armed forces. Make sure you know which options apply to you.

Did you know?

If a GP needs to refer you for a physical or mental health condition, in most cases you have the legal right to choose the hospital or service you’d like to go to.

This will include many private hospitals if they provide services to the NHS and it does not cost the NHS any more than a referral to a standard NHS hospital.

You can also choose a clinical team led by a consultant or named healthcare professional, as long as that team provides the treatment you require. Find out more about choosing a hospital or consultant and choosing a mental health service.

You can book your appointment via the NHS e-Referral service. It can be done while you’re at the GP surgery, or online, using the shortlist of hospitals or services provided in your appointment request letter. The shortlist is selected by your GP, so make sure you tell them about your preferences during the appointment.

To agree on the shortlist, you and your GP can compare information about hospitals or consultants on this website, including quality outcomes, waiting times, parking and travel. Use the services near you link to make an informed decision before booking.

You have the legal right to ask for your appointment to be moved to a different provider if you’re likely to wait longer than the maximum waiting time specified for your treatment.

The hospital or clinical commissioning group (CCG) will have to investigate and offer you a range of suitable alternative hospitals or clinics that would be able to see you sooner. Read the guide to waiting times for more information.

Find out more about:

What can I do if I’m not offered a choice?

You should always be offered a choice at the point of referral and an opportunity to discuss the options with the person referring you. If you feel you have not been offered a choice, you should speak to the person who is referring you in the first instance.

If you still feel that you have not been offered a choice, you could complain to your CCG as they must ensure patients are given choices. Find out more about your local CCG.

If your local CCG is unable to resolve the complaint to your satisfaction, you’re entitled to take your complaint to the independent Parliamentary and Health Service Ombudsman.

Find out more about the NHS complaints procedure. You will also find guidance in section 13 of the NHS Choice Framework.

The future of patient choice in the NHS

The NHS is working hard to improve opportunities for patients to make choices about their care.

In the near future, NHS England wants all patients to be able to say:

  • I have discussed with my GP or healthcare professional the different options available to me, including the pros and cons and, where appropriate, whether to choose to not have treatment.
  • I was offered appropriate choices of where to go for my care or tests.
  • I was given an opportunity to choose a suitable alternative provider because I was going to wait longer than the maximum waiting time specified in my legal rights.
  • Information to help me make decisions was available and I knew where to find it in a format that was accessible to me.
  • I was given sufficient time to consider what was right for me.

Page last reviewed: 26 September 2019
Next review due: 26 September 2022

Who to ask for advice and decision-making criteria to use when looking for a private consultant

How to Choose an NHS Consultant

One of the benefits of going private for your healthcare is that you can choose which consultants and surgeons you see. But how do you find a private consultant, and how do you choose between the ones you find?

GP advice and recommendations

Usually you will need a GP referral before you can proceed with treatment from a private consultant, so this is the best place to start. Your GP will be able to recommend the most appropriate private specialist for your condition. You do not have to take your GP’s recommendation, however they will know the specialism and reputations of most local doctors in private practice.

Medical insurance restrictions

Many private medical insurance policies will limit your choice of private consultants, and some will even insist that you use one of the consultants chosen by them. For example, BUPA have a scheme called Open Referral, which gives you a choice of two or three local specialists that you must choose from.

If you do not use the consultant recommended by your insurance company, you could find that they will not cover the full cost of your treatment if it exceeds the price you would have paid.

Other ways to choose a private consultant

Once you have narrowed down your choice (or had it narrowed for you by your GP or insurance company) you need to find out more information. There are many ways to find out about local consultants, including:

  • Talk to friends and relatives who have had treatment.
  • Research the consultant online either at their own website or their hospital website.
  • Google the consultant to see if there are any positive or negative news reports about them.
  • Check their qualifications and experience in the field.
  • Check their published success rates, including unexpected returns to theatre and infection rates.

Decide your priorities

When choosing your consultant, it is important to think about why you went private in the first place. For instance, if it was speed of treatment, then you need to look for good availability. If it was quality, then you need to choose a consultant who works out of a hospital that meets your standards.

It is also worth considering whether getting the very best consultant is worth travelling for, and potentially being out of reach of your visitors.

Talk to the consultant and their team

First impressions can be very telling, so try and make contact with your chosen consultant or his team. The way your inquiry is dealt with will give you a good idea of how you will be dealt with on the day.

Once you are happy, you should make an appointment with the consultant, but remember, your course of treatment is not set in stone. If you do not feel that you are able to communicate with your consultant, if you don’t like their attitude or you feel uncomfortable for any other reason, you do not have to proceed with treatment. You will have to pay again for a new consultation with someone else, but this may be better than pursuing private treatment with someone you are not comfortable with or lack confidence in.

How to Choose an NHS Consultant

NHS Choose and Book, also known as the NHS e-Referral Service, is an excellent initiative that allows patients to choose where they receive their specialist treatment.

If you are referred to a consultant, the scheme gives you the right to choose your preferred hospital or clinic. This includes all of the NHS hospitals in England, as well as some independent hospitals that receive NHS funding, for example Goring Hall Hospital. You can also choose your consultant, as well as the date and time of your first appointment.

NHS Choose and Book step-by-step

The following steps apply to patients within West Sussex who are suffering from a musculoskeletal condition, for example painful bones, muscle or joints.

  1. Before going to see your GP, you have the option to refer yourself to a physiotherapist for an NHS assessment and treatment. You don’t need a referral from your GP and you can contact your preferred physiotherapist directly to see if they provide NHS treatment.
  2. Following physiotherapy, if your condition has not improved, you should then make an appointment to see your GP.
  3. Your GP will review your condition and if necessary make a referral to the MSK (musculoskeletal) triage for an assessment with a senior physiotherapist.
  4. During this assessment, an extended scope physiotherapist (esp) will review your condition and determine the best course of action. If appropriate, they will refer you to an orthopaedic consultant for an assessment.
  5. At this stage, you can request your hospital/clinic and consultant from a list of suitable options. You may even be able to book your first appointment there and then.
  6. Alternatively, you can take some time to consider and research your options. You will be given everything you need to book your appointment from the comfort of home via telephone or the internet. Bookings can be made through the NHS’ Choose and Book website.

Choosing your hospital and consultant

When choosing your preferred hospital and/or consultant, here are some of the things you may want to consider:

  • How far away/accessible is your chosen hospital?
  • How soon can you be seen for a consultation?
  • How long will you have to wait until you can start your treatment?
  • Which hospital/consultant does your physiotherapist/GP recommend?
  • Which hospital/consultant has the most experience of treating your condition?
  • Reviews and feedback from other patients.

As well as looking at each hospital’s own website, you can also find useful information, including patient feedback by department, on the NHS Choices website. The National Joint Registry is another valuable resource, which can help you to assess your orthopaedic consultant’s experience.

Currently, the NHS Choose and Book service can only be used to book your first appointment. Nonetheless, it is a fantastic system that has helped to empower patients and improve the referral process.

If you have to endure increasingly long waiting times for routine elective surgery, there could be a solution for you. In some cases you can ask to be switched to a different hospital waiting list if you have been told that you will have to wait for treatment for more than 18 weeks.

