"GP's reluctance to refer father to hospital outside PCT region - disregard of Patient choice"

About: Royal Brompton Hospital Royal Free Hospital / Respiratory medicine

(as a relative),

My father was referred to the Royal Free hospital last year for a diagnosis on his breathing problems.

He was diagnosed with serious and untreatable lung condition, idiopathic pulmonary fibrosis which was a major concern for our family.

After a year or so we started to be concerned that the consultants at the Royal Free truly knew enough about the condition so we did our own research and found that there were only a few consultants in the UK who in our opinion truly understood this condition and were looking at new developments on how to treat it.

This is where the problems started. We went to our GP to ask for what we thought would be a simple referral but as the new specialist was at a hospital (Royal Brompton)outside our PCT region the request was met with resistance. We were told it would need justification as to why we wished to go to a hospital outside our PCT region. I mentioned that I thought we had a right to choose any hospital within the UK but after talking to the Practice Manager it seems like they are limited to only referring to hospitals within their PCT region unless there is justification for going outside. This seems to go completely against Patient choice where they are supposed to be able to choose where they are treated. Our justification that we wanted a second opinion as we thought that the Royal Free had not carried out the right diagnosis was obviously not good enough.

It took a call to the Barnet PCT PALs helpline to help clear this up and they confirmed our thoughts that we did have the right choose a different hospital. They also confirmed that GPs are under pressure to refer to local hospitals only but that the patient did have the right to choose elsewhere. Thankfully they called the GP on our behalf to get them to carry out the referral as we requested.

Our situation has now been resolved but what concerns me greatly is this apparent Patient Choice and yet GPs are not openly offering this choice but also blocking patient's requests when being presented with them. Luckily my father had myself to fight for his rights but what about others who are reluctant to question their GP and are reluctant to complain for their own wellbeing.

Our trust in our GP has been been greatly affected now and even though the practice manager seemed to understand that there was a conflict here between patient choice and the PCT's hidden agenda he was unable to help without a push from the PALS service.

This Patient Choice can not work in the current system if PCT's are not willing to work with it.

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Response from Patient care, Royal Brompton & Harefield NHS Foundation Trust

This is very frustrating to hear. We are a specialist centre and patients can be (and are) referred to us from all over the country. This is especially relevant when care is needed for patients with complex respiratory conditions – we have several international experts within the Trust.

Anyone experiencing difficulties in getting a referral can contact our services development team – Mr Nick Hunt at n.hunt@rbht.nhs.uk.

We are very glad to hear that this story had a happy ending!