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NHS patients' rights

This information applies to Scotland

Right to a GP

People who are ordinarily resident in the UK, including people from other EEA countries and abroad, have the right to be registered with a General Practitioner (GP) if you live within the GP's catchment area. You can choose which GP you want to be registered with. The GP does not have to accept you. However, if they do refuse to accept you, they must have reasonable grounds for doing so, and must give you their reasons in writing – see under heading Registering with a GP.

For more information on NHS treatment for people from abroad, see NHS charges for people from abroad.

There is also a NHS fact sheet about Healthcare in Scotland for holidaymakers from overseas on the NHS inform website at www.nhsinform.co.uk.

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Choosing a GP

You can obtain a list of local GPs from your NHS Board. A list of NHS Boards can be found on the Scottish Government website at www.scotland.gov.uk. The list will contain the following information about each GP:

  • surgery address and telephone number
  • gender of the GP
  • languages spoken by the GP, if the GP agrees this should be included
  • particular health interests, if the GP agrees this should be included
  • whether the GP does minor surgery
  • whether the GP offers contraceptive and/or maternity services
  • what the GP’s out of hours arrangements are.

The list may also contain information on whether any alternative therapies are available within the practice. It may also give details of surgery hours, whether there is an appointment system and whether there are any special clinics run at the surgery.

You can also find details of GPs in Scotland from the NHS24 website at www.nhs24.com.

GP practice charters

Some GP practices have established their own practice charters which describe the standards of services a patient can expect and the arrangements for certain services, for example, repeat prescriptions. A practice charter may be displayed in the surgery premises. There is a useful leaflet produced by the Scottish Government called 'It's okay to ask' which contains a number of tips and questions that a patient can ask during a health care appointment. It can be found on the NHS inform website at www.nhsinform.com and in hospitals and GP surgeries.

If you are unable to find a GP

If you have been unable to find a GP yourself, you can ask your NHS Board to find you a GP. You could also contact the Practitioner Services Department of the NHS National Services Scotland at www.psd.scot.nhs.uk which must help you find a GP.

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Registering with a GP

You should take your medical card to the GP’s surgery in order to register with the GP of your choice. A GP may wish to see you before agreeing to register you. The GP will forward the medical card to the local NHS Board, who will send you a new medical card.

Children under 16 should be registered by their parent(s), but do not have to register with the same GP as the rest of their family.

If you are staying somewhere in the UK for less than three months, you can ask to be registered with a GP on a temporary basis. You can also register temporarily if you move around the country and have no permanent address.

NHS numbers and NHS medical cards

NHS numbers help staff across the NHS get up-to-date information on patients' health. However, if you do not have an NHS number, you can still get NHS treatment.

A hospital should give your baby an NHS number shortly after birth. If the baby was not born in hospital, a number will be given once the hospital has been told about the birth. If your baby was born abroad and does not have an NHS number, you can get one by registering with a GP.

To get a medical card for your baby, you may need to give their NHS number to a chosen GP. However, procedures for getting medical cards vary from area to area. If in doubt, you should ask your GP. If you do not have a medical card, or have lost it, you should contact your local NHS Board, giving your name, address and date of birth, and the name and address of your previous GP. If possible, you should also give your NHS number.

You can register with a GP without a medical card by completing a form supplied by the GP. The NHS Board will then send you a new medical card.

Problems with registering

Unless the GP’s register is full, or you live too far away for home visits, it is unlikely that the GP will refuse to register you.

However, if the GP does refuse to accept you, then they must have reasonable grounds for doing so. These must not have anything to do with race, gender, social class, age, religion, sexual orientation, appearance, disability or medical condition. The GP must give you the reasons for their decision in writing.

If you have been unable to register with a GP, you should contact the local NHS Board. You should send your medical card, with a letter giving the name of any GPs who have refused to register you, and of any GPs with whom you would prefer not to be registered.

The NHS Board will try to find a GP who is prepared to accept you. This will not necessarily be a GP of your choice. Once you have been allocated a GP, the GP must accept you and treat you, and can only remove you from their list under certain circumstances (see under heading GP removes patient from register). The NHS Board will then have to find you another doctor. The NHS Board cannot help you find another GP if you are already registered with a GP.

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Treatment from a GP

You are entitled to treatment from a GP at the surgery where you are registered. When you contact your GP surgery, you must be given access to a GP, nurse or other health professional within 48 hours if that is what you need. If this doesn’t happen you can make a complaint. You have no automatic right, however, to see your own GP.

A GP must provide any treatment which is immediately necessary in an emergency, even if you are not registered with them.

Treatment outside surgery hours

All GPs must make sure that a service is provided for their patients when they are off duty. This service could be provided by, for example, other partners in a group practice, a rota between GPs, a commercial deputising service (a locum), or a telephone number which patients can use out of hours.

