The NHS is making changes to the way that hospitals across England handle referrals for specialist or planned care. The NHS in Essex is preparing to introduce these changes for some hospital services this autumn.
Instead of automatically booking a hospital outpatient appointment, a specialist clinical team will review your referral to decide the best next step for your care. This could be an appointment, a test, advice from a specialist, or care from another NHS service.
The aim is simple: to help you get the right care sooner and avoid appointments or journeys to hospital that you may not need.
The changes are part of wider NHS plans to make care easier to access, reduce unnecessary waits and provide more care closer to people’s homes where this is appropriate.
When a GP or other healthcare professional refers you to a hospital for planned care, a hospital specialist team will no longer book you straight into an outpatient appointment.
Instead, the hospital team will look at the information provided by your GP or healthcare professional and decide what is best for your care. This could be:
- an appointment with a hospital specialist
- a test or investigation such as a scan, x-ray or blood test
- giving your GP or another healthcare professional advice about your treatment
- referring you to a different NHS service that is better placed to help with your care
- giving you advice about managing your medical condition.
Sometimes the hospital team might first ask for some additional information before deciding on next steps.
The aim is to make sure you receive the right care, in the right place, as quickly as possible.
You should be told what has been decided, what happens next and who is responsible for the next stage of your care.
We want people to get the right care as quickly as possible.
At the moment, some people wait for a hospital appointment and then find they need a test first, could be cared for by another service, or could receive specialist advice through their GP without needing to attend hospital.
Reviewing referrals earlier can help people get the care they need sooner, reduce unnecessary appointments and delays, and make better use of NHS specialist staff.
It also supports the NHS ambition to provide more care closer to home, where this is safe and appropriate, and to use specialist advice and digital technology to make care more convenient for patients.
No. Your GP or other healthcare professional will continue to refer you to hospital when they believe you need specialist care.
The difference is that, for the hospital services adopting the new approach, a specialist clinical team will review your referral before deciding what should happen next.
If a hospital appointment is the right next step for you, you can still be offered one.
However, going to hospital to see a specialist might not be the best course of action for you.
For example, the hospital team may decide that you need a test first, that another service can provide your care, or that they can give your GP advice about your treatment without you having to make an unnecessary journey to hospital.
Referrals for hospital services that are part of the new approach are reviewed by healthcare professionals, including consultants and other specialist clinicians.
This is a clinical rather than an administrative process.
Yes. Sometimes the hospital team might decide that another NHS service or specialist team is better placed to provide the care you need.
If this happens, you should be told why your referral has been redirected, what will happen next and who is responsible for the next stage of your care.
No. If your referral is redirected, it does not mean it has been rejected.
It means a clinician has reviewed the referral and believes another form of assessment, advice or treatment is more appropriate for you.
Nobody should be removed from a pathway without clinical review.
The new approach aims to reduce avoidable delays by making sure you get the right support earlier.
Where services are working in this new way hospitals should be aiming to review routine referrals and decide on the next step for each patient within five working days of receiving them. Urgent referrals should be reviewed within two working days.
This does not mean you will receive an appointment or treatment within that time. It means by then a decision should be made about what happens next.
All hospitals across England are working to the same targets.
Urgent referrals (like cancer referrals) will remain urgent. Clinical need will continue to determine how quickly you need to be seen or treated.
Yes, you should continue to be informed and involved in decisions about your care. Your NHS rights to choose where you receive care will continue to apply where relevant.
Follow any advice given to you by your GP or healthcare professional.
You should also be told when you can expect an update and who to contact if you have not heard anything within the expected timeframe.
If your symptoms get significantly worse while you are waiting, seek appropriate medical advice rather than waiting for your referral to be processed.
All hospitals in Essex will start to introduce changes for some services from this autumn.
Patient safety will always come first and so these changes will be introduced in stages.
Hospitals will begin by using the new approach in several chosen specialist services. Each hospital will decide which specialities should go first.
Hospitals will add more services over time as they become ready to introduce the changes to other areas.
The detailed timetable for introducing these changes in each hospital in Essex is still being agreed. Further information will be shared as plans are confirmed.