What choices do I have?

If you need to see a consultant you can ask to change your hospital if:

  • your treatment is not urgent and you have to wait more than 18 weeks before starting treatment for a physical or mental health condition
  • you have to wait more than two weeks before seeing a specialist for suspected cancer

Your CCG (or NHS England, if you have been referred to a consultant-led specialised service) must take all reasonable steps to ensure that you are offered an appointment at a suitable alternative organisation that can start your treatment earlier than if you were to continue to wait for treatment from the provider you originally chose. If there is more than one suitable alternative organisation, you must be offered a choice from all of them.

Are these legal rights?

Yes, but there are circumstances in which you may not ask to change your hospital.

Can I change hospitals during treatment?

Yes, if you have waited more than 18 weeks for non-urgent treatment to start you have a legal entitlement to change hospitals during treatment. However you do not have a legal entitlement to ask to be switched to a different hospital waiting list if:

  • the services you are using are not led by a consultant
  • you choose to wait longer for your treatment to start
  • delaying your treatment is down to a risk associated with treating you at that time – i.e. you do not currently meet the safe criteria for treatment
  • you fail to attend appointments which you had chosen from a set of reasonable options
  • you decide not to start, or you decline, treatment
  • a doctor has decided that it is appropriate to monitor you for a time without treatment
  • you cannot start treatment for reasons not related to the hospital, for example, you are a reservist posted abroad while waiting to start treatment
  • your treatment is no longer necessary
  • you are on the national transplant list
  • you are using maternity services.

Did you know you have the right to choose where to have your NHS surgery?

If you or a loved one needs to see an NHS specialist, you can choose to access any hospital or treatment centre in England.

We know that making an informed decision, and the right choice for your individual needs, is important to you and your recovery, so we want to help as much as possible.

Why choose Southampton NHS Treatment Centre?

We are passionate about creating an exceptional experience for all our patients, and believe in treating you as quickly and carefully as possible, helping you to feel better, faster. As our patient you can benefit from:

  • Short waiting times
  • Rated ‘Outstanding’ by the CQC
  • Free NHS healthcare
  • 100% patient satisfaction
  • 100% cleanliness rating
  • Onsite diagnostic imaging
  • Free Wi-Fi
  • Onsite parking

Department of Health – Information Booklet

For a visual guide and more information on how to change your hospital, the Department of Health website prepared a document to download. Please note that the following link will lead you out of our page and Care UK is not responsible for the content.

You will also find a lot of other useful information on your choices within the NHS on this page.

Leslie’s story

Leslie was a patient at one of our Care UK hospitals who, having been told he would have to wait 65 weeks for a hip replacement, looked for another solution. He discovered that he could switch waiting lists and decided to benefit from the short waiting times at Care UK. Watch his story here:

If you have to endure increasingly long waiting times for routine elective surgery, there could be a solution for you. In some cases you can ask to be switched to a different hospital waiting list if you have been told that you will have to wait for treatment for more than 18 weeks.

What choices do I have?

If you need to see a consultant you can ask to change your hospital if:

  • your treatment is not urgent and you have to wait more than 18 weeks before starting treatment for a physical or mental health condition
  • you have to wait more than two weeks before seeing a specialist for suspected cancer

Your CCG (or NHS England, if you have been referred to a consultant-led specialised service) must take all reasonable steps to ensure that you are offered an appointment at a suitable alternative organisation that can start your treatment earlier than if you were to continue to wait for treatment from the provider you originally chose. If there is more than one suitable alternative organisation, you must be offered a choice from all of them.

Are these legal rights?

Yes, but there are circumstances in which you may not ask to change your hospital.

When may I not ask to change to a different hospital?

If you have to wait for more than 18 weeks for non-urgent treatment to start, you do not have a legal entitlement to ask to be switched to a different hospital waiting list if:

  • the services you are using are not led by a consultant
  • you choose to wait longer for your treatment to start
  • delaying your treatment is down to a risk associated with treating you at that time – i.e. you do not currently meet the safe criteria for treatment
  • you fail to attend appointments which you had chosen from a set of reasonable options
  • you decide not to start, or you decline, treatment
  • a doctor has decided that it is appropriate to monitor you for a time without treatment
  • you cannot start treatment for reasons not related to the hospital, for example, you are a reservist posted abroad while waiting to start treatment
  • your treatment is no longer necessary
  • you are on the national transplant list
  • you are using maternity services.

Did you know you have the right to choose where to have your NHS surgery?

If you or a loved one needs to see an NHS specialist, you can choose to access any hospital or treatment centre in England.

We know that making an informed decision, and the right choice for your individual needs, is important to you and your recovery, so we want to help as much as possible.

Why choose St Mary’s NHS Treatment Centre?

We are passionate about creating an exceptional experience for all our patients, and believe in treating you as quickly and carefully as possible, helping you to feel better, faster. As a patient at St Mary’s you can benefit from:

  • Short waiting times
  • Rated ‘Good’ by the CQC
  • Free NHS healthcare
  • JAG accredited endoscopy unit
  • Zero cases of hospital-acquired MRSA
  • Free Wi-Fi
  • On-site diagnostic imaging

Department of Health – Information Booklet

For a visual guide and more information on how to change your hospital, the Department of Health website prepared a document to download. Please note that the following link will lead you out of our page and Care UK is not responsible for the content.

You will also find a lot of other useful information on your choices within the NHS on this page.

Leslie’s story

Leslie was a patient at one of our Care UK hospitals who, having been told he would have to wait 65 weeks for a hip replacement, looked for another solution. He discovered that he could switch waiting lists and decided to benefit from the short waiting times at Care UK. Watch his story here:

Updated 14 October 2015

How to Choose an NHS Consultant

© Crown copyright 2015

This publication is licensed under the terms of the Open Government Licence v3.0 except where otherwise stated. To view this licence, visit nationalarchives.gov.uk/doc/open-government-licence/version/3 or write to the Information Policy Team, The National Archives, Kew, London TW9 4DU, or email: [email protected]

Where we have identified any third party copyright information you will need to obtain permission from the copyright holders concerned.

This publication is available at https://www.gov.uk/government/publications/the-nhs-constitution-for-england/how-do-i-give-feedback-or-make-a-complaint-about-an-nhs-service

Most NHS care and treatment goes well but sometimes things can go wrong. If you are unhappy with your care or the services you have received, it is important to let us know so that we can improve.

There are 2 ways to tell the NHS what you think:

  • give feedback
  • make a complaint

1. Giving feedback

Feedback helps us improve the quality of your care. You can give good or bad feedback by telling the NHS organisation or service about it. For example, you can do this through the ‘Friends and Family Test’, or, you can speak to a member of staff.

Other ways to give feedback should be clearly displayed at the service you visit.

If you are unhappy with an NHS service, it is worthwhile discussing your concerns early on with the provider of the service, as they may be able to sort the issue out quickly. Most problems can be dealt with at this stage but, in some cases, you may feel more comfortable speaking to someone not directly involved in your care.

