What is a GP referral and how to get it?

A GP referral is when your general practitioner directs you to see a specialist for further diagnosis, treatment, or care. To get you, you typically need to schedule an appointment with your GP to talk about your health concerns. A referral letter from GP outlines the reasons for the referral and may include specific information about your medical history and any relevant test results.

What can I get a GP referral for?

Usually, you have to visit your GP or talk to a hospital doctor to get a referral to another NHS service. Sometimes, nurses or other healthcare workers can also make referrals.

Examples of referrals might involve:

• Getting scans or tests to diagnose a health problem.
• Accessing services to improve well-being, such as quitting smoking or managing diabetes.
• Receiving physiotherapy for physical rehabilitation.
• Undergoing minor surgical procedures.

Do you need a GP referral to see a private consultant?

According to the NHS, you can access private treatment from a consultant or specialist without a GP consultant referral. However, the British Medical Association (BMA) recommends that patients seeking specialized treatment should be referred by their GP. 

Each insurance plan is different—some insist on a referral, while others let you refer yourself. Especially with COVID-19, insurers often offer online GP visits, making it easier to get referrals and advice from home.

Some programs, like Bupa’s direct access scheme, let you skip the GP if you have certain symptoms, like cancer or joint issues. Knowing what your policy covers ensures you get the care you need when you need it. Checking your policy or talking to your insurer can clear up any confusion.

How is a GP referral made?

It is typically made during a consultation with your general practitioner. Here’s how it usually happens:

You schedule an appointment with your GP to discuss your health concerns or symptoms.

During the appointment, your GP assesses your condition and determines if further investigation or treatment by a specialist is necessary.

If your GP decides a referral is needed, they will write a referral letter. This letter includes details about your symptoms, medical history, any relevant test results, and the reason for the referral.

Your GP sends the referral letter to the specialist or hospital either electronically or by mail, depending on the system used by your healthcare provider.

The specialist or hospital reviews the GP referral letter to hospital and determines the next steps. This may include scheduling an appointment with the specialist or additional tests.

If the referral is accepted, you will receive communication from the specialist’s office or hospital to schedule an appointment.

After your appointment with the specialist, they may provide further treatment, and recommendations, or refer you to additional services if necessary.

It’s important to note that the exact process may vary depending on factors such as General Practice waiting time, the urgency of your condition and the procedures followed by your GP and the specialist.

Why is GP referral important?

Seeing your GP and getting a referral to see a specialist is really important when you need specific care. It means you can get the right treatment for your health issues. Specialists, who are doctors with extra training in certain areas, can help figure out what’s going on and what treatment you might need. Your GP can refer you to a specialist if they think it’s necessary. 

Sometimes, you might want to go private for treatment. If you have medical insurance, it’s usually best to talk to your insurer about whether you need a referral or not. It’s also okay to ask for a second opinion if you need more clarification on the treatment your GP recommends. And remember, you have the right to start treatment within a reasonable time once you’ve been referred.

Referrals aren’t just for treatment

They can also be for preventive care or screening tests to catch health issues early. This can prevent diseases from progressing and improve long-term health.

If you’re considering private treatment, your GP can guide you on whether you need a specialist assessment or if it’s best to self-refer. Many private practitioners and hospital doctors can provide the care you need if your GP makes a referral.

Remember, you have the right to ask for a second opinion or to self-refer if you feel it’s necessary. It’s all about ensuring you get the care you deserve.

Can I choose whom I see for treatment?

Yes, you often have a choice in selecting your healthcare provider. Your GP can discuss options with you during referrals. Private healthcare may offer more choices, but NHS patients can also request specific specialists. However, availability and insurance coverage may affect your options. Always check with your GP or insurer for guidance.

What is a GP open referral?

GP open referral is a method where your GP doesn’t specify a particular specialist when referring you. Instead, they indicate the needed medical specialist, like neurologist or orthopaedics. This allows flexibility, especially in private healthcare settings where insurance plans may have restrictions on which specialists or hospitals you can visit. Open referrals ensure you receive appropriate care within your insurance cover while providing you with options for specialised treatment.

What to do if a GP refuses a referral?

If your GP refuses a referral and you disagree, you have options.

Firstly, you can ask to see another doctor or healthcare professional for a second opinion. While not legally guaranteed, healthcare providers often accommodate this request. 

Additionally, you can discuss your concerns with your GP, explaining why you believe a referral is necessary. 

If unresolved, you may consider filing a complaint with the practice or seeking advice from relevant healthcare regulatory bodies.

How long is the waiting time for an appointment?

The waiting time for an appointment after a referral can vary based on the urgency of the condition and the type of treatment required. Here are the typical waiting times for different types of referrals within the NHS:

First Outpatient Appointment

Maximum Waiting Time is 18 weeks from the date of your referral.

Suspected Cancer

Urgent Referral- Within 2 weeks 
From Referral to Start of Treatment- Within 2 months (60 days).
From Cancer Diagnosis to Treatment- Within 1 month (31 days).

Chest Pains and Suspected Angina

Specialist Chest Pains Clinic- Within 2 weeks.

Inpatient Treatment

Maximum Waiting Time is 6 months from the decision to treat.

Guaranteed Waiting Time

General Rule: All patients should start treatment within 18 weeks of the referral, barring exceptional circumstances.

How to Track Your GP Referrals

NHS e-Referral Service:

If your referral was made through the NHS e-Referral Service, you can track the progress of your referral online. This system allows you to manage your appointment and check the status of your referral.

Direct Hospital Contact:

If your referral wasn’t made through the NHS e-Referral Service, the hospital will typically contact you with an appointment date. This may take a few weeks. If you have been waiting for a considerable amount of time without any communication, you should contact the hospital directly to inquire about the status of your referral.

Private Medical Treatment:

For referrals to private healthcare providers, you should contact your private provider for information and assistance regarding your referral status.

What happens when you are referred by your GP to see a specialist?

• Initial Information
  Your GP should provide an estimate of how long the waiting time might be based on current guidelines and typical wait times. However, these estimates can change due to factors such as clinic cancellations or staff availability.
• Condition Management
  While waiting for your appointment, your GP or hospital doctor may manage your condition and can attempt to expedite your appointment if your condition worsens.

Will my doctor get paid for referrals?

Doctors can receive payments for referrals, but strict laws are in place to prevent improper incentives. These regulations ensure that referrals are made based solely on the patient’s medical needs, maintaining trust in the healthcare system. The goal is to ensure doctors refer patients to specialists based on the best interests of the patient, not financial gain.

What to do if I have private health insurance?

If you have private health insurance, check your policy to understand the referral process. Some insurers require a GP referral, while others may have a list of approved specialists. Contact your insurance company to confirm coverage for the treatment you need and to inform them about your referral. Once approved, schedule an appointment with the specialist. Your GP may help complete any necessary claim forms. Before proceeding, ensure you understand any potential costs, including consultations, tests, and treatments.

Instead of concluding: How to make the right choice

When it comes to healthcare decisions, making the right choice is crucial. Start by understanding your options and reviewing your insurance policy if applicable. Consult with your GP for guidance and ensure you’re informed about any potential costs.

Research specialists to find one who matches your needs and preferences. Consider factors like experience, reputation, and treatment approach. If you’re unsure, seek a second opinion.