Patient Choice and Planned Care

Patient choice

Did you know that in many cases you have the legal right to choose where you have your NHS treatment? The NHS is offering more and more options to enable you to make choices that best suit your circumstances, giving you greater control of your care and hopefully better results.

If you need to be referred for a physical or mental health condition, in most cases you have the legal right to choose the hospital or service you’d like to go to. This will include many private hospitals and independent sector providers as long as they provide services to the NHS and it doesn’t cost the NHS any more than a referral to a traditional NHS hospital.

You do not have a legal right to choose if you need urgent or emergency treatment or are:

• serving in the armed forces
• accessing maternity services
• detained under the Mental Health Act
• detained in or on temporary release from prison, in court, an immigration removal centre or a secure children’s home.
• referred to high-security psychiatric services, or drug and alcohol misuse services provided by local authorities.

You can also choose a clinical team led by a consultant or named healthcare professional, as long as that team provides the treatment you require.

Planned care

Also known as elective care, planned care is the provision of services with planned appointments or interventions in a place like a GP surgery or hospital. Planned care can be an outpatient appointment or surgical procedure. It covers medical procedures such as joint replacements and cataract surgery. It also includes tests to detect diseases and medical conditions. Some planned care procedures are done as day cases. This is when a patient leaves hospital on the day of their procedure. Some patients might have to stay in hospital overnight or for longer.

People that need planned care start with a visit to a health professional like a GP. They will discuss options and decide if a referral to another service is needed. This might include deciding if a patient needs a diagnostic test such as a scan or x-ray. Planned care may take place on an urgent or routine basis, but not as an emergency.

Planned care covers a lot of specialities, these include:

• audiology
• cardiology
• dermatology
• ear, nose, and throat
• gynaecology
• ophthalmology
• respiratory medicine
• rheumatology
• trauma and orthopaedics
• therapies
• urology

The planned care team is responsible for commissioning planned care services in your area. The team:

• work closely with all care providers, local councils, GPs, charitable organisations
• speak to people that live in Hampshire and the Isle of Wight by talking to all these people, we can understand what services need to be like. We also plan how providers can deliver services in a cost-effective way.

Advice and Guidance

Advice and guidance (A&G) is defined as non-face-to-face activity delivered by consultant-led services which can be:

• Synchronous (for example, a telephone call)
• Asynchronous (enabled electronically through the NHS e-referral service, or through other agreed IT platforms or email addresses)

By providing a digital communication channel, A&G allows a clinician (often in primary care) to seek advice from another (usually a specialist) prior to or instead of referral. Reasons why a clinician may wish to seek advice and guidance include:

• Asking another clinician or specialist for their advice on a treatment plan
• Asking for clarification regarding a patient's test results
• Seeking advice on the appropriateness of a referral
• Identifying the most clinically appropriate service to refer a patient into

Advice and Guidance can also be used as a method to support the offer of choice, as long as the patient is informed by the referrer and accepts that the A&G request may convert to an appointment at the receiving hospital.