Out of Area Referral

[Gibson01]

Met my cardiologist today who seems to be at a loss to diagnose the cause of my Refractory Angina. I asked for a referral to the Royal Brompton Hospital which I understand is the only uk centre of excellence. Cardio seemed to express concern as to how to manage a referral out of area. Anyone had experience of this?

[Hidden]

hello

Yes I had referral to another hospital in same area - GP was able to do this. This was because I wanted a second opinion and I believe you have the right to be treated at a hospital of your choice. A referral letter was sent to the cardiology department of the other hospital.

I’ve also had referral out of area but it was my local cardiologist’s decision - I was hoping for that referral.

What my cardiologist did was directly email the specific cardiologist in mind. It’s caused some issues with transferring records but pretty much worked out ok.

However, at a guess they should know how to email the cardiology department of another hospital.

Other things you could do to help the Cardio people (you shouldn’t have to) is contact the PALS service for the Royal Brompton and ask them what the process is / what your doctor needs to do to make a referral. I think most hospitals have e-referral systems in place so it should not be impossible.

Also could ask the PALS service for your “home” hospital and ask them how referrals are made out of area.

It’s definitely possible, good luck but you may need to do some of the leg work for them!

👍 I now have three hospital numbers 😂

[Lezzers]

My understanding is you can ask to be treated at any hospital across the country but understandably the waiting times for the more specialist hospitals are going to be longer. I also don't think there is an automatic referral for second opinion there has to be a good reason as to why the second opinion is required & I believe it's down to your GP to make that decision. We've got an issue where we've moved home &;into a different health authority area. We asked my husband's oncologist for his cancer care be moved to a hospital in the new area that has a very good reputation. The oncologist said it's down to the gp to make the referral, unfortunately something seems to have been lost in translation & the new hospital don't seem to understand why my husband has been referred to them when his cancer care is (supposedly) already under the care of the original hospital!

[Milkfairy Heart Star]

Hello,

The Royal Brompton is not the only place of excellence providing care for those of us living with refractory angina.

A club that, truly, none of us want to join.

Where in the UK are you based?

How referrals are processed are dependent on whether you live in England, Scotland, Wales or Northern Ireland.

It can be difficult to obtain a cross border referral to England.

In some cases a hospital Cardiologist can refer you to a specialist tertiary centre.

The other option is to ask your GP to refer you.

[Hidden]

My understanding is that within the NHS you have no right to a second opinion, but your request should be respected if there is good reason. In this case your current cardiologist and presumably his/ her colleagues are apparently unable to properly diagnose your condition so should be seeking a second opinion themselves, and really it should not be down to you to push them to it. The responsibility for the referral therefore lies with the originating hospital although you may have some opportunity where you go under NHS Patient Choice which they should respect. If I were you I would be pushing your local cardio unit to get things set up and accept no excuses, bearing in mind just because the cardiologist didn't know how to set up a referral, which might be understandable because he /she only deals with clinical matters, there will be an administrator who should be knowledgeable about how it is done

[Tos92 in reply to Hidden]

Hi Hidden

You mention that there is no right to a second opinion on the NHS, unless there is a good reason for it. Does that mean there is still possibility to obtain a second opinion on the NHS dependent on what the issue is?

I’m currently in a similar-ish situation with wanting to be referred to a cardiologist outside my local area, but instead of going private again, I wanted to explore if it was possible to do it through the NHS.

[Hidden in reply to Tos92]

The General Medical Council, which regulates doctors, state that all doctors must ‘respect the patient’s right to seek a second opinion’.

The Department of Health accepts that if a doctor thinks that it is in the best interest of the patient to refer for a second opinion, they should do so. Although you do not have a legal right to a second opinion, a healthcare professional will consider your circumstances and whether a second opinion is needed.

Source; elht.nhs.uk/patients/how-se...

Hope this helps.

[Kristin1812 Heart Star in reply to Tos92]

It is possible. I was admitted to a tertiary Centre beyond our area. I had such better care, than locally, ao I asked them if they would be willing to continue my cardio care. It was arranged…took a little time, because the funding then had to transfer with you, When the episode settled (2/3 years later) I was discharged, but could go back to the tertiary centre when its clinically needed. Im about to have another OP appointment with new symptoms the GP is struggling with, she says she needs their advice.

[Milkfairy Heart Star in reply to Tos92]

In primary care, a GP is the healthcare professional responsible for referring a patient. They should provide you with a good reason to refuse your request of a second opinion.

In secondary care a hospital consultant can refer you to another consultant for a second opinion.

Some consultants will ask a patient to go back to their GP to do the referral.

If necessary contact Healthwatch or the Patients Association to help support you if your request is refused.

For those of us living with rare conditions such as vasospastic angina it shouldn't be an issue.

When I went to see my GP, I took in information from the BHF website and other relevant research articles to support my request. I suggest you do the same.

I asked my previous Cardiologist to refer me to my present Cardiologist without any problem.

Another good source of information about your rights and the NHS's responsibilities is the NHS Constitution which applies in England.

gov.uk/government/publicati...

In over 10 years, I have never had a problem being referred to a specialist.

Good luck.