Medical Ethics – Seems only to apply if patients actually know about it…………..
Autonomy
An adult patient who… suffers from no mental incapacity has an absolute right to choose whether to consent to medical treatment… This right of choice is not limited to decisions which others might regard as sensible. It exists notwithstanding that the reasons for making the choice are rational, irrational, unknown or even non-existent.
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.
ALSO to be found on page two of NG145 (I'm guessing it is present in most if not all guidelines)
The right to choose who treats you ***************** VERY IMPORTANT
Further information to be posted in replies please add anything you think useful - I will be posting links to stuff for Scotland, NI and Wales (as I find stuff) unless anyone can beat me to it 😘👍. All contributions are welcome, be it official blurb or pertinent experience. Let’s make this a powerful useful post 😊👍
Written by
Charlie-Farley
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Thank you for the information, am I assuming correctly that if an Endo Consultant works for the NHS and the Private sector in a different county to where I live I could ask my doctor to refer me to their clinic under my "right to choose " ?
Apologies for requesting you to confirm, but as you know our brains struggle with the simplest information sometimes 😶
My doctor has referred me to a local hospital stating he couldn't request which Consultant I could see....
Reading the leaflet it would appear so. I’m pretty sure this is not publicised by many GPs and surgeries. We had a friend who picked a particular hospital to get referred to for knee replacement surgery so I knew it was possible and seeing a post last night made me realise this needed to be a post rather than a reply.
You can get to the online leaflet in the post - there is a link and once on the online leaflet you can download and print a hard copy.
Here’s one of the pages inside (I did a screenshot).
Thank you so much Charlie-Farley and everyone else in this thread.
The appointment hasn't appeared in my NHS App yet, the current status is " for a possible appointment in April" no action required by patient the dept will contact you in due course!
I will wait for the appointment details to be uploaded then have a look to see what if any options are available 🤞🤞
I'm so grateful that when I started to self medicate with a supraphysiological dose of T3-only, some years ago, an understanding GP alerted me to Patient Autonomy. It gave me added confidence to take control..... shared information like this will be helpful to others.
Interesting article. But I would like to add - and to stress - that silence is construed as consent. If you don't say anything or make any objection, the doctor will take it that you agree to what he is proposing. So, if you don't like it, for goodness sake say something!
Thankyou. Interesting and really useful. Can this all info be pinned for future reference? Ive exerted my patient automony with the right to choose two weeks ago and changed my GP Practise. Something I'd put off as better the devil you know but they crossed my bottom line and my patience has finally run out.
I didn't realise how simple it is these days....
I found out you can choose and change your GP Practise on the NHS App. So long as you are in their postcode area they can't refuse. Took me about three mins to change mine. Job done!! The NHS app helfully brings up the GP Surgeries and you simply select which one you want. Had no idea it was so easy. And NHS App immediately told me I'm registered with said chosen new GP Practise!! I've noticed since it's immediately flagged the change with my hospital consultants too. Amazing.
I would suggest you make sure you have plenty of your usual repeat meds at the time as that side seems to be much slower.
My new Practise don't use their title of doctor, just first name. Hoping this translates into they're more interested in the rights of patients and working WITH you together, not AT you......time will tell. 🤞🤞
I’ll ask and thank you for sharing your move to a new surgery. This sort of information is so empowering. I’m guessing there are ‘metrics’ recorded for these sorts of actions. We can vote with our feet! Using patient autonomy we can also avoid.
Couldn’t agree more re choice - it like the choice of sandwiches at the crap game Oscar hosts in his flat in the film The Odd Couple (one of the funniest films ever).
Oscar “ I got green sandwiches and I got brown sandwiches”.
That's really interesting and as you say helpful for those with a range of surgeries to chose from. I've actually Googled all the surgeries in my town ( clearly too much time on my hands and no life 🤣) and was shocked at how crap they all were. An average rating of 2.3 out of 5. The reviews pulled no punches.
I've been with my practice for 30 plus years. They've gone from being excellent to merely adequate but I'm guessing that's true for most surgeries these days. On occasion I've been tempted to move, usually when they've been particularly incompetent, but looking at the reviews there arent any better ones around.
Speaking to relatives who all use different surgeries, it seems all of them are woeful. My MIL has a particularly bad one.
There's bad, and plain unsafe. My old gp practise failed to put through a referral for suspicion of cancer from an out of hours doctor...he suspected a reoccurrance. After a month I rang the hospital to enquire when I would get an app and they said they hadn't received a referral. Turns out that's because it was still languishing in my GPs electronic file waiting for them to act (out of hours gps cant send referrals directly). This despite the practie manager viewing the said referral two weeks previously and assuring me it had been sent during a meeting to discuss my lack of post operative care and the fact doctors in tbe practise said I was too complex for them!! . Final straw after a string of mishaps. Unforgiveable. All trust smashed.Surely the new GP surgery has to be able to do better than that????
