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Overview

GPs
GPs

General Practitioners (GPs) are among a group of health professionals who offer a first line of contact between patients and the NHS. Usually, a small group of GPs work together in a practice, often referred to as a surgery, clinic or health centre. Only a small number of GPs now work by themselves in a single-handed practice. 

GPs provide consultations in surgeries and through home visits.  Most GPs are not NHS staff. They are independent contractors to the NHS and provide their own premises and employ their own staff.

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Definition

GPs are often thought of as community doctors. This is because they provide access to a wide range of physical, psychological and social services in the local area. They work alongside other health professionals to provide preventative healthcare and treat patients, as well as advising them about self-help and healthy living.

GPs may also be involved in the healthcare of their patients outside the surgery, for example, in hospitals or emergency centres. They have to be knowledgeable about a large number of medical conditions to be able to assess many different problems and provide the best course of treatment or referral. Many GPs receive further training, leading to a specialist qualification such as in Primary Care (MRCGP).

GPs have to be highly organised and able to consult with other healthcare professionals, as well as patients and their families.

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Service Description

Registering with a GP

Contact the GP practice and ask to register with them. They will ask you to complete a GMS1 registration giving details such as:

  • your name and address
  • your date of birth
  • your NHS number (if you know it)
  • other information, such as the name and address of your previous GP.

Some GP practices will also ask to see proof of your identity, for example:

  • photo identity, such as your passport or driving licence
  • proof of your address, such as a recent utility bill (gas, electricity, water or phone bill, but not a mobile phone bill) or council tax bill

The GP practice will send the GMS1 to the local Shared Services Partnership office, who will write to you confirming that you’re registered with the GP practice. Your medical records will be transferred to the new practice.

Can I register with a specific GP?

You will be registered with the GP practice, rather than an individual GP.

If you prefer to see a specific GP, the practice can note this in your records. However, you may have to:

  • wait longer to see your preferred GP or
  • see someone else if your preferred GP is unavailable

What if the practice doesn’t accept me?

Sometimes, you may not be able to register with a GP practice, for example, if:

  • you live outside the area that the practice covers
  • the practice is not accepting new patients

You will need to register with another GP practice in your area instead.

If you have difficulty registering with a GP you can contact your local Shared Services Partnership office and ask for 'Contractor Services' or alternatively contact NHS 111 Wales (if available in your area) or 0845 46 47.

NHS medical cards

The GP practice may also ask you for your NHS medical card or your NHS number. However, you don’t need either of these to register with a GP or to get NHS treatment.

When you register with a GP, the Shared Services Partnership office may send you a new NHS medical card. However, not all  Shared Services Partnership offices issue medical cards and some will only do so on request.

Health checks

When you register with a new GP practice, you’ll be invited to make an appointment for a health check within six months.

Health checks are usually done by the practice nurse, who will ask you about your personal and family medical history. They will also ensure that any tests or checks you need are up to date, such as measuring your blood pressure or arranging cervical screening.

Services

Your local GP practice provides a wide range of family health services, including:

  • advice on health problems
  • vaccinations
  • examinations and treatment
  • prescriptions for medicines
  • referrals to other health services and social services

GPs may also provide patients with contraception advice, sexual health services and maternity care.  All GPs have a contract to provide a 24-hour service, although in Wales all GPs have opted to have their out of hours services provided and managed by the Local Health Board. If you require a GP after surgery hours you should telephone your surgery and listen to the recorded message which should direct you to the out of hours service covering your practice.

Visiting your GP

When visiting your GP, it’s a good idea to come prepared with as much information as possible. This will help your GP diagnose your condition as quickly and as accurately as possible. To help your GP pinpoint anything that may be triggering your condition, it might be useful to keep a record of your symptoms.

Some patients feel overwhelmed and anxious about visiting their GP, particularly if they haven’t been before or are visiting for the first time in several years. However, GPs are used to nervous patients and will be happy to answer any questions you may have.

If you find visiting your GP stressful, you may want to write down any questions you have before your visit. You may also want to take notes or record the conversation with your GP so that you can listen to it later in the comfort of your home. It is a good idea to talk to your GP about this before your appointment. If you would like further support, you may wish to take a friend or relative to the consultation with you. For further information visit Questions to ask as a Patient for more useful tips and advice.

Referrals

Your GP may decide to refer you if he or she thinks that you would benefit from the advice of a specialist (usually a consultant at a hospital). Your GP will write a letter to the consultant outlining your symptoms. The consultant will then contact you with details about when and where your appointment will be.

