Hospital Care

Hospital referrals Most hospital care starts with a referral from a GP, dentist, optician, NHS 111, urgent care service, or another clinician. For non-urgent consultant-led care, the NHS Constitution gives patients rights around access, quality, information, confidentiality, involvement in decisions, and complaints.

A referral should usually explain:

• why you are being referred
• what symptoms or risks need assessment
• whether it is routine, urgent, suspected cancer, or emergency
• what tests or information have already been provided
• what happens next

Ask for a copy of the referral letter if you need it for your records.

Outpatient appointments

Outpatient appointments are hospital appointments where you do not stay overnight. They may be face-to-face, telephone, or video.

You can ask:

• who you are seeing and why
• what tests may happen
• whether you can bring a parent, carer, advocate, interpreter, or supporter
• whether reasonable adjustments can be made
• how results will be shared
• who to contact if symptoms worsen

NHS hospitals also have PALS, which can help patients, parents and carers with questions, concerns, communication needs, and problems accessing care.

Inpatient care

Inpatient care means staying in hospital overnight or longer. You should be involved in decisions about treatment and discharge, and staff should explain your care plan, medicines, risks, consent, and next steps.

For children, parents and carers should normally be involved unless there is a safeguarding, legal, or confidentiality reason not to. Ask about staying with your child, visiting rules, school support, play specialists, safeguarding support, and discharge planning.

Day surgery

Day surgery means you have a procedure and usually go home the same day. Before surgery, ask about:

• consent and risks
• anaesthetic plan
• fasting rules
• medicines to stop or continue
• transport home
• pain relief
• wound care
• emergency contact number after discharge
• when the child or adult can return to school, work, sport, or normal activity

Waiting lists

For non-urgent consultant-led treatment in England, the usual maximum waiting time is 18 weeks from when your appointment is booked through the NHS e-Referral Service or when the hospital receives your referral. This right has exceptions, such as where delaying treatment is clinically appropriate or where the patient chooses to wait longer.

Keep evidence of:

• referral date
• appointment letters
• cancellations
• symptoms getting worse
• impact on school, work, caring, sleep, mobility or mental health
• any safety concerns

If waiting is causing harm, ask your GP or hospital team to update the referral with new clinical information.

NHS Choice

For many routine referrals, patients can choose where to go for their first outpatient appointment. NHS England guidance says patient choice rights are part of the NHS Constitution and apply to many elective referrals, though not every service or urgent pathway is covered.

You can ask:

• “Can I choose a hospital with a shorter wait?”
• “Can I be referred through NHS e-Referral Service?”
• “Can I change provider because I have waited too long?”
• “Is this referral covered by patient choice?”

Second opinions

You can ask for a second opinion if you are unsure about diagnosis, treatment, risk, or lack of progress. It is not always an automatic legal right, but NHS clinicians should consider reasonable requests.

For hospital patients whose condition is deteriorating, ask the ward about the hospital’s urgent escalation process, sometimes known as Martha’s Rule, where available. This allows patients, families or staff to request a rapid review by a separate clinical team.

Hospital discharge

Hospital discharge should be planned with you. NHS guidance says hospitals should discuss your treatment plan, including discharge or transfer, and assess whether you need more care after leaving hospital. You can ask the ward manager or PALS for the hospital discharge policy.

Before leaving, ask for:

• discharge summary
• diagnosis and treatment given
• medicine list and side effects
• follow-up appointments
• wound care instructions
• red flag symptoms
• who to call if things get worse
• school/work/care advice
• equipment, carers or community support if needed

Hospital transport

NHS non-emergency patient transport may be available where a medical condition means someone would struggle to safely attend treatment independently. It is not normally for convenience or lack of ordinary transport.

Ask the hospital, clinic, GP, or local NHS booking service:

• am I eligible for patient transport?
• can a parent/carer travel with me?
• do I need wheelchair access?
• can transport support oxygen, mobility aids, autism, learning disability, anxiety, or sensory needs?
• what happens if appointments are delayed?

Accessible support and reasonable adjustments

You can ask NHS services for reasonable adjustments, including:

• Easy Read letters
• large print, Braille or audio
• BSL interpreter
• language interpreter
• quiet waiting area
• longer appointment
• wheelchair access
• support for autism, ADHD, learning disability or sensory needs
• parent/carer involvement
• communication passport or hospital passport

Put requests in writing and ask for them to be recorded on your file.

Accountability and complaints

Start locally:

1. Speak to the ward, clinic, consultant secretary, GP or service manager.
2. Contact PALS for informal help.
3. Make a formal complaint to the NHS trust or provider.
4. Escalate unresolved complaints to the Parliamentary and Health Service Ombudsman.

Useful evidence includes appointment letters, referral dates, discharge summaries, medication lists, photos, symptom diaries, school records, emails, call logs and names of staff spoken to.

Official links

• NHS hospital services: https://www.nhs.uk/nhs-services/hospitals/
• NHS waiting times: https://www.nhs.uk/nhs-services/hospitals/guide-to-nhs-waiting-times-in-england/
• NHS Constitution: https://www.gov.uk/government/publications/the-nhs-constitution-for-england
• NHS patient choice guidance: https://www.england.nhs.uk/long-read/patient-choice-guidance/
• Hospital discharge: https://www.nhs.uk/nhs-services/hospitals/going-into-hospital/being-discharged-from-hospital/
• Patient transport: https://www.england.nhs.uk/urgent-emergency-care/improving-ambulance-services/nepts-review/

Best practical advice: keep records, ask questions early, request adjustments in writing, chase referrals politely, escalate safety concerns quickly, and use PALS when communication breaks down.