28 September 2023 , 07:00
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If your GP surgery refers you for medical treatment, the choice is in your hands. It’s up to you to decide where you’d like to be treated - that might be your local hospital, one near your family or, if you don’t mind travelling, somewhere further away that offers specialist care.
Waiting for treatment can be a worrying time, so you can also look at how the healthcare provider is rated by other patients to put your mind at rest – and make a decision based on this.
Your GP practice can talk through your choices, so don’t be afraid to ask any questions you need to help you get the best healthcare for you. You’ll be offered advice about the different options available to you and how to choose – and you’ll also be given enough time to decide.
Putting you in control of where you’re seen has so many benefits. You can make your own decision based on what’s important to you, whether that’s the quality of care as rated by patients and the Care Quality Commission (CQC) rating or shorter waiting times.
If you need help with recovery after an operation, you don’t need to automatically opt for your local hospital – you can choose one near friends or family so they can look after you until you’re back on your feet again.
Your questions answered
Dr Roberto Tamsanguan is a GP at Bromley by Bow Health Centre in East London and National Clinical Advisor at NHS England
What kind of conditions and ailments can I use patientchoice for?
It’s any consultant-led service where you would expect to be referred to a hospital and see a consultant or a member of their team.
That includes everything from a gastroenterology appointment all the way through to someone that needs a hip replacement.
A patient would contact their GP, and if their GP was unable to manage their care any further or needed hospital input, they’d be given a choice of hospital provider which suits their needs.
You would have a discussion about what the available options are in your area and GPs use a system that allows them to find local hospitals and check that the service fits the patient’s needs. You should be offered a minimum of five choices of healthcare providers, where clinically appropriate, that suit your needs.
What are the main factors you see that influence people’s decisions?
The most common factor is being able to get to the hospital easily.
Another is speed of being seen: ‘where am I going to get what I need the fastest so I don’t have to wait in pain?’ Some people might also look at the CQC rating.
If I find websites tricky, how else can I make my choice?
You can speak to your GP about it in the consultation, and they may be able to book the appointment for you then if one is visible on the system.
Some GP practices work with the admin teams so they can support patients with booking appointments.
If someone can’t use digital, then they will be given a telephone number and can call the national booking service.
So if I don’t want to go to my local hospital, what do I do?
When you are referred, have a conversation with the clinician and find out which other services would be suitable for your needs.
They could either be neighbouring services to your home, near where you work or any location providing you’re able to get there.
Can I have time to think about where to go or do I have to decide there and then?
It’d be perfectly acceptable to ask for some time and often a GP is able to create a shortlist for a patient and the patient can then take that shortlist away.
Will I get an appointment more quickly because of this?
Appointments are usually based on how clinically urgent a condition is, rather than first come first served. However, it’s likely that having more choice may enable you to be seen quicker because waiting lists are different in different hospitals. My Planned Care myplannedcare.nhs.uk lists all hospitals and all specialties as well as an average waiting time.
How is patient choice working at your surgery?
In London, a good example is where a patient wants to go to a specialist centre, or a centre that’s well known for treating a certain condition. Having the flexibility of not having to go to your local general hospital has allowed patients the ability to see an expert in the field of their condition.
Other patients have looked at My Planned Care and found that a hospital close to their home has a much shorter waiting time on average and they’ve been seen faster.
If you had to choose where to be treated, what would you base your decision on?
If it was me, I’d want to understand the waiting times - that’d be fundamental. But also having access to the local services, so if I needed an outpatient appointment, would it be okay to go to that location as a follow up?
I’d want to make sure that I’ll be happy to have the end-to-end process delivered at that hospital.
How does communication work and how do my results get back to my GP?
With local hospitals, we’ve got very strong IT links and we’re able to read each other’s records. With hospitals further away we routinely receive letters and correspondence from them and that’s been going on for years.
“ Having more choice may enable you to be seen quicker”
ALL ABOUT CHOICE: Dr Roberto Tamsanguan shares his advice for patient“Patients are willing to travel to be seen quickly”
Dr Jamila Adi based in Hounslow, West London, talks about her experience of referring patients: “I’ve had a good experience of using the ‘choose and book’ e-Referral service. I’ve had three patients who were keen to be seen quickly all across different specialties.
“One of the specialties I was looking at had quite long waiting times – that was ENT (ear, nose and throat). Most hospitals have a waiting time of over 18 weeks, so I wanted to see how it could help mitigate that for patients with tinnitus and neck lumps. About 70 hospitals came up from all over England and you would choose five.
“I’d see the patient in my clinic then call them a few days later to have a discussion so they’re involved in where they’re choosing to go and the type of care they want - and also how far they’re willing to travel.
“Most wanted to stay within London or the outskirts. A lot of patients say ‘I don’t mind driving or I can get a bus or tube there’. Patients are all really elated – they say they’re willing to travel anywhere if they can be seen quickly.”
Dr Jamila Adi said she has good experience of using the ‘choose and book’ e-Referral serviceBreaking down language barriers
Essex-based GP Dr Marjorie Gillespie talks about accessibility: “The key to giving patients choice is to make the system accessible to everyone, so when patients with interpreters visit Dr Marjorie Gillespie, she goes through the information with them both.
“They can then take the information away and do the booking themselves at home with family members or friends that can help them with any language difficulties,” says Dr Gillespie. “Also, you can use the online service.”
Dr Gillespie will always make it clear if she thinks patients might need support at their appointments, whether that’s access requirements or language support.
“We can flag in our referral that patients need either physical adaptations, interpreters or extra assistance at their appointments.
“It’s important that people feel comfortable going to the hospital. They mustn’t feel there’s a barrier.
“So if you get an appointment and it’s in a local hospital that’s providing an NHS service, it’s for you. It is the NHS buying this care for you. So please go. Don’t be scared. Nobody’s going to be charging you.”
CARE FOR ALL: Dr Marjorie Gillespie believes NHS services should be accessible to everyone