2. How to make a complaint

How to Choose an NHS Consultant

When making a complaint, you can choose to complain to either:

  • the healthcare provider: this is the organisation where you received the NHS service, for example your hospital, GP surgery or dental surgery
  • the commissioner: this is the organisation that paid for the service or care you received

The commissioner will vary depending on the NHS service you are complaining about.

If your complaint is about primary care services such as GPs, dentists, opticians or pharmacy services, contact NHS England.

If your complaint is about services such as hospital care, mental health services, out-of-hours services and community services such as district nursing, contact your local clinical commissioning group.

If your complaint is about public health organisations (those who provide services which prevent disease, promote health and prolong life), contact your local authority.

Complaining to the commissioner may be the right option if you are not comfortable complaining direct to your healthcare provider, or if you feel this is not appropriate.

You can complain in writing, by email or by speaking to someone in the organisation.

You should make your complaint within 12 months of the incident, or within 12 months of the matter coming to your attention. This time limit can sometimes be extended as long as it is still possible to investigate your complaint.

Anyone can complain, including young people. A family member, carer, friend, or your local MP, can complain on your behalf with your permission.

3. What to expect after making a complaint

  • have your complaint acknowledged and properly looked into
  • be kept informed of progress and told the outcome
  • be treated fairly, politely and with respect
  • be sure that your care and treatment will not be affected as a result of making a complaint
  • be offered the opportunity to discuss the complaint with a complaints manager
  • expect appropriate action to be taken following your complaint

4. Getting help with making a complaint

Making a complaint can seem difficult, but support is available.

Contact your local council or local Healthwatch to find out about independent NHS complaints advocacy services in your area.

Contact your local citizens’ advice bureau for support with complaints about the NHS, social services or local authorities.

Most hospitals have a Patient Advice and Liaison Service (PALS), who provide confidential advice, support and information to patients, their families and carers. Contact the hospital or visit their website for more details.

5. If you’re not happy with the response to a complaint

If you are still not happy with the response provided, you can ask the independent Parliamentary and Health Service Ombudsman to look at your complaint.

Parliamentary and Health Service Ombudsman
Millbank Tower
Millbank
London, SW1P 4QP
Phone: 0345 015 4033

For public health services complaints, contact the Local Government Ombudsman.

The NHS Constitution sets out your rights as a patient, and explains the commitments the NHS has made to providing you with a high-quality service. Organisations providing NHS care must take account of the NHS Constitution when treating you, so you may find it helpful to refer to it if you are thinking about making a complaint.

6. Useful contact details

Healthwatch

To find the contact details for your local Healthwatch, visit the Healthwatch website or call Healthwatch England on 03000 68 3000.

Citizens Advice

You can contact Citizens advice by calling 0344 411 1444.

Primary care complaints (for example, GPs, dentists)

NHS England
PO Box 16738
Redditch, B97 9PT

Secondary care complaints (for example, hospitals)

To find information about your local clinical commissioning group, visit NHS Choices.

The 2012 NHS reforms in England allowed trusts to generate more income from private practice in the expectation that this would support improved NHS care, but, as Sarah Walpole and colleagues show, existing governance arrangements provide no assurance that such benefits are being realised

The 2012 Health and Social Care Act was the largest ever reorganisation of the English NHS. 1 It attracted considerable controversy and changed substantially over 50 days of parliamentary debate. 2 An independent analysis found that, although it had the potential to improve care, it also created numerous risks. 3

The ideological underpinning of the initial act was that a market would increase patient choice, with greater competition through diversity of supply. 3 But this attracted concerns about commercialisation of the NHS, encouraged by revelations about conflicts of interest (COIs) of parliamentarians. 4 5 The accompanying secrecy, with the government rejecting calls from the Information Commissioner and the Information Rights Tribunal to disclose the risk register of the act, offered little reassurance. 6

One of the many amendments, introduced just before Christmas 2011, as the act was completing its parliamentary passage, changed a key clause. It raised the cap on income that NHS foundation trusts could earn from privately paying patients. 7 When foundation trusts were proposed in the 2003 Health and Social Care Act, concerns were raised that they would prioritise private income at the expense of NHS patients. In response, the government imposed a cap at between 2% and 30% of the trust’s income, based on what it had earned in its “baseline year” (when it first became a foundation trust). The 2012 act raised the cap to 49% of income. Andrew Lansley, then health secretary, said “If these hospitals earn additional income from private work, that means there will be more money available …

September 10 2018

NHS patients have been able to choose where to receive NHS treatment since 2006, yet many of us still do not realise that Patient Choice is our right. If you are in a position where you or a loved oneneed to choose where to receive treatment, read our insider tips on how to make an informed decision.

1. Make sure you are happy with your choice

When the decision is made that treatment is required, your GP, referring clinician or local referral management organisation, should offer you four or five options in your immediate area.

2. Expand your Patient Choice options

You can decide to choose one of the options given to you or expand your options by searching for a hospital that suits you more. NHS patients in England can choose to have treatment at any NHS hospital, NHS treatment centre, NHS clinic or NHS care centre in the country.

3. What if you are not happy with the options given to you

If your GP (or optician for cataract surgery or dentist for oral surgery) refers you for treatment you have the legal right to choose where you receive that care. However, if you feel you have not been offered a suitable choice, you should discuss this with your GP or referring healthcare professional.

If you are not satisfied with the response you can complain to your CCG (Clinical Commissioning Group), which is duty bound to offer you a choice. If your CCG cannot resolve the issue you are entitled to take your complaint to the Independent Parliamentary and Health Service Ombudsman.

4. Consider all options made available to you with Patient Choice

The NHS gives you several options you can choose from; NHS hospitals, NHS Clinics and NHS independent sector treatment centres (ISTCs) run by independent organisations; such as Care UK hospitals. Whether the hospital is run privately or not, it will still offer free NHS health care.

5. State your choice clearly

When your choice is made, you can book your appointment via the NHS e-Referral service or local NHS referral service where there is one. This can be done either at your GP surgery or later online using the list of choices in your appointment request letter. The list is compiled by your GP, so it is important to let them know of any preferences you may have during your appointment with them.

6. What if you have been waiting for weeks?

If you are already on a waiting list and you are waiting for longer than the maximum waiting time associated with your treatment, you have the legal right to change your mind and move to another hospital’s shorter waiting list. Your hospital or Clinical Commissioning Group (CCG) will investigate why you are waiting longer than you should, and they must offer you a range of alternatives.

Find out about how an NHS private patient unit enables you to have private treatment in an NHS hospital.

An NHS private patient unit is a separate ward, series of rooms or side ward that is allocated solely for the accommodation of private patients. You, or your private medical insurance company, will still pay for these services, just as you would at a wholly private hospital, and you will still be seen privately by your consultant, even if he or she also works for the NHS at the hospital.

Advantages of NHS private patient units

A private ward in an NHS hospital should feel exactly the same as a private ward in a private hospital. You will usually have your own room and en suite facilities, the quality of your environment will be substantially better than the NHS wards and you will have a high quality of care, with improved staff / patient ratios.

You will also have the reassurance that private medical fees you are paying will go towards supporting the wider work of the hospital, rather than lining the pockets of shareholders of private companies.

