When we talk about the NHS, we often think we have to accept what we’re given – whether that’s a specific treatment, consultant, or hospital. However, patient choice is a fundamental part of the healthcare system. The NHS Choice Framework enshrines a legal right for patients to choose where they receive non-urgent treatment.
NHS guidance states that the maximum waiting time for a non-urgent consultant-led treatment is 18 weeks. Unfortunately, since the COVID-19 pandemic, NHS performance has declined dramatically. As of early 2024, the waiting list remained high at 7.5 million people.
Patience choice is the solution. It allows patients to opt for treatment in regions where waiting times are shorter or with organisations like Medefer, where you’ll receive a consultant-led review within 48 hours, shortening waiting times for testing from weeks to days.
In this guide:
- What is patient choice in the UK?
- The NHS and patient choice
- Why aren’t GPs offering patients a choice?
- The role of Medefer in patient choice
- How to make your decision
- Should you exercise patient choice?
What is patient choice in the UK?
Most patients in England aren’t aware of their rights. They accept lengthy waiting times to see their local consultants. According to Which?, 63% of its members didn’t recall being offered a choice of consultant or hospital by their GP. These patients are being denied their rights.
Let’s clear up the confusion:
In England, patient choice refers to your right to make decisions about your healthcare, including where and how you receive non-urgent treatment. Most patients are familiar with choosing their GP. However, few realise the choice also extends to some consultant-led care.
Under the NHS Choice Framework, patients have the legal right to choose their hospital, consultant, and even the timing of their treatment. This applies primarily to non-urgent consultant-led care. But it’s not just in the framework; it’s a core principle of the NHS Constitution for England. As with any other right, if infringed, you can complain if you’re not offered a choice.
Due to rising waiting lists and challenges in the NHS, patients are not always offered this choice. However, we believe this choice is precisely what’s needed to reduce waiting times – it’s Medefer’s guiding mission.
The NHS and patient choice
The NHS is experiencing unprecedented demand – or rather, it’s experiencing an unprecedented rise in long waiting times. More than 300,000 people have been waiting longer than 52 weeks for an appointment since their referral as of late 2023. Since then, numbers have begun to fall, but the pressure on the healthcare system remains.
Due to a lack of awareness about patient choice and problems in timely care, many patients have opted for private healthcare to bypass long waiting lists. Currently, just 1 in 10 patients exercise their right to choose. However, doing so could cut up to 3 months off their waiting time by selecting a different hospital in the same region.
How does patient choice work?
When should you be offered a choice? How does it work? And where can you choose to go? We often hear patients ask these questions when learning about their rights. Thankfully, the answers are simple.
If your GP believes you need non-urgent consultant-led care, you should be offered a choice of hospital. Your GP will use the e-referrals system, which provides a shortlist of hospitals. You can choose from this list (including asking your GP to refer you to Medefer). If you’re not ready to make a decision, go home and think about it. You can either log in to the system yourself to make your selection or let your GP know your choice at a later date.
The e-referrals system doesn’t let you pick the consultant. But that doesn’t mean you can’t choose. If you know the consultant you want, tell your GP your preferred choice – they’ll include the information as part of their referral. However, it’s not guaranteed you’ll see that consultant, but you will see a member of their team.
Potential exceptions to patient choice include:
- Emergency Services: In urgent or life-threatening situations, patient choice is not applicable, and patients will be taken to the nearest suitable hospital for immediate care.
- Specialist Care: Highly specialised services, such as those for rare or complex conditions, may not offer patients the option to choose their provider due to the limited number of centres offering such treatments.
- Mental Health Services: Some mental health services, particularly those related to secure care or compulsory treatment under the Mental Health Act, may not provide patient choice options.
- Prisoners and Military Personnel: People in prison or the armed forces are not always entitled to the same level of patient choice in their healthcare.
- Maternity Services: While patient choice can apply in some aspects of maternity care, there may be limitations in certain regions or situations.
Why aren’t GPs offering patients a choice?
Currently, GPs are extremely pressed for time. As the British Medical Association (BMA) notes, “GP practices across the country are experiencing significant and growing strain with declining GP numbers, rising demand, struggles to recruit and retain staff and knock-on effects for patients.”
Although the pressures of the pandemic have subsided, demand for GP appointments is still much higher than before the launch of the vaccination program. Given these pressures, GPs may forget to offer patients a choice, avoid the conversation due to time constraints, or believe that most patients don’t understand the system.
While these reasons are understandable, a patient’s legal rights come first. You should always ask for a choice of hospitals and consultants. Ask your GP about the best treatment in your area and do your own research (see below). You can also ask your GP to refer you through Medefer.
The role of Medefer in patient choice
Medefer serves a leading role in championing patient choice. When GPs refer patients, they can do so through Medefer. These referrals are then reviewed and managed by our team of UK-registered NHS consultants. A consultant will review your case within 48 hours, deciding if you need further testing and care or if there’s nothing to worry about. In that case, you’ll be referred back to your GP with a thorough discharge letter explaining the reasoning.
Patients no longer need to wait for an in-person hospital appointment or travel miles to another hospital. We have an average waiting time of 18 hours from GP referral to initial consultant review. Thanks to this landmark shift, we’ve earned a 90% patient satisfaction rating. No more worrying – you get diagnosed sooner.
How to make your decision
When deciding where to receive non-urgent treatment, several key factors can help guide your choice:
Hospital location
Hospital location is the biggest factor guiding a patient’s decision. Being near family or friends is often crucial for a successful recovery. But there are also travel costs – getting to an outpatient appointment in a neighbouring city can be challenging.
Remember, through Medefer, you can select a consultant anywhere in the UK and enjoy a virtual consultation. That means lower cost and no travel times. You can have the consultation at home.
Choosing a consultant
If your primary concern is the consultant overseeing your treatment, research their experience and performance. Resources such as the National Joint Registry (NJR) or Society for Cardiothoracic Surgery (SCTS) provide valuable data. The NHS also offers information on consultant outcomes, though it varies by region.
Waiting times
Part of the incentive behind patient choice is the opportunity to reduce waiting times. Looking through the statistics can be disheartening. However, you can browse the waiting times on the NHS website to find the best option in your region.
Safety records
Safety inspections by the Care Quality Commission (CQC) and infection rates are crucial considerations. Review reports available online to ensure you’re selecting a hospital with good safety standards. Avoid hospitals with high infection rates or those that “require improvement” unless you have information clarifying the specific area of concern.
Expert and patient reviews
Lastly, there are expert and patient reviews. You can find out more about the surgeon in a specific hospital using popular patient review sites:
Some organisations require consultants to pay to be listed on these sites.
Should you exercise patient choice?
Yes. If you feel you can receive a higher standard of care somewhere else, you should use your right to choose. However, if you’re happy with your local hospital, there’s no issue staying with them. We advise that you stay local if you’ve already had investigative tests done. These results often aren’t accessible at other hospitals, delaying your treatment.
We know it can seem overwhelming. After all, you’ve gone from believing you have no choice to having several options. Thankfully, we’re here to help. We support patients in their decisions, making finding a consultant easier.
When your GP next refers you to a specialist, why wait weeks for an appointment? With Medefer, your case is reviewed by a consultant within just 48 hours. We’ll organise any necessary tests and ensure you receive timely follow-up care so you never have to worry about delays.
Plus, you’ll have access to specialist care without even leaving home – perfect for managing non-urgent referrals. Simply email us at patients@medefer.com or call 08000 112 113 for further details.