NHS Boards are responsible for ensuring that the standard of care provided by commercial deputising services is satisfactory. If you are unhappy about the standards of treatment you have received, the first step is to report your concerns to your GP.

For more information about making a complaint about the NHS, see NHS complaints.

Home visits

You cannot insist that a GP visits you at home. A GP will only visit you at home if they think that your medical condition requires it. A GP can also decide how urgently a visit is needed.

If you were to become seriously ill after a GP had refused a home visit, the GP could be found to be in breach of their contract with the NHS, or could be found to have been negligent. You may therefore wish to make a complaint.

For information on making a complaint about a GP in Scotland, see NHS complaints.

You can be visited at home by a community nurse if you are referred by your GP or by a hospital consultant. If you are not an urgent patient, you can make an appointment and should be visited on the day arranged.

You should also be visited at home by a health visitor if you have recently had a baby or if you are newly registered with a GP and have a child under five years.

Medication

If a GP decides you need medication, they will usually give you a prescription. In some cases the GP may provide the medication themselves, for example, if the surgery is in an isolated area.

A GP must supply any drugs needed for immediate treatment in an emergency.

Alternative therapies

Some GPs are qualified in alternative therapies and may offer these as part of their NHS treatment. In some areas GPs may be able to refer a client to alternative practitioners, but this will not always be available.

Second opinions

You can ask your GP to arrange a second opinion either from a specialist or another GP. However, the GP does not have to do this if they do not think it necessary. You have no right to a second opinion.

You do have the right to see a GP competent to deal with your particular case. If a GP refers you for a second opinion, you cannot insist on seeing a particular practitioner. However, you should not be referred to someone you do not wish to see.

If the GP refuses to arrange a second opinion, you may wish to change your GP (see under the heading Changing a GP).

If a GP is unsure about a diagnosis, they could be found negligent if they failed to refer you to a specialist and you suffered as a result of this. If you have not been referred for a second opinion and have suffered as a consequence, you may wish to complain.

For information on making a complaint in Scotland, see NHS complaints.

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GP charges

There is no charge for basic GP treatment for NHS patients who live in the UK. There are charges for visitors from overseas, except in the case of an emergency. There may also be charges for certain services, for example, check-ups for employees and vaccinations for travelling abroad.

For more information, see Help with health costs and Scottish Government guide on help with health costs.

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Changing a GP

You can change your GP at any time you wish without having to give a reason. If you tell the NHS Board that you want to change your GP, they must give you details of how to do so and provide you with a list of alternative GPs.

You do not need the consent of your GP to change GPs. When you have found another GP willing to accept you, you should take your medical card to the new GP to be registered (see under the heading Registering with a GP). You can then make an appointment to see the new GP immediately.

Problems with changing a GP

If you wish to change your GP, but cannot find a new GP who will accept you, you should contact the NHS Board or NHS National Services Scotland, who should find you an alternative (see under the heading Choosing a GP).

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GP removes patient from register

A GP may be able to remove you from the patient register in some situations, for example, because you move out of the practice area or are physically or verbally abusive to people at the practice. In most cases, the GP must have given you a warning, and provided you with the reasons for your removal from the register. The GP will inform the NHS Board who then notifies you. The removal from the register takes effect from the eighth day after the NHS Board receives the GP’s notice, or from the date that you are included on another register if this is sooner. You are entitled to emergency treatment, or the continuation of treatment which is occurring more than once a week, until you are accepted by another GP.

If you have been violent, or have threatened to be violent, towards your GP or practice staff, and the police have been informed, you can be removed immediately from the GP’s list. You will only be accepted for emergency treatment by the GP who has removed you if the GP is satisfied that it is clinically necessary. You will have to apply to the NHS Board to allocate you to another GP.

If you have been removed from a GP's register because of violence you may have difficulty registering with another GP. You may wish to complain if you feel you have been treated unfairly, for example, if you feel discrimination was involved. You may be able to get help to do this from a Citizens Advice Bureau - where to get advice.

For information on making a complaint see NHS complaints.

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If you move out of GP’s area

If you are changing address, but are not moving too far, you may wish to stay with your current GP. You should ask the GP if they are willing to continue treating and visiting you at the new address.

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Complaining about a GP

If you have a problem with your GP, you should first of all use the local resolution procedure to complain to your GP's practice.

For information on making a complaint see NHS complaints.

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NHS 24

In Scotland, advice about NHS services and treatment, as well as personal health advice and support is available from NHS 24 at www.nhs24.com or by phone on 111.

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NHS inform

Health information, including local health information services across Scotland, is available from NHS inform at www.nhsinform.co.uk or by phone on 0800 22 44 88.