Perhaps the biggest advantage is the swift access to specialist facilities, such as intensive care units or high dependency units, which many small private hospitals do not have. Your consultant will also have his specialist team around him, who may not all work with him when he works at private hospitals. So by staying in a private unit at an NHS hospital, you have the best of both worlds.

Disadvantages of NHS private patient units

While private units may appear the same as private hospitals, you may find that they are subtly different. The NHS is not geared for private care, nor does it have much experience of it.

In a recent interview, Natalie-Jane Macdonald, managing director of BUPAHealth and Wellbeing, told the Health Service Journal that BUPA customers had noticed a real difference. ‘Our ongoing surveying of our customers shows lower levels of satisfaction for members treated in NHS units compared with private units. We don’t believe this is because of the clinical care they’re receiving; it’s more the customer service aspects.’ In other words, the staff on private wards simply do not have the same customer service ethos as their wholly private colleagues.

Some would say that this is simply the ‘snob factor’ coming into play, but then for certain patients, the prestige and kudos of being treated in an exclusive private hospital is what they pay their money for in the first place. It’s easy to see how an NHS private unit would not quite make the grade for these patients.

Regulating private care in NHS hospitals

With the growth of private care within NHS hospitals, the boundaries between private a public healthcare were becoming less distinct and so a series of rules and safeguards were created to ensure that the two systems remained separate. The document ‘Guidance on NHS patients who wish to pay for additional private care’ was published in March 2009 and sets out, with examples, exactly how the two systems are to be kept apart.

According to the NHS website, you can’t. But I’m sure when I was referred by the midwives for DC2 they let me have a say and I chose an NHS one I had seen privately for other gynae stuff.

Is it just down to luck/the medical professional’s personal ethics as to whether they let you or not?

It’s just there’s a bunch of consultants at the hospital I will deliver at (have moved since previous DCs) and having done my research, some have great reviews and some don’t, and, well, I’d prefer the ones with good reviews unsurprisingly!! Or at least avoid the ones with bad reviews.

I’m high risk and need an ELCS as well so there’s no doubt at all I will get a consultant, it would just be nice to have the choice..

Im under the consultant and have been through the last 4 pregnancies and iv always been under the same one although it’s not always him I see, I don’t think you can choose but I’m not 100%. maybe if you have a valid reason for not wanting a specific consultant they might let you see another but I don’t think your guaranteed to see the consultant u pick each time.

I think you could request whose clinic you were under (in my experience I’ve been able to do that for a number if medical things and never been refused if I had a reason), but you most likely wouldn’t always get to see the consultant in person – you could get any one of their team at your appointments. In my hospital I’ve seen the actual named consultant twice, and one of her colleagues two or three times.

I would imagine that you could get any one of the team performing the ELCS on the day too, rather than your named consultant depending on shifts and other emergencies. I think only privately would you be guaranteed your named preference.

Thank you both for your replies!

Ha, yes – I’ve never seen my consultant either, and last time I didn’t get my consultant doing the ELCS either!

I’d just feel reassured that if something was an issue, I could escalate it to somebody I trust if that makes sense. And their team tend to have similar policies as well, or at least they should do

Most patients get a GP referral before seeing a private consultant – but do you actually need one?

How to Choose an NHS Consultant

For most people, their GP is still their first point of contact, even if they have the most comprehensive private medical insurance. Your GP is the lifelong guardian of your health, keeping records of the minor ailments that they have treated themselves, as well as bigger health problems that have required specialist help.

That’s why most private specialists will not agree to see a patient without a recommendation letter from their GP.

If I’m going private, why do I still need my NHS GP?

Private GPs are rare and most people will have a local GP who is part of the NHS. Your private consultant will not know you or your medical history, and so they will need your GP to be involved. Your consultant will need to refer to them regarding your medical history so that they can provide appropriate and informed treatment.

Your GP will be consulted throughout your treatment, and kept informed of any procedures that take place, so that they can update your medical records.

Can’t I go direct to the private hospital?

Some private hospitals will see patients directly, without referral, but even then they will still need to consult with your GP before providing treatment, so you don’t really save much time. It is far better to keep your GP in the loop from the start.

With most GPs controlling their own budgets these days, they will be happy to help you find private treatment, as this mean they won’t have to fund your treatment.

GP referrals and private medical insurance

You may find that it is a condition of your private medical insurance that they will only fund treatment that is recommended by your GP for medical reasons. If this is the case, then a letter from your GP is essential or you could find yourself footing the entire bill for your treatment. You should always check your policy details to see if a GP referral is required before you proceed with any treatment.

Do I need a GP referral for cosmetic surgery?

In most cases you do not need a GP referral letter for cosmetic surgery. If the procedure is a minor one, such as rhinoplasty or a face-lift, your GP may not be involved at all. However, for more complex procedures that involve major surgery, such as a tummy tuck, you will need to let your GP know in case of complications.

Are there any other treatments I can get without a GP referral?

If you want to see a private physiotherapist you will not normally need a GP referral, although they will want to know a detailed history of your injury or the condition that lead to you needing their help.

You can also access health screening without a GP referral, although in this case you should make sure that the results are sent to your GP so that they can be added to your medical records. In the case of health screening, a visit to your GP in advance may be worthwhile in any case, as they may be able to put your mind at rest and save you the cost of the tests altogether.

Advice on how to go about choosing a private hospital or clinic for your medical treatment

How to Choose an NHS Consultant

Even if your private medical insurance restricts your options of private clinic or hospital, you should still have some choice of where you are seen for your consultation and where you have any subsequent treatment. So how do you choose the right private hospital or clinic for you?

Where to find private clinics and hospitals

Most people know some of the private hospitals in their local area, and naturally you will be able to find out much more online. The Care Quality Commission lists the details of all facilities under their jurisdiction in an online database. This not only lists the name and contact details of all private hospitals and clinics, but also lists their specialties, services and the date and results of their last inspection. This database will also link you to the hospital or clinic’s own website.

As well as the CQC database, there are a number of other searchable websites that list private health providers, such as Private Healthcare UK.

What facilities are available?

One of the key questions is whether the hospital or clinic offers the services you require, or better still, specialises in this kind of treatment. It may be worth travelling to a specialist unit, rather than having treatment nearer home at a less experienced facility.

You also need to check what facilities are available in case of an emergency. Many smaller private hospitals do not have intensive care or high dependency units, which means that you will be sent to the nearest NHS hospital if anything goes badly wrong.

How do they rate?

The Care Quality Commission is an independent body that oversees a wide variety of care providers in the UK. The CQC undertakes regular inspections and publishes the results of these online. These inspections include important performance indicators such as:

  • unexpected returns to theatre.
  • hospital acquired infection rates
  • mortality rates
  • emergency transfers
  • emergency readmissions.

You can see an overview of each report online and download a full report, of around 20 pages, including staff and patient comments.

Many hospital and clinic websites will also list many of these performance indicators, and if they don’t then you should ask them for this data.

Previous patient feedback

You can also find patient satisfaction rates and more detailed patient feedback online, either at the hospital or clinic’s own website or on comparison websites and forums. While the raw data of performance indicators will tell you part of the story, the personal experience of fellow patients can often be far more illuminating.

