The NHS is a massive organization – it’s all too easy to get confused about where to go and how best to get the right care. So let us help.
I need to get a doctor’s appointment
Your surgery will have its own booking routine. ‘Ask what it is, and keep tabs on changes. Surgeries often alter systems to adapt to changing needs. Many surgeries offer telephone consultations and online appointment booking. Ask if your surgery offers these and how to access them. Bypass the frustration of your surgery being engaged when you call by going down there in person. A face-to-face encounter can be more fruitful and you’ll actually be in situ for a first appointment.
If you have more than one ailment, book a double appointment. GPs allow 10 minutes per patient so you don’t want to feel rushed. If it’s not urgent, don’t try booking on a Monday morning. Try later in the week when the clamour has slowed, and always be polite to the receptionist! It’s a tricky job and she’s only doing what the doctor has asked of her. And be prepared for her to ask about your symptoms – she’ll need some basic facts so the doctor understands the urgency and nature of your ailment so you can be fitted in if necessary or offered advice. Often, all you need say is “It’s about my medication”. And make it clear if you’re worried that your problem is serious. Receptionists have a list of red fmags which require immediate attention.
I need to… be referred to hospital
Be clear about what you want from your doctor – different medication or referral on to a specialist. You’re entitled to ask for a referral, but it’s your doctor’s decision, based on what they think is clinically necessary. They’re likely to suggest treatment options and other tests before referring you on. You can get a good idea of what to expect for your condition if you read the guidelines from NICE (nice.org.uk), the body which advises GPs on NHS treatment and drugs.
For example, you used to be referred for varicose vein treatment on the NHS for cosmetic reasons, but now veins need to ache or carry the risk of ulceration before you can be referred. It’s worth remembering that you have the right to choose which hospital and consultant you’re referred to (excluding some healthcare services such as cancer, maternity and emergency services). Get advice from your GP and decide what’s important to you. If you’re going for a simple course of medication, the location of the hospital may matter. If you’re going in for an op, hospital infection rates may be more important.
When tests or referral are recommended, or you start seeing a specialist, ask about expected waiting times for results and appointments, and who to contact with questions. Surgeries and hospitals have their own processes and if you make sure you understand them, you’ll know how long to wait and who to contact if things don’t go as expected.
I need to be seen immediately
- Call your doctor or 999 for emergency medical advice if you, or someone you care for, has:
- severe chest pain
- an allergic reaction, especially to medication, or sudden swelling of the lips or tongue
- faintness/loss of consciousness
- difficulty using an arm/leg or speaking, or sudden loss of vision
- bleeding that won’t stop
- coughing or vomiting blood
- severe tummy or pelvic pain
- fever with a headache and neck stiffness/pain on looking at the light
- a rash that won’t disappear when pressed with a glass
- confusion or speaking/acting strangely
- thoughts of self-harm.
A recent Healthwatch survey revealed that a fifth of us admit to using A&E for none mergencies. Anna explains: ‘Open all hours, with drugs on tap and guaranteeing seeing patients within four hours, A&E has become NHS Express.’ But, she says, it’s unfair blaming people for using it when they don’t know the alternatives or they’re difficult to access.
For minor ailments, ask your pharmacist. They can treat conditions like skin conditions, coughs, colds, allergies, aches and pains. And you don’t need an appointment. Just ask at your chemist. Or try nurse practitioners at your surgery. You’ll need an appointment, but they can treat minor ailments and prescribe.
Walk-in centres are great for immediate treatment of minor ailments. Call 111 to fjnd your nearest one. For long-term conditions or follow-up care, you’ll be referred to your GP.
Every surgery must offer an out-of-hours service for patients. Call your surgery or 111 for details of how to access it. NHS 111 is open 24/7 and offers non-urgent medical advice and can tell you where to go locally for medical care.
I need to make a complaint
Initially, talk to the person concerned or in charge. GP surgeries must have a procedure and person responsible for dealing with complaints – ask at reception who that is.
At hospital, ask for the person in charge of the ward or the department. The NHS complaints system is notoriously complex but these groups can help:
- NHS Complaints Advocacy: 0300 330 5454; nhscomplaintsadvocacy.org
- Your local Patient Advice and Liaison Service (PALS): ask your GP or hospital or call 111 for details.
- Healthwatch: 0300 068 3000; healthwatch.co.uk
- The internet is an increasingly popular way to be heard. NHS Choices (nhs.uk) and Patient Opinion (patientopinion.org.uk; 0800 122 3135) publish patients’ stories and can help direct comments to, and encourage a response from, the right person.
Healthwatch’s Anna Bradley says patients can be reluctant to flag up issues, but it can help improve service. ‘We all need to be willing and able to challenge the service we get when it’s not up to scratch.