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Maternity services

If you are pregnant, you will be able to receive services from one or more of the following:-

  • midwives, based either in a hospital or in a local health centre or clinic. Midwives are responsible for the care of all normal pregnancies and labours. You do not need to be referred to a midwife by your GP
  • a GP. Not all GPs provide ante-natal care and arrange for delivery. If your GP does not provide this service, you may wish to register with another GP for your maternity care. The NHS Board can provide details of GPs who offer maternity care
  • an obstetrician based in a hospital. Generally, an obstetrician will only get involved if there are complications. However, you can request to see an obstetrician, even if the midwife or GP is providing all the care.

You may have a range of options to choose from on the type of ante-natal care you want and where you give birth. How much choice you have will depend on the area in which you live, but could include:-

  • full hospital care. This would only happen, in practice, if you require a high degree of medical intervention
  • shared care between a GP and hospital staff. Some areas offer a domino midwife scheme, where you are visited at home by a midwife who accompanies you to hospital and delivers the baby there, either with or without the hospital midwife’s help. Normally, you would return home shortly after the birth
  • A short delivery system, where the baby is delivered by a core midwife in the hospital and then discharged to the care of the community midwife within six hours
  • a home birth, with the birth attended by, and ante-natal care provided by, a midwife and possibly a GP. You have the right to have your baby at home and may need to contact the supervisor of midwives to arrange for this. Alternatively, you could register with an alternative GP just for your maternity care.

Information on local maternity services can be obtained from your NHS Board, a community midwife, a health visitor or GP. This information will include, for example, the type of care offered, where the birth can take place, what pain relief is offered and what tests are available and what they are for. In some areas, there are maternity charters which set out the rights of pregnant women and new mothers, and the standards of service you can expect.

If you are having difficulty obtaining the type of care you want, or you require more information on how maternity services are organised in your area, you should contact the supervisor of midwives at your local maternity hospital or at the NHS Board.

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Right to hospital treatment

You cannot receive NHS hospital treatment without being referred by your GP, unless you are attending a special clinic, for example, for the treatment of sexually transmitted diseases, or you need urgent medical attention in an emergency.

Violent patients

If you are violent and/or abusive to NHS staff, you may be refused NHS hospital treatment, or given a verbal or written warning before treatment is withheld or withdrawn. Violent or abusive behaviour could include verbal abuse, threats, violence, drug or alcohol abuse in hospital, and destruction of property. Each NHS Board can decide which types of behaviour could lead to treatment being withheld or withdrawn and how such policies are implemented. However, treatment cannot be withdrawn for more than twelve months. If you are violent and/or abusive to NHS staff and have severe mental health problems or are suffering life-threatening conditions, you will not be denied treatment.

It is an offence to assault, hinder or obstruct an emergency worker (for example, a paramedic, doctor or nurse) while they are carrying out their duties. The penalty is a fine of up to £10,000 or imprisonment of up to 12 months.

Emergencies

If you need urgent medical attention, you can go directly to the accident and emergency department of a hospital without needing a referral from your GP. Not all hospitals have accident and emergency departments. Some hospitals have minor injuries units instead, where you can attend without a GP referral.

It is the responsibility of the hospital providing the emergency treatment to meet the cost of treatment. If emergency admission as an in-patient is needed, the cost will be met by the health authority where you live.

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Treatment which may not be available on the NHS

Access to some forms of treatment, for example, in-vitro fertilisation (IVF), may be subject to the priorities of your NHS Board. Some treatment may not be provided in your area. Access to some treatment may depend on your need. You can get details of those services not provided, and any prioritising criteria, from the NHS Board.

Discrimination

Health care providers must not discriminate against you because of race, sex, disability, religion or belief or sexuality when they decide what treatment to give you as a patient. It is not against the law for them to discriminate against you because of your age. For more information about discrimination, see under heading Discrimination.

An NHS clinic has refused to offer fertility services to us, because we are a lesbian couple. Can they do this?

No, they can't. If they are refusing to treat you just because you are a lesbian couple when the treatment would be offered to a straight couple, this is sexuality discrimination and it's against the law. You will need to get expert advice about how to take this further.

However, if they don't offer fertility treatment to any couples, regardless of their sexuality, you won't be able to complain about sexuality discrimination.

Licensing of new medicines

When a new medicine (or drug) is developed, it must be licensed before it can be made available for use in the UK. The Scottish Medicines Consortium (SMC) approves certain licensed medicines for general use by the NHS in Scotland.

