Referrals

You have been referred for onward care – what you need to know.

What happens when you are referred by your GP to see a specialist?

This page describes what you can expect to happen when your GP has referred you to see a specialist or consultant, at a hospital or a community health centre.

Why have I been referred?

Your GP has referred you because they want a specialist’s help in deciding on the best way to treat your condition. This might involve referring you for tests or investigations that cannot be carried out in a GP surgery.

How will I hear about where and when the appointment is?

GP practices and hospitals use different ways of arranging appointments:

• Following your consultation in the surgery, your GP practice may send you a reference number and a password you can use to book, change or cancel your appointment online or by phone. In time, more and more GP practices will refer patients in this way.
• You may receive a letter from the hospital confirming your appointment. You need to reply as soon as possible and tell the hospital if you can attend on the date offered.
• Alternatively, sometimes patients receive a letter asking them to telephone the hospital to make an appointment with a specialist.

Wait times

Wait times for appointments to see a Specialist Consultant at a hospital or a community health centre are beyond the control of Primary Care and the practice and cannot be expedited. You can find out the average wait times of different hospital departments at www.myplannedcare.nhs.uk

Contacting your local hospital for help and support

Most patients are referred for care in the local area through East Lancashire Hospitals Trust and you can visit their website at lht.nhs.uk

Patient Advice and Liaison Service (PALS) is a free and confidential service for anyone who has concerns or questions about aspects of care. PALS are here to help you identify what to do, where to go and who to speak to for support. PALS Freephone: 0800 234 6088

Seeing the specialist

What happens if I need a test or procedure?

Normally, if the specialist thinks you need any test, investigation or surgical procedure, the specialist is responsible for:

• arranging the test, investigation or procedure, explaining how and when you will receive a date and what to do if the date is not suitable for you; and
• giving you the results and explaining what they mean (this may be done in a separate appointment with the specialist or by letter).

What happens if I need new medicines?

The specialist might suggest prescribing new medicines for you or might want to make changes to the medicines that you are already taking. The specialist is responsible for:

• giving you the first prescription for any new medicine that you need to start taking straightaway; and
• giving you enough medicine to last at least the first seven days, unless you need to take the medicine for a shorter time. After this, you will need to contact your GP surgery if another prescription is required. It is important that you understand whether you need to start any new medicines, or whether the specialist has changed the medicines you already take, so ask the specialist if you are not sure. In some cases, your GP will not be able to prescribe certain medicines and you will need to continue to receive these from the hospital. You will be told about this at your appointment.

What if I need a Fit Note (previously known as Sick Note)?

If you need to be certified as unfit for work following treatment by a specialist:

• The specialist should issue you with a Fit Note.
• The Fit Note should cover the period they expect you to be unfit to work, or until your next contact with the specialist. You should not need to see your GP to get a Fit Note following hospital treatment, unless your inability to work is unexpectedly prolonged.

What if I need a follow up appointment?

The specialist will discuss with you whether you should attend hospital for ongoing follow-up care or whether you should be discharged back to your GP. If the specialist thinks you do need to be seen again, the hospital will give you another appointment or tell you when to expect this. If you do not hear anything, please contact the specialist’s office, rather than your GP surgery.

What do I do if I have any questions?

• If you have any specific questions related to your hospital care, your specialist will be able to help you with this, so it is important that you make sure you know how you can contact your specialist’s office.
• If you have any general questions related to your health, your GP surgery will be able to help you.

If you are unsure about any of the questions in the checklist, please make sure you discuss them with a member of staff before you leave hospital.

What happens if I would like a private referral?

If your GP thinks you need specialist treatment and you want to pay for it privately, they will write a letter of referral to a private consultant or specialist explaining your condition and your medical history in exactly the same way. It is recommended that you approach your private doctor or consultant first to find out what information is needed to make the referral.

If you have private medical or health insurance and would like to use this to cover the costs of your treatment, it may be sensible to check your policy to find out:

• if your policy covers the treatment you need
• whether your insurance company accepts consultant referrals from GPs or if it has its own list of consultants
• when you need to contact your insurance company to tell them you’ve been referred for treatment

If you make a claim for treatment under your private medical insurance, some sections of the claim form will probably need to be completed by a doctor. In most cases, the doctor who provides your treatment will be the best person to complete the form, because they will have the information required. Please be aware that if you ask your GP to complete this form there may be a charge.