See for yourself

At the end of the day, nothing can take the place of your own personal inspection. If you are planning to spend hundreds, or even thousands of pounds on treatment, you should take the time to visit the clinic or clinics you are considering to see for yourself the standards of service and level of facilities on offer. It is important that you are happy with your chosen facility or you will just add unnecessary anxiety to your procedure.

Make an appointment to visit the hospital or clinic, talk to the staff and some of the current private patients and make sure that it ‘feels right’ on a personal level for you.

Share this with

These are external links and will open in a new window

These are external links and will open in a new window

Close share panel

With the NHS facing mounting pressure during the coronavirus outbreak, many doctors, nurses and health workers are finding themselves being asked to step up in some way. One of them is Dr Asif Munaf, whose promotion to consultant has been fast-tracked – but he says he is looking forward to the challenge.

“It’s what we have prepared for all our lives. We prepared for times like this,” said Dr Munaf, whose first shift in his new role was on Wednesday.

The father-of-one has been promoted to consultant level a year earlier than planned with the single task of treating patients with Covid-19.

But Dr Munaf, who at the age of 31 believes he is one of the UK’s youngest medical consultants, said he was “confident” in his new role.

“It’s going to be quite intense, but I’m looking forward to the challenge,” said Dr Munaf, who is based at Lincoln County Hospital, where has been working as a registrar for the past three years .

“It’s a postman’s job to deliver. it’s a doctor’s job to fight whatever [disease] is in front of them.”

With all routine operations being cancelled for three months, Dr Munaf said many medics have changed and adapted to new roles as the NHS braced itself for a surge in cases.

How to Choose an NHS Consultant

Daily tasks for Dr Munaf as a consultant will include assessing and carrying out procedures on patients in the Covid-19 isolation wards, as well as communicating with their family members.

Dr Munaf said even before he was made a consultant the amount of patients being treated with the virus had been “relentless” and he was shocked by how many adults, usually fit and healthy, had been “very unwell”.

After his first shift in his new role, Dr Munaf told the BBC he had treated 28 patients, all with confirmed or suspected cases of Covid-19.

He said most of them were unwell but improving, three were “seriously unwell”, and “one was dying”.

The consultant said difficult decisions had to be made about the treatment of patients, including those who would be “made comfortable – an overused medical euphemism for being allowed to die” because of the severity of their medical condition and likelihood of survival.

Oxygen supply was not an issue at Dr Munaf’s hospital, but he said the hospital was short on continuous positive airway pressure (CPAP) machines, with more of the devices, which deliver oxygen to the lungs without needing a ventilator, expected to arrive later this week.

Dr Munaf said part of his job was training surgically-trained nurses how to operate the CPAP machines they would need to use on surgical wards being converted into Covid-19 wards.

  • EASY STEPS: How to keep safe
  • A SIMPLE GUIDE: What are the symptoms?
  • GETTING READY: How prepared is the UK?
  • MAPS AND CHARTS: Visual guide to the outbreak
  • TRAVEL PLANS: What are your rights?
  • PUBLIC TRANSPORT: What’s the risk?

To limit risk of infection Dr Munaf has been placed in a hotel away from his family, is required wear full personal protective equipment (PPE), and has had to shave off his beard “for the first time in 15 years”.

“I look 10 years old now,” he joked, but added he was concerned about the “lack of PPE across the NHS”.

He has not been alone in that concern and Dr Munaf told the BBC the PPE available to him and his colleagues was “exceedingly poor”.

He said PPE was essential to protect staff during the crisis but said being covered up when treating patients was “dehumanising our approach”.

“They feel like they are drowning and you cannot put a comforting hand on their shoulder,” he said.

“You see the fear in their eyes. One of the biggest comforts to a patient is a doctor’s touch.”

Dr Munaf said despite expecting to face unprecedented pressures in his new role, he was “relishing the opportunity” to “really fight this pandemic”.

“It’s once in a generation, it’s something we can tell our kids about. We were there,” he said.

“It’s time to step up. It’s our time to shine.”

Thinking about NHS provision, on a scale of 0 to 10, where 0 means not important at all and 10 means extremely important, how important, if at all, are each of the following to you? Being able to choose which hospital or consultant to see

about this tracker

  • Last update: Sep 28, 2020
  • Biannual tracker
  • 1646 – 1682 GB Adults per wave
  • Methodology
  • Download full data set

Explore more data & articles

About YouGov

At the heart of our company is a global online community, where millions of people and thousands of political, cultural and commercial organizations engage in a continuous conversation about their beliefs, behaviours and brands.

Company
  • About YouGov
  • Contact Us
  • Careers
  • Investor relations
  • Modern slavery act
  • Support
Global Sites
  • Australia
  • Austria
  • Brazil
  • Canada
  • Denmark
  • Finland
  • France
  • Germany
  • Hong Kong
  • India
  • Indonesia
  • Italy
  • Malaysia
  • Mexico
  • Middle East
  • Norway
  • Pakistan
  • Philippines
  • Poland
  • Singapore
  • Spain
  • Sweden
  • Switzerland
  • Taiwan
  • Thailand
  • Turkey
  • United Kingdom
  • United States
  • Vietnam

At the heart of our company is a global online community, where millions of people and thousands of political, cultural and commercial organizations engage in a continuous conversation about their beliefs, behaviours and brands.

  • About YouGov
  • Contact Us
  • Careers
  • Investor relations
  • Modern slavery act
  • Support
  • Australia
  • Austria
  • Brazil
  • Canada
  • Denmark
  • Finland
  • France
  • Germany
  • Hong Kong
  • India
  • Indonesia
  • Italy
  • Malaysia
  • Mexico
  • Middle East
  • Norway
  • Pakistan
  • Philippines
  • Poland
  • Singapore
  • Spain
  • Sweden
  • Switzerland
  • Taiwan
  • Thailand
  • Turkey
  • United Kingdom
  • United States
  • Vietnam

Copyright © 2018 YouGov PLC. All Rights Reserved.

How to Choose an NHS Consultant

I am a consultant at a major, regional hospital in Surrey. By major you can take that to indicate that we have an A&E department. I had agreed to give an interview to an anti lockdown activist in which I would have revealed my identity. I have since changed my mind and only feel able to give an anonymous statement.

I have changed my mind simply because that all staff , no matter what grade, at all hospitals have been warned that if they give any media interviews at all or make any statements to either the Main Stream Press or smaller, independent press/social media we may immediately be suspended without pay. I have a family, dependents and I simply can’t do it to them. I therefore cannot reveal my identity at this time but wish to state as follows:

In my opinion, and that of many of my colleagues, there has been no Covid Pandemic, certainly not in the Surrey region and I have heard from other colleagues this picture is the same throughout the country. Our hospital would normally expect to see around 350,000 outpatients a year. Around 95,000 patients are admitted to hospital in a normal year and we would expect to see around a similar figure, perhaps 100,000 patients pass through our A&E department. In the months from March to June (inclusive) we would normally expect to see 100,000 outpatients, around 30,000 patients admitted to hospital and perhaps 30,000 pass through A&E. This year (and these figures are almost impossible to get hold of) we are over 95% down on all those numbers. In effect, the hospital has been pretty much empty for that entire period.

