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HOSPITAL CARE
Dear Patient
Your GP surgery is not responsible for any aspect of hospital care. This information page provides some general information about various issues around hospital care, which we are frequently presented with, and informs you how to address your concerns or queries directly with the hospital concerned.
WHAT TO EXPECT WHEN YOU ARE REFERRED TO HOSPITAL
NHS England, the British Medical Association and the National Association for Patient Participation have come together to produce an information leaflet for patients, which provides details on what you can expect to happen before, during or after your hospital visit. This leaflet covers some of the topics on this page and you might find it a useful read.
What to expect leafletQUERIES REGARDING HOSPITAL CARE
Please be aware that all NHS organisations are as busy as ever, dealing with urgent cases as well as prioritising clinical care. We urge all patients awaiting a hospital appointment or a result to be patient and wait to be contacted by the hospital directly. However, if you have a query about any hospital related matter, please contact the hospital directly.
HOSPITAL APPOINTMENTS
APPOINTMENT QUERIES Please direct all queries regarding hospital appointments to the secretary of the consultant you are under. They can advise you when your appointment is likely to be. Do not accept any requests to 'speak to your GP' to facilitate a speedier hospital appointment.
WAITING LISTS AND EXPEDITING APPOINTMENTS GPs have no control over and are in no way responsible for hospital waiting lists. If your query is regarding your position in the waiting list, or when you are likely to be seen for your outpatient appointment or your hospital procedure, please ring the secretary of the consultant you are under in the first instance.
If you feel that you need your appointment bringing forward, again you need to speak with the hospital team. More information on expediting your appointment can be found on our expediting appointment page.
Expediting appointment pageMISSED APPOINTMENTS If you miss an appointment at the hospital for the first time, the hospital should have in place a reasonable policy to rebook your appointment, rather than an automatic discharge back to the GP for yet another new referral. After all, the hospital will still be in receipt of the original referral from the GP, so should have the necessary information to work with.
If you find you have been discharged inappropriately, please ring the secretary of the consultant you were meant to see and explain the circumstances of your missed appointment. For more information, please visit our missed appointment page.
Missed appointment pageHOSPITAL TESTS AND RESULTS
The responsibility for providing results of hospital tests, or acting on hospital tests lies with the hospital directly. This is in line with good clinical practice and GMC guidance.
We do not have any special hotline numbers to the hospital and we are not routinely copied in to results of tests carried out by other services, therefore our staff cannot provide you with results of tests organised elsewhere. Furthermore, our admin staff simply do not have the capacity to ring hospital departments and chase results of tests organised by the hospital.
Indeed, due to hospital contract changes from April 2017, hospitals are now obliged to provide you with results of your tests and also to respond to any queries you might have about your care, in very much the same way that we as GPs respond to patients with queries about the care provided by ourselves. Accordingly, hospital matters should not fall to your GP to resolve.
Please contact the secretary of the consultant whom you are under so that you can put your query directly to the responsible doctor.
HOSPITAL PRESCRIPTIONS
IMPORTANT NOTE ON URGENT MEDICATIONS REQUESTED BY HOSPITAL
There are no circumstances in which a GP must prescribe urgent medications requested by the hospital. Regardless of what you may have been told at hospital, the hospital itself is responsible for supplying any urgent medications they recommend. Failure of the hospital to supply the required urgent medications represents a breach of the hospital contract. More information is available immediately below.
GPs do prescribe medications requested by hospital, but these are on a routine basis and require written instructions that are sent to us in the form of discharge summaries, outpatient prescriptions or clinic letters. As they are routine requests, they are processed in the normal manner and can take anything from 2-5 working days or more.
For the avoidance of doubt, we do not prescribe medications simply on patient say-so - even if the hospital has told you to approach us - for clinical safety reasons, we always need sight of some form of hospital correspondence.
URGENT/SPECIALIST MEDICATIONS If the hospital needs you to start specialist or urgent/same-day medications, then as part of the hospital contract, it is actually their responsibility to provide that medication for you, whether this is after a face-to-face appointment or a remote assessment. If you require urgent medication as recommended by the hospital, please contact the secretary of the hospital doctor or the hospital department that has made the recommendation.
In situations where you have already left the hospital without your urgent medication, hospitals must still meet their responsibility of supplying it to you. Hospitals have access to electronic means to send a prescription to your chemist (as we do), as well as paper prescription pads, the postal service and even transport to be able to supply you with the urgent medication that they want you to start. Do not accept any disingenuous claims that you would need to make a special journey to the hospital to collect a prescription and that therefore you should see your GP instead.