Prescriptions

Many GP services are provided free of charge through the NHS. However, you may have to pay for non-essential services, such as travel vaccinations and insurance or driving/medical reports. Since the 1st of April 2007 pharmacies in Wales no longer charge for dispensing your prescription as long as they were written by a GP in Wales. Since the same date, prescription pre-payment certificates have no longer been available for Welsh patients.

Changing your GP practice

Visit the GP practice you want to join and ask to register as a patient with them. You don’t have to explain why you want to change your GP.

Most people change their GP when they move to a new area.

You don’t need to tell your current GP that you’re changing to a different practice or why you want to leave. However, if you do, it may speed up the time it takes for your medical notes to be transferred to the new surgery.

The new GP practice will ask you to complete a GMS1 registration form, which they will then send to your local Shared Services Partnership office.

When registering with a new GP, you may want to ask for an information leaflet about the surgery and its services and policies.

You can register with a GP on a permanent or temporary basis. Temporary patients may include people travelling through the area for three months or longer and students attending university outside their hometown. If you are ill and travelling through the area for three months or less, you can register with a GP as a temporary patient. If you stay for longer than three months, you can permanently register with that GP if they are prepared to take you on.

For more information on GPs see GPs - Frequently Asked Questions

To find a local GP practice see the GPs Local Services Search

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Complaints/Concerns

From April 2011, the way in which NHS organisations in Wales dealt with complaints, claims and incidents (collectively known as concerns) changed.  These new arrangements are now called Putting Things Right and require a different approach to dealing with concerns.  NHS staff have received training to support and encourage the sorting out of problems as they arise and being open if something goes wrong.

For more information on raising a concern see the Welsh Government booklet titled Putting Things Right - Raising a concern about the NHS from April 2011 

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Q&A

How do I get a referral to an NHS specialist?

You are entitled to ask for a referral for specialist treatment on the NHS. You will need to see your GP if you wish to be referred to a specialist in a particular field, such as a surgeon, or a gynaecologist (a specialist in the female reproductive system).

All your medical records are held by your GP who understands your health history and treatments better than anyone. Therefore, your GP can decide whether a specialist referral is necessary and, if so, can recommend what hospitals, or clinics, would be appropriate to visit.

If you ask your GP to refer you to a specialist, it is likely that they will first suggest that you try various tests, or treatment options, to see whether your condition improves. Generally, you cannot self-refer to a specialist within the NHS, except when accessing sexual health clinics or accident or emergency (A&E) treatment.

A specialist will only see you with a letter of referral from your GP. The letter will give the specialist essential background information, such as your medical history, and it will also contain details for the specialist to pay particular attention to.

If you wish to see a private specialist, you are still advised to get a letter of referral from your GP. However, if you see a private specialist without a GP referral, your GP is not obliged to accept the specialist's recommendations.

Can I demand a specific treatment?

Your GP doesn’t have to prescribe a particular medication or treatment for you if they think it’s not the right option. You're entitled to ask for their reasons for the decision.

You're also entitled to make a suggestion and explain to your GP why you believe that a medication or treatment is a good option.

Remember that:

  • some types of treatment aren’t available on the NHS, and
  • you need a referral from your GP to have some types of treatment on the NHS, such as cosmetic surgery.

Second opinion

If you’re not satisfied with your GP’s advice, you may want to consider getting a second opinion. Although you're not legally entitled to a second opinion, a healthcare professional will rarely refuse to refer you.

You may feel happier with a different GP, but be aware that they may give you the same advice.

NICE and NHS medicines and treatments

The National Institute of Health and Clinical Excellence (NICE) regularly looks at new medication and treatments to assess whether they:

  • are safe,
  • are more or less effective than other medication or treatments, and
  • represent value for money, by assessing how well a medication or treatment works in relation to its cost.

NICE will not automatically reject a medication or treatment because it’s expensive. NICE recognises that something can be both expensive and represent good value for money.

The NHS in England and Wales is legally obliged to fund medicines and treatments that NICE recommends. This means that when NICE recommends a medicine or treatment, the NHS must ensure it’s available to those people it could help, normally within three months of the guidance being issued. So, if your doctor thinks a medicine or treatment recommended by NICE is right for you, you should be able to get it on the NHS.

Medicines and treatments not recommended or assessed by NICE

The NHS is not legally obliged to fund a medicine or treatment not recommended by NICE, even if your GP thinks it would benefit you.

In fact, most NHS medicines and treatments have never been looked at by NICE. The Department of Health (DH) only asks NICE to provide guidance when there’s uncertainty over the use of a treatment.