At the start, staff that questioned this were told that we were being used as ‘redundant’ capacity, kept back for the ‘deluge’ we were told would come. It never did come, and when staff began to question this, comments like, ‘for the greater good’ and to ‘protect the NHS’ came down from above. Now it’s just along the lines of, ‘Shut up or you don’t get paid’.

The few Covid cases that we have had get repeatedly tested, and every single test counted as a new case. Meaning the figures reported back to ONS/PHE (Office for National Statistics & Public Health England) were almost exponentially inflated. It could be that Covid cases reported by hospitals are between 5 to 10x higher than the real number of cases. There has been no pandemic and this goes a long way to explain why figures for the UK are so much higher than anywhere else in Europe.

The trust has been running empty ambulances during lockdown and is still doing it now. By this I mean ambulances are driving around, with their emergency alert systems active (sirens & / or lights) with no job to go to. This I believe has been to give the impression to the public that there is more demand for ambulances than there actually is. Staff only wear face coverings/masks & social distance when public facing, as soon as they are out of public view, the masks come off and social distancing is not observed. Indeed jokes are made about the measures, and I have heard staff express amazement that despite warnings on packets and at point of sales, telling people masks are totally ineffective and dangerous, the public still buy them, because a politician has told them too.

We have cancelled the vast majority of operations and of these ALL elective surgery has been cancelled. That’s surgery that has been pre planned/waiting list. Non elective surgery, this tends to be emergency surgery or that which is deemed urgent has been severely curtailed. The outcome of this is simple. People are at best being denied basic medical care and at worst being left to die, in some cases in much distress and pain.

Regarding death certification. All staff that are responsible for this have been encouraged where possible to put Covid-19 complications as reason for death, even though the patient may have been asymptomatic and also not even tested for Covid. I feel this simply amounts to fraudulently completed death certificates and has been responsible to grossly inflating the number of Covid deaths.

The fact is that regardless of what you actually die of in hospital, it is likely that Covid-19 will feature on your death certificate. I have included with my statement the detailed published guidance from Government on Death Certification which shows how Covid-19, as a factor is encouraged to at least feature on a death certificate. Remember Covid-19 itself cannot kill. What kills is complications from the virus, typically pneumonia like symptoms. These complications are in reality incredibly rare but have featured and a large amount of death certificates issued in recent months. As long as Covid-19 appears on a death certificate, that death is counted as Covid-19 in the figures released by the ONS and PHE. I genuinely believe that many death certificates, especially amongst the older 65+ demographic have been fraudulently completed so as to be counted as Covid-19 deaths when in reality Covid-19 complications did not cause the death.

There have been Thursday nights when I stood, alone in my office and cried as I heard people cheering and clapping outside. It sickens me to see all the ‘Thank You NHS’ signs up everywhere and the stolen rainbow that for me now says one word and word only; Fear.

There are many good people in the NHS and whilst I do not plead forgiveness for myself, I do plead for them. Most are on low pay, they joined for the right reasons and I did and have been bullied and threatened that if they don’t ‘stay on message’ they don’t eat. I know that if a way could be found to assure staff within the NHS of safety against reprisals, there would be a tsunami of whistleblowers which I have no doubt would help end this complete and brutal insanity.

I am finding it increasingly hard to live with what I have been involved in and I am sorry this has happened. To end, I would simply say this. Politicians haven’t changed, the country has just made a fatal mistake and started trusting them without question.

Some skin conditions are best helped with an expert. Here’s how to choose one.

How to Choose an NHS Consultant

How to Choose an NHS Consultant

From hormonal breakouts to dry, rough skin – we all have minor skin problems from time-to-time. But, when skin problems persist, they can have a huge impact on someone’s comfort, self-confidence and mental health. Psoriasis has been linked to depression and acne can greatly impact someone’s confidence. While going to your GP is a great first step in addressing any persisting problems or chronic skin conditions, the expertise of a dermatologist might just be able to relieve your symptoms – if not rid them altogether – and regain some of your self-confidence.

What exactly is a dermatologist?

You may be surprised to hear that we are medical doctors who, after medical school, specialise in dermatology before taking advanced consultant exams. So a consultant dermatologist is an expert in everything related to the skin, hair and nails and their medical health. No other doctors have the same level of expertise or training.

What can a dermatologist treat?

We are trained to diagnose and treat more than 3,000 different conditions in patients of all ages from birth to old age. These include, amongst many others, acne, eczema, skin cancer and psoriasis.

Skin, scars and age spots

Dermatologists also improve the appearance of their patients’ skin, hair, and nails, including reducing the severity of scars left by acne or skin cancer surgery, addressing skin pigmentation issues and eliminating signs of ageing, such as wrinkles and age spots.

Dermatologists use a wide range of sophisticated techniques to address these conditions, including surgery, laser and light therapy, cryotherapy, and the prescription of medicines to be applied to the skin or taken orally.

What is a cosmetic dermatologist?

A cosmetic dermatologist is a qualified dermatologist with further training in cosmetic procedures to improve the appearance of the skin such as removing harmless moles, treating sun spots or pigmentation, facial redness, and acne scarring. A cosmetic dermatologist is also able to offer anti-ageing treatments.

When should I see a cosmetic dermatologist?

If you want any form of cosmetic skin treatment then you should always see a cosmetic dermatologist. They will correctly and safely administer the many cosmetic procedures available for the skin, such as wrinkle treatments, skin fillers and chemical peels. These treatments require an expert understanding of the structure and physiology of the skin and its underlying tissues – this expertise is an intrinsic part of the medical training a dermatologist undertakes in qualifying in this discipline.

What should I look for when choosing a cosmetic surgeon?

Unfortunately, there are no rigorous laws or regulations in the UK to prevent an individual from calling themselves a dermatologist, cosmetic dermatologist, or skin doctor. It is therefore vital to do your homework and check the credentials of your treating doctor. Do not be caught out by someone pretending to be something they are not.

  • Check the General Medical Council (GMC) register. All you need is the treating doctor’s name. All qualified UK doctors will be on the GMC register
  • Only a doctor that has completed specialist dermatology training will also be on “specialist register” which can be checked here
  • If you find your treating skin doctor is not on the specialist register, do not be afraid to ask why. Anyone who is properly trained will not mind the question
  • If you are looking for an accredited dermatologist to perform a cosmetic procedure, check sites such as the British Cosmetic Dermatology Group that have GMC registered specialists listed

How do I see a dermatologist?

There are a number of methods one can see a dermatologist. The simplest way is to see your GP and request referral to a specialist on the NHS. If your GP feels this is appropriate and a condition they are unable to manage, they will refer you to your local NHS dermatology department.

If you have private healthcare, you can also request referral from your GP to a private dermatologist for review of your skin. Alternatively, if you wish to see a dermatologist for a medical or cosmetic problem, it is possible to make contact directly with their office and arrange an appointment.

Remain wary of what you read, as many ‘experts’ are often incorrectly called skin doctors or dermatologists. It is up to you to do your homework and double-check what you read!