The following is an extract from the NHS Standard Contract, which hospitals must work to, regarding the supply of urgent medication:
Hospital contract 2023-24
HOSPITAL PHARMACY PRESCRIPTIONS If you are issued with a hospital prescription at your appointment, please take it to the hospital pharmacy to get it dispensed. Many patients present to us because they do not wish to wait at the hospital pharmacy. Please note, we are under no obligation to convert any hospital issued prescription to a GP issued one. If we do so, it will be at our discretion and the timescale will be in line with the non-urgent medication process as described below. For medications that must be urgently started, these must be supplied by the hospital as previously indicated.
NON-URGENT MEDICATIONS Where the hospital wishes us to commence you on non-urgent medication, they will send us an outpatient prescription. These will be processed routinely as per our normal prescription process, which may take anything from 2-5 working days (as indicated on the outpatient prescription itself). These are not urgent and in any case, urgent medications must be supplied by the hospital as described above. Therefore, please do not be offended if the processing of your non-urgent prescription does not meet with your expected timescale.
MEDICATIONS AFTER PRIVATE CONSULTATIONS Please note we are under no obligation to issue medications following a private consultation or convert a privately issued prescription to a GP issued one. Requests will be reviewed on an individual basis and if agreed, will be processed in line with the non-urgent medication process and timescale as described above.
More information on private providers and medication can be found on our private providers page:
Private providers pageMEDICATIONS IN RELATION TO HOSPITAL PROCEDURES Responsibility for advising on and prescribing medications in relation to hospital procedures or operations lies with the hospital. For instance, the hospital will advise you on stopping blood thinners before an operation, or whether you need a loading dose of antibiotics or blood thinners before a procedure. Responsibility for issuing such medication lies with the hospital, therefore if you have any queries regarding these matters, please contact the hospital.
Download info leafletFIT NOTES AFTER HOSPITAL CARE
For fit notes (sick notes) following hospital admission, outpatients or operations, please ask your hospital doctor to provide you with one before you leave hospital. Despite what the hospital might say about seeing your GP for a fit note, it is the legal and contractual duty of the hospital doctor treating you to provide a fit note should you require it.
If you have already left hospital without your fit note, please contact the secretary of the consultant whom you were under. It remains a hospital responsibility to issue the first fit note after any hospital attendance.
When asking for your fit note please ensure that it is for the full time period required - there is no regulation that states the hospital fit note can only ever issue you fit notes of maximum two weeks' duration. If your consultant has already advised that you need to be off work a lot longer, then they must issue a fit note for the full duration (see extract from hospital contract below).
Hospitals have access to paper fit note pads, the postal service and electronic means to get your fit note to you, and as of November 2023, as part of hospital contract changes, all hospital must have in place facilities to be able to send a fit note to any patient electronically. There is therefore no excuse for the hospital not to be able to issue a fit note for you ahould you require it.
Download info leaflet eMED3 (fit note) in secondary careThe following is an extract from the NHS Standard Contract, which hospitals must work to, regarding the supply of urgent medication:
You will notice the contract states the fit note supplied should cover the full period until recovery (or until next review), not for two weeks or other or shorter arbitrary time period. If your fit note is not for the correct duration, please contact the hospital for them to correct this problem.
If you still have difficulty obtaining your fit note from the hospital, please contact the PALS (Patient Advice and Liaison Service) of the hospital concerned and they can assist you (see bottom of page for link).
CHASING HOSPITAL LETTERS
Please note that we have no control over how quickly (or slowly), it takes for the hospital to write to us. Although hospitals are contractually obliged to send outpatient letters to us within seven days of the clinic attendance, this is rarely the case, and some letters take a month or more to arrive. The following is an extract from the NHS Standard Contract, which hospitals must work to, regarding outpatient letters:
If is wrong to assume that we will already have received outpatient letters and have taken any necessary action within a matter of a week and that if that necessary action has not been taken, it is then our fault. If we have not received an outpatient letter, we will not be in a position to have our already extremely busy admin staff ringing the hospital to chase letters and as indicated above, we have no special hotline to the hospital in order to do this.
We therefore kindly ask that patients ring the hospital secretary to chase up any letters that are not yet with us. As indicated above, in their own contract, it is the hospital's responsibility to ensure that letters are promptly with the GP if they want us to take action, and not for the GP to chase up what the hospital wants from us.
PRIVATE PROVIDER INFORMATION
If you query relates to a private provider, either a private hospital, or consultant or other organisation, please see our detailed information on the whole issue of private providers and particularly medication requests can be found on our private providers page.
Private providers page
Yours sincerely
Ivy Grove Surgery
STILL HAVING PROBLEMS WITH HOSPITAL CARE?
If you are not getting anywhere with your query regarding hospital care, please contact the hospital and ask to speak to the Patient Advice and Liaison Service (PALS). They can investigate and escalate matters for you.
Derby PALS© Dr Michael Wong 2022