All medicines must be licensed by the Medicines and Healthcare products Regulatory Agency (MHRA). There is no ban on prescribing licensed medicines that NICE has not yet assessed or where a NICE appraisal is in progress.

The DH has issued clear guidance to local organisations, such as Health Boards and NHS Trusts, on what to do when NICE has not issued guidance on a new medicine. In these circumstances, Health Boards are expected to take into account all the evidence available when deciding whether to fund treatments.

Do I need a GP referral for private treatment?

It’s possible to seek private treatment from a consultant or specialist without being referred by your GP. However, the British Medical Association (BMA) believes that, in most cases, it’s best practice for patients to be referred for specialist treatment by their GP.

GP referrals

If you're unwell or have symptoms, you should see your GP first who will decide whether you need treatment. If you do, they will decide whether they can treat you or if you need to be referred to a specialist.
 
If your GP thinks you need specialist treatment and you want to pay for it privately, they can write a letter of referral to a private consultant or specialist explaining your condition and your medical history.

Your GP will only refer you to a specialist if they believe that specialist assessment or treatment is clinically necessary. If they don't think it is necessary, they do not have to refer you.

Private consultations

If you’ve had a private consultation for tests and diagnosis, you can still have treatment on the NHS. Your position on the NHS waiting list should be the same as if your original consultation was on the NHS.

Treatment without a GP referral

If your GP doesn’t think you need specialist treatment, it’s possible for you to seek treatment without a referral. However, the BMA believes that it’s usually best if patients are referred by their GP for specialist treatment.

What if I have private medical insurance?

Insurance companies usually require a letter of referral from a doctor. Some companies will accept GPs’ referrals to consultants, while others have their own lists of consultants.

If you have private medical or health insurance and you need specialist treatment, check your policy to find out:

  • if your policy covers the treatment that you need
  • whether your insurance company accepts consultant referrals from GPs or if it has its own list of consultants
  • when you need to contact your insurance company to tell them that you’ve been referred for treatment

If your insurance company accepts GP referrals, arrange to see your GP as soon as possible.
 
If you make a claim for treatment under your private medical insurance, some sections of the claim form will probably need to be completed by a doctor. In most cases, the doctor who provides your treatment will be the best person to complete the form because they will have the information required.

You can also ask a GP or a NHS hospital doctor if they will complete the form. However, they do not have to do this and if they do complete the form, they’re entitled to charge for this service.

Can I speak to a GP about someone else’s health?

It depends whether you have the person’s consent (permission).

If you have consent

Your friend or relative can give their GP permission, either verbally or in writing, to discuss their health with you. If you have consent, you can speak to your friend or relative’s GP about their health.

If you don’t have consent 

You can raise concerns about your friend or relative’s health with their GP without their consent, but because of patient confidentiality, the GP won’t be able to discuss any details.

A GP can only intervene if a friend or relative needs treatment under the Mental Health Act (1983). This act allows some people with mental health problems to be compulsorily detained in a psychiatric hospital. The NHS Wales website has more information about mental health and the Mental Health Act (1983).
 
However, if you agree, the GP may be willing to tell your friend or relative that you’re concerned about them and may suggest including you in some of the discussions.

You can speak to your own GP about someone else’s health, but they won't be able to discuss a specific case. Although your GP could help you understand how to provide support, it may be quicker and easier to get information elsewhere.

Getting information and advice

If you’re concerned about a friend or relative’s health, there are many ways for you to get information and advice. For example, you can:

  • use the A-Z index to find information about hundreds of different health conditions
  • call NHS 111 Wales (if available in your area) or 0845 46 47  

You could talk to your friend or relative directly if you wish to discuss their condition or treatment. Tell them of your concerns about their health and offer help and support.

Sometimes it can be difficult for someone to see or admit they have a health problem, for example, if they have a drink or drug problem.

Medical records

Under the Data Protection Act (1998) a person’s medical records can be accessed by:

  • the person themselves
  • a parent or guardian for children under 16 - although in some cases the child may be entitled to decide if this information is passed on
  • a friend or relative if they have the person’s written permission
  • a friend or relative if they have power of attorney

Consent to treatment

In English law, no one can give consent to treatment on behalf of another adult. Only the person receiving the treatment can give their permission for it to go ahead.

If a person’s condition means they’re unable to make a decision about their treatment; for example, if they have dementia, the healthcare professionals treating them must act in the person’s best interests.

See the A-Z for more information about consent to treatment.

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The information on this page has been adapted by NHS Wales from original content supplied by NHS UK NHS website nhs.uk
Last Updated: 06/05/2020 12:19:50