Payments of up to £77,000 are handed annually for at least five years to consultants who contribute to raising standards of care.

By Paul Kelso, Health Correspondent

Friday 2 February 2018 17:38, UK

How to Choose an NHS Consultant

Clinical Excellence Awards are bonus payments made to consultants working in NHS England and NHS Wales for work “over and above” their normal role.

They are intended to recognise and reward consultants who contribute to raising standards of care, through clinical work, research or participation in policy making, leadership or governance.

There are 12 levels of award, worth between £3,016 for level 1 and £77,320 for platinum or level 12.

Consultants can apply every year and if successful they receive the payments annually for at least five years.

Levels 1-8 are awarded by local hospital trusts while levels 9-12, known as bronze, silver, gold and platinum, are decided by a panel appointed by the Department of Health.

More than 300 bronze, silver, gold and platinum awards are made every year, but as they are paid annually more than 2,300 consultants currently receive payments worth more than £106m, according to the latest published list.

How to Choose an NHS Consultant

2017 awards

Analysis of consultants named as having received bronze, silver, gold and platinum awards in 2017 shows that 318 successful applicants shared payments worth £14m, but only 20% were women.

More from Nhs

Coronavirus test shortage forcing thousands of GPs and nurses to stay off work, government told

Pictures of car involved in alleged racially aggravated hit and run released

Coronavirus: Rishi Sunak urged to fulfil NHS coronavirus funding vow as BMA warns of ‘triple whammy’

Coronavirus: Treatment hailed by Trump as ‘breakthrough’ is ‘not conclusive’, NHS says

Sky News Daily podcast: COVID stories: Survival and thanks to the NHS

Captain Tom Moore knighted by the Queen during private ceremony at Windsor Castle

Over a four year period from 2014 women received 19.3% of the top level awards.

A Sky News Freedom of Information request to NHS trusts in England revealed that women were more likely to receive the lower value Levels 1-8.

Analysis of responses from 44 Trusts showed that 30% of awards went to women.

Is the system biased against women?

Women are as successful as men if they apply, with around 25% of candidates of both genders receiving awards, and the success rate for women has increased in recent years.

But senior female doctors and professional groups believe the system has an inherent bias in favour of men, who make up two-thirds of the consultant workforce.

Because the system is incremental and requires doctors to show continued development and work beyond their day jobs every year, it may penalise women who have career breaks to raise children, as well as those who work part-time because of childcare demands.

How to Choose an NHS Consultant

What they say

Sally Davies, Medical Women’s Federation

“You don’t suddenly become eligible and suitable for an award, you work at it, you do things, you enjoy things, you add things to your portfolio, and often that’s a time for women when you might be part-time, when they might have young children at home and be the person that does most of the childcare.

“So given the choice of being a Royal College Examiner or sitting on a national committee which takes you away from home, women may not be in the position to commit the time.

“It makes you question whether women in medicine are valued, it makes you question are they the ones in the NHS running the system, ie too busy with patient care, raising standards than actually sitting down and applying for an award.

“It also makes you ask, are they being encouraged?”

Jane Dacre, President of the Royal College of Physicians

“It does not seem right that to me that only 20% of awards are given to women and it is not right that the higher up the food chain you go the less likely women are to get them.

“We can explain some of it away, but not all of it.”

British Medical Association

“There has been good progress made in narrowing gender differences in national Clinical Excellence Awards in recent years.

“We’re pleased to see that the success rate for women who apply for them has almost doubled, from 14% in 2012 to 26% in 2016.

“However, clearly more needs to be done to make them both fair and representative at a local and national level.

“Through recent contract negotiations the BMA has proposed improvements to the CEA system to ensure the process is open and transparent, but the culture around recognition needs to improve so that more women feel empowered to apply.”

“Clinical excellence awards are designed to recognise the exceptional contribution of doctors who find new and innovative ways of improving the quality and delivery of care, benefitting patients and saving the NHS money in the long run.

“To be considered for an award, doctors must demonstrate the delivery of high-quality patient care and a commitment to the continuous improvement of the NHS.”

Department of Health and Social Care

“Any eligible consultant can put themselves forward for a Clinical Excellence Award and the latest figures from the national competition, for which the ACCEA is responsible, actually show similar success rates for male and female applicants.

“We are working to reform local Clinical Excellence Awards as part of the wider consultant contract negotiations – in the meantime we expect employers to run a fair, open and transparent awards scheme”.

Hi all, First post – I don’t know the abbreviations yet.

My wife is 36 wks pregnant. The baby was suspected breech, and so we started to look into c-sections. We read the NICE Guidance (https://www.nice.org.uk/guidance/cg132) and she concluded that she wanted a c-section even if the baby wasn’t breech.

It turns out the baby is head down.

So, we are now trying to get a c-section where there is no clinical reason. The NICE guidance says that this should be possible. “For women requesting a CS, if after discussion and offer of support . a vaginal birth is still not an acceptable option, offer a planned CS. An obstetrician unwilling to perform a CS should refer the woman to an obstetrician who will carry out the CS.”

The Oxford University Hospitals NHS Trust don’t follow the guidance (apparently it’s not legally binding?). The Oxford policy is to send you for re-education until you change your mind. Or. there is a slim possibility that they will refer you to an obstetrician in another NHS trust. We think this is our best hope at this stage, but we are having to do all the leg-work to make it happen. 36 weeks doesn’t leave us much time to sort this out, especially with Christmas.

So, does anybody know if their NHS Trust DOES follow the NICE guidance and offer c-section based on maternal request (no clinical need)?

Does anybody have experience of how to make this happen (ideally in Oxford University Hospitals NHS Trust)?

Thanks all in advance – really appreciate any help/experience you can offer!

This website is dedicated to the millions of thyroid patients who are being ignored and left to suffer unnecessarily, and to healthcare practitioners, who want to better serve those patients.

The NHS : How do I get a second opinion?

    HomeArticleNHS Information The NHS : How do I get a second opinion?

You can ask your GP or another healthcare professional for a second or further opinion (an opinion about your health condition from a different doctor). Although you do not have a legal right to a second opinion, a healthcare professional will rarely refuse to refer you for one.

Do you need a second opinion?
Before asking for a second opinion, its worth asking your GP or consultant to go over and explain anything you dont understand.

If youre unhappy with your diagnosis or would like to consider a different course of treatment, discuss this with them. Your GP or consultant will be happy to explain things and in many cases there may be no need for a second opinion.

Can anyone else ask for a second opinion?
Your family or carer can also ask for a second opinion on your behalf, but only with your consent. If someone requests a second opinion on your behalf, they should have all the information about your illness or condition, and check they understand it thoroughly.

Sometimes a GP or consultant may ask a colleague to provide a second opinion. For example, doctors may ask their colleagues about a complicated case.

Second opinion from a different GP
If you would like a second opinion after receiving advice from your GP, you can ask them to refer you to another GP.

Alternatively, you may consider asking to see a different GP at your surgery, if youre registered at a surgery with more than one GP, or changing to a different GP surgery. For more information, see choosing a GP.

