What happens once your GP or nurse has confirmed a referral to a consultant or specialist is required?

A referral letter will be dictated or a pro-forma completed by your GP (or nurse) and then forwarded to the Referral Management Service (RMS) by our admin team.

The RMS will then contact you to arrange an appointment.

If the RMS is unable to contact you, an appointment will be made on your behalf and an appointment letter posted to you.

Information regarding how to change the appointment, if it is unsuitable, will accompany the appointment letter.

If you have ANY questions about your referral and appointment, please call the RMS on their Freephone number IN THE FIRST INSTANCE (you will need to know your NHS Number included on your appointment letter):

0800 031 6639

or email BHCCG.BrightonReferrals@nhs.net

The RMS is open 8am to 6pm Monday to Friday(excluding Public Holidays).

Further information about how to chase a referral can be found below.

A "shared care agreement" (SCA) in the NHS is a formal arrangement between a patient's GP and a private or hospital consultant specialist, allowing them to jointly manage a specific health condition. The GP takes on some responsibility for prescribing and monitoring specialist medications under the guidance of the specialist, ensuring the patient receives coordinated care.

Does my GP have to accept my SCA request?

No. A GP is not legally bound to sign and is entitled to refuse an SCA if they are not happy with the burden of responsibility it puts on them. 

I have been diagnosed privately, does my GP have to accept an SCA from any provider?

No. Our GPs will only consider requests from providers who meet rigorous NHS standards and requirements specific to the services they offer. 

You may also find the Right to Choose information in the following topic useful.

When can I stop seeing my private consultant? 

Responsibility will always sit with the specialist. This includes initiating any medication, and an SCA can only be requested once the medication dose is stable (titrated). If our GP agrees to takeover prescribing, it will only be to issue the medication on the titrated dose. 

You will be required to attend annual reviews with your specialist and agree to this as part of the SCA. Failure to attend regular monitoring may lead to the SCA being suspended.  

What is Right to Choose?

The national NHS Right to Choose (RTC) Framework allows NHS patients the ability to select their healthcare provider when receiving a referral from a GP or another designated professional for their initial or first appointment. This right applies provided the referral is for a clinically appropriate physical or mental health service.

Which providers can a patient choose from?

Patients are free to select any appropriate qualified provider across England if the provider is commissioned by the NHS in England to provide the service needed. This includes NHS organisations as well as private and independent providers.

When does the right to choose apply?

Patients can exercise their right to choose when:

• They receive an NHS referral for their initial or first appointment.

• A GP, dentist, or optometrist has made the referral.

• The service is led by a consultant (for both physical and mental health) or by a mental health professional (for mental health services only).

• The provider is commissioned by the NHS in England to provide the service needed

When does the right to choose not apply?

Exceptions to the right to choose include situations where:

• the patient has self-referred.

• The patient needs urgent or emergency treatment.

• The patient is already receiving care and treatment for the condition.

• The organisation or clinical team they have chosen does not provide the right care for their condition.

• The patient is a prisoner or on temporary release from prison.

• The patient is detained in prescribed accommodation, such as a court, secure children's home, secure training centre, immigration removal centre or young offender institution.

• The patient is detained in a secure hospital setting.

• The patient is a serving member of the armed forces.

• The patient is detained under the mental health act 1983

• The service is commissioned by a local authority outside of a joint commissioning agreement or is delivered through primary care.

Will Right to Choose cover the cost of medication?

Yes, initially. At the end of the titration period, a Shared Care Protocol (SCP) is sent from the provider to the GP to consider taking over the prescribing.

Patients who are accessing a private assessment and then wish their GP to take on shared care for a specialist treatment should have this discussion with the GP prior to referral, as not all GPs accept shared care prescribing. Patients should also be advised that they may need to fund follow up appointments with the specialist provider such as an annual review. There may be a situation where they need more regular specialist review e.g. if they experience side effects or complications that need more regular specialist input.

GPs are asked to provide letters or complete reports for a variety of reasons. Some letters, and reports for third parties are not covered by the NHS contract and are considered private work. This work can carry a fee to complete.

Why is there a charge?

The GP will require time to review the patients medical record in order to provide factually accurate information. There may also be an administrative cost to produce and send the information to the patient or third party. 

I have a deadline, how long will the work take?

NHS contracted work, including unexpected and acute work, will always take priority over private letters and reports. We normally advise an estimated timescale of 28 days to complete. 

What information will my GP provide?

The GP will only write what they know, supported by factual information contained in the medical record. 

They will not accept requests for specific wording, and the information they provide will be final. 

We reserve the right to withdraw our offer at any point before completion if we receive unreasonable requests from the patient or third party. 

What type of letter or report will you accept?

Examples include insurance and travel cancellation claims, fitness to travel, confirmation of medical conditions, and letters for some mitigating circumstances. 

What will not be accepted?

We cannot provide countersignatures for passport applications, some letters in support of council requirements, some confirmations of ID or contact details, and anything that is not contained in your medical record.  

Please note, we use a third party known as iGPR to support the completion of some GDPR compliant medical reports. Further information on this can be found in our Privacy Notice, or ask at reception for a copy. 

The DWP (Department for Work and Pensions), or a healthcare professional working for the Health Assessment Advisory Service on behalf of the DWP may require certain medical information relating to patients on whom a certificate is being considered. 

If this is the case, they will write to your GP directly, specifying the information that is required. A GP cannot offer an opinion on incapacity to work to anyone else, and there is no obligation to provide reports or letters of support direct to the patient free of charge. This includes the Citizens Advice Bureau and the Tribunal Service. 

Please contact Jobcentre Plus or the Appeals service as appropriate, for further advice in the first instance, if you feel further information is required.