Anyway found out from hospital today that I remain cancer free....phew. Hurray!! 6 worrying weeks. Time to celebrate.... 🤗🤗 Yippee!!
Hope you are celebrating 🥂. That really is unforgiveable certainly for something as serious as cancer.
I've found the same problem if I've used out of hours or the Livi doctors, they arent able to do certain things and you are praying the surgery actually acts on what they've said. It really shouldnt be a lottery though.
The poor old NHS is on its knees. My youngest son recently left after working there for 11 years, he's not tempted to go back. Bad pay, rubbish management and non existent morale are not incentivising.
It's the same in all the public services, they're all falling apart.....we never came out of austerity....... you can only run a service on a shoe string for so long. Eg caretakers in my LA were out sourced, they get sent all over a very large county but dont get paid for travel costs....consequently the costs of that means for four sessions a caretaker I know earns £1 per shift! So he's leaving...
Terrible 😢- it’s just not economical. When will they realise- oh yes- when it’s too late.
I’m truly thrilled you had a clear result Wavy - it’s a good news day today. I’ll go to sleep smiling- good news, when it comes along keeps us all sane! 🤗
I’ve wanted to say that for ages but thought it too political. We are becoming a third world country. The rich get richer and the poor get poorer and multiply in number.
I haven’t read all the links above in detail but as far as I can see and going by what happened last time I had an op, you can choose where to be treated,but not a named individual to treat you. I tried to choose the surgeon but at the last minute the op was performed by someone else.
If you've gone out of area then there's an argument to be had over the named surgeon because your local HA are paying for that surgeon to operate on you. Usually the GP has to get the local CCG to approve it financially. I had to argue this....albeit it was before the pandemic.... and won. My surgery involved a series of ops and frankly I didn't want different surgeons putting their ten penneth in. That hospital have changed that practise and now patients are seen through by one surgeon.....turns out most patients felt the same way. No surprises there then!
Thank you Charlie-Farley for this. It’s extremely useful information on many levels. Particularly pertinent for me at the moment as my GP too, like YorkshireLass_1964 said she could not ask for a particular consultant and that I might just get ‘one of the team’. This consultant is the only one in the U.K. who says she deals with my heart condition. However, so far, the consultant’s secretary phoned me to tell me I would indeed be seeing her - I do hope this turns out to be the case. I was aware of this ability to request but I thought it had died a death with other NHS changes.
So this is really good up to date information. It means I also feel much more confident about naming the endo I want after this cardio appointment.
waveylines suggestion of pinning gets my vote too.
The Charter of Patient Rights and Responsibilities
My health, my rights, my NHS
Accessing and using NHS services in Scotland
I have the right to safe, effective, person-centred and sustainable care and treatment that is provided at the right time, in the right place, and by the most appropriate person. Sustainable health and care services look to reduce waste and harm, and distribute available resources to where they will deliver best value for the people we care for and for the health and care system.
You must have a referral for healthcare from a GP or public consultant to access most types of healthcare under the Northern Ireland Planned Healthcare Scheme (NIPHS).
Your GP or public consultant can discuss your options with you. They can refer you directly to a consultant at a private hospital in Northern Ireland.
But you can also use a referral to a public hospital in Ireland to access private healthcare in Northern Ireland. You just need to arrange an outpatient appointment with your chosen hospital in Northern Ireland.
Referral process
At any stage in the public healthcare process in Ireland, you can decide to get healthcare in Northern Ireland under the NIPHS.
If you are unsure if you qualify for the NIPHS, contact the NIPHS office.
Here’s the link - note it is under review- if it goes out if date please let me know and I will update 😊👍
If you have an ongoing medical issue that has not been resolved following investigation or treatment, you may wish to be referred for specialist treatment; this can be requested via your GP surgery. A clinician might refer you to a specialist if they have any concerns that they wish to be further investigated.
NHS referrals
You will be referred by your GP to the appropriate specialist. You’ll get a referral letter through the post offering you an appointment for review. The letter will explain what to do next.
Unfortunately the waiting times can be lengthy and you may be waiting for several weeks, or even months, before receiving an appointment.
If your medical issues worsen, or you require treatment in the interim, a further appointment can be arranged with your GP for medical care.
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
NW London Hospitals Referring Patients to 'liothyronine withdrawal clinic'.
Want to know why doctors aren’t referring patients?
A very important petition re patient choice
(NHS Choices page)