Second opinion from a different consultant
If you would like a second opinion after seeing a consultant (a senior medical doctor who specialises in a particular field of medicine), you need to go back to your GP and ask them to refer you again. If your GP agrees to refer you to a new consultant, the consultant will be told that this is your second opinion. They will also be sent any relevant test results or X-rays previously carried out.

This does not mean that the new consultant will automatically take over your care. If you want to be treated by the new consultant, this will need to be arranged with the doctors and hospital.

How long will I have to wait for a second opinion?
People who ask for a second opinion have already seen a doctor, so they may have to wait. A second opinion with a different consultant will also usually be at a different hospital, which may involve some travelling.

Getting a second opinion may therefore delay any treatment that you need. If you have a serious medical condition, you should take this into account when deciding to ask for a second opinion. Ask your doctor whether a delay in starting treatment could be harmful.

Read the answers to more questions about NHS services and treatments.

Did you know that if you need to see an NHS specialist you have the right to choose any hospital or treatment centre in England?

This right to choose means that you can decide where to have treatment for most specialities including orthopaedics, ophthalmology and general surgery.
Choosing where to be treated is important as clinicians and researchers agree that if you choose a hospital in which you feel comfortable and confident, you’re likely to improve both the result of your treatment and your experience while you are in hospital.

HMT St Hugh’s Hospital is part of a UK-wide initiative called Choose and Book, which allows patients to select where they would like to receive their treatment at a time that is convenient for them.
Choose and Book offers greater flexibility for patients to select the right healthcare provider for their specific needs. If location or transport is an issue, it’s great to know that you’re able to select a hospital or clinic close to home.

You can also book your appointment at a time to suit you which is ideal if you have to juggle work, childcare or looking after elderly relatives.

What to Choose

When your GP refers you to a specialist for an initial outpatient appointment, you can choose:

– the organisation that provides your NHS care and treatment anywhere in England.
– which consultant-led team will be in charge of your NHS care and treatment.

When and where to choose

Sometimes decisions on where you want to be treated are made there and then in the GP consulting room, so it makes sense to be prepared to ask the right questions.

Some providers have exclusion criteria such as past medical history which may mean you are not suitable for treatment in that hospital or treatment centre. Your GP will be able to advise you of any such criteria.

What can I do if I am not offered a choice?

If you are not offered a choice of hospital, first talk to your GP. If you are still not offered a choice, contact your local Clinical Commissioning Group (CCG). For more information visit www.england.nhs.uk/ccg-details

The benefits of choosing St Hugh’s Hospital:

How to make a Choose and Book appointment

Once you have been referred for treatment by your GP, if it’s convenient, you can book your appointment before you leave the practice. They will send the appointment booking to us electronically and give you a copy of the details. If you need to consult your diary or would like time to consider your options, you will be sent an appointment request letter so you can book an appointment at a later date. As soon as you have attended your appointment , your treatment will proceed from there.

If you have any queries regarding patient referrals please call our Choose and Book team on 01472 251100 and select extension 3307 or 3349.

IFR (Individual Funding Request) –

An individual funding request (IFR) is a request for NHS funding for treatment that is not normally available and one which is only paid by the CCG (Clinical Commission Group) under certain circumstances.

The IFR process is clinically led. This means that a patient needs the support of one of our hospital consultants who makes a case on their behalf but only if the clinician considers there to be clinical grounds of exceptionality for the request.

The IFR applications are taken through a formal triage and where appropriate, referred to a clinically led IFR panel. This is usually held monthly. The IFR panel takes a number of factors into consideration including clinical effectiveness, cost effectiveness, grounds for exceptionality and equality considerations for other similar patients. Getting funding is a tough business and quite often the IFR team request further information before making a final decision. There are no guarantees when applying for IFR funding. Everything depends on the eligibility and exceptionality of the criteria

This is my: Choose and Book

Choose and Book is a NHS service that lets you the patient choose your clinic where you want your test and book an appointment which best suits you.

Your GP will tell you if you need a test or scan. Your GP will then discuss with you the clinics which are available to you to book your appointment. By using any of this is my: clinics, you will also be able to choose the date and time of your appointment.

What does Choose and Book mean for me?

As well as giving you a choice of test centre, date and time for your appointment, Choose and Book will also give you the ability to:

  • plan and manage your appointments around any existing appointments, if you are currently undergoing treatment;
  • fit your treatment in with your other commitments, at home and at work;
  • choose appointments that fit with your needs; and
  • check the status of your referral and change or cancel your appointments easily over the phone or on the internet.

How does Choose and Book work?

When you and your GP agree that you need an appointment for a test, Choose and Book shows your GP which clinics are available for your examination. Your GP will then discuss with you the clinically appropriate options that are available for treating your medical condition.

If you know which one of our centres you would like to be seen at then you may be able to book your appointment before you leave the practice. You will be given confirmation of the place, date and time of your appointment.

You may need more time to consider your choices you will take home with you an Appointment Request Letter so you can book your appointment later. Your Appointment Request letter has a unique booking reference number, your NHS number and a list of hospital or clinic options for you to choose from. Your GP practice will also give you a password with your Appointment Request letter.

You can then book an appointment with us via the telephone or via the internet.

Consultant in Elderly Medicine with a Special Interest in Orthogeriatrics

It’s an exciting time to be joining the newly formed Bedfordshire Hospitals NHS Foundation Trust which has resulted from the merger of The Luton and Dunstable University Hospital and Bedford Hospital NHS Trusts on 1 April 2020.

The Department of Elderly Medicine (DME) at Luton & Dunstable Hospital is fully committed to improving the quality of care delivered to its frail and older population and is looking for dynamic individuals to join the team.

The successful candidate will work with existing consultants to provide a comprehensive care of the elderly service for patients across Bedfordshire Hospitals within acute and community settings, with a primary focus on patients admitted with orthopaedic trauma, rib fractures and head injuries.

The Trust has been developing its DME strategy and is working across Bedfordshire with social care partners, primary care networks, community and mental health service providers. Our aim is to improve patient care across the acute interface and deliver better patient outcomes as part of the Bedfordshire Care Alliance. Consultants joining the organisation are given dedicated time in their job plans for new service development and to pursue their sub specialty interest.

The Hospital has always been renowned for its friendly atmosphere and good working relationships. The Trust has University Hospital status with UCL and the Royal Free, which provides an opportunity to strengthen our teaching and R&D programme and brings a more academic environment to the hospital. This department is fully committed to teaching and training both undergraduate medical students and postgraduate doctors.

Luton & Dunstable Hospital is a busy University Teaching Hospital situated adjacent to Junction 11 of the M1 Motorway. There’s very good access to Central London by road or rail and the Midlands and the North via the M1 and A1. The hospital is within twenty minutes of London Luton Airport. Residence is required within reasonable travelling time of the hospital.
Applicants must be fully registered on the UK General Medical Council’s Specialist Register or be within six months of CCT at the date of interview.

An informal visit may be arranged by appointment with Dr Tammy Angel, Clinical Director for Elderly Medicine on 01582 497461. The hospital phone number is 01582 491166.

To apply online please click the apply button.

Closing Date: 25th October 2020. Interview date: 4th December 2020.