Treatment for end of life or rare conditions

A patient may want to ask for treatment with a licensed medicine not approved for use by the NHS in Scotland, for example for an ‘end of life’ or rare condition. The Scottish Government recommends that a patient discusses treatment options with their clinician. The Scottish Medicines Consortium (SMC) uses Patient and Clinician Engagement (PACE) groups to gather detailed information for discussion on the benefits of a medicine, including how it can impact the quality of a patient’s life. There is a factsheet about PACE on the SMC website at www.scottishmedicines.org.uk.

Paying for treatment not available on the NHS – 'top-up' payments

There are some treatments used for certain illnesses, for example, cancer, which are very expensive and are not available on the NHS. You can choose to pay for these treatments yourself without this affecting your other NHS care. This means that NHS care should not be withdrawn if you buy additional care privately.

Any private care should be provided separately from the NHS care.

There is guidance about getting private and NHS care at the same time on the Scottish Government website at www.scotland.gov.uk.

Complaining that treatment is not available on the NHS

If you are unhappy because a certain form of treatment is not available on the NHS, you can complain. There is a special process to request 'end of life' medicines and medicines to treat very rare conditions.

For information on making a complaint see NHS complaints.

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Seeing a consultant

You have no right to see a consultant or a particular doctor, although this can be requested. Your GP cannot insist that you see a particular consultant or doctor. You do have the right to see a doctor competent to deal with your case.

If you have special reasons for seeing a particular consultant, for example, if your child is the consultant’s patient, you could ask for an appointment, explaining your reasons for wanting to see them. If you still have difficulty in seeing the consultant, you could write to the hospital administrator asking for their help.

You may wish to get a second opinion after seeing a consultant, either as an out-patient or an in-patient. You will need to request this from the consultant, who may arrange for you to see someone else. If the consultant does not agree, you could ask your GP to help.

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Hospital waiting lists

You may be unable to receive the hospital treatment you need immediately, and may have to go on a waiting list. There are maximum waiting times for in-patient treatment under the NHS plans. If necessary, treatment may be arranged in an alternative hospital to meet this guarantee.

There are also waiting time standards for a first appointment as an out-patient.

Waiting lists do not operate on a ‘last come, last served’ basis. Where you are on a waiting list depends on a range of circumstances and may change. If your condition deteriorates dramatically, your GP may recommend you be seen as a matter of greater urgency. How long you will have to wait for a date to see a specialist or have an operation, will therefore depend on the severity of your condition, how busy the specialist is and other demands on the hospital facilities.

You can telephone a freephone NHS helpline for information about waiting lists, the NHS waiting times information line on 0800 028 2836 (Monday to Friday from 8.00 am to 10.00 pm). GPs also have access to a national waiting times database. The Scottish Government Health Directorate and NHS Boards can also provide information about local waiting lists.

More information about waiting times is contained in the NHS fact sheet called Hospital waiting times which is available on the NHS inform website at www.nhsinform.co.uk.

If you have been waiting longer than the Scottish Government’s target you can complain.

For information on making a complaint, see NHS complaints.

If you are waiting to be admitted to hospital, you should contact the hospital appointments’ department or the consultant on a regular basis, reminding the hospital staff that you are still waiting. If you are prepared to go into hospital at short notice you should say so, in case a cancellation occurs. You should also keep your GP informed of your condition, particularly if it deteriorates.

If you are on a hospital waiting list and fail to turn up for an appointment or admission, you may be put back to the bottom of the waiting list. If you aren’t available for a period of time for a good reason, for example, work commitments, illness or a pre-arranged holiday, you should let the hospital know and your position on the waiting list will be paused until you become available again.

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Care in hospital

Waiting times

If you go into an accident and emergency department, you should be assessed immediately. You should not wait more than four hours before being admitted to a ward, sent home or transferred to another hospital.

If you have to wait for a longer period than that set out in the NHS plan, you may wish to complain.

For information on making a complaint, see NHS complaints.

Visits

Most hospitals have visiting hours during which visits to patients can be made. A person has no automatic right to visit you, and your doctor may decide that visits would be detrimental to your health. There is usually also a limit to the number of people who can visit at any one time. The restrictions on visits from children are the same as those for other visitors.

If someone wishes to visit you outside visiting hours, they should discuss this with the ward sister. If they cannot get permission from the ward sister, they should contact the hospital administrator if they wish to pursue the matter.

Financial help with visits

If you're getting Income Support, income-based Jobseeker’s Allowance, income-related Employment and Support Allowance or Pension Credit, you may be able to get help from the Social Fund for travel costs to visit a sick relative.

For more information, see Help for people on a low income – the Social Fund.

Children

There may be a number of issues which you may wish to consider if your child is to go into hospital, for example, whether you can stay with your child, how much help you can give with feeding and looking after your child and what will happen to your child’s education. Action for Sick Children may be able to advise on all these issues. It also produces a leaflet for parents whose child is going into hospital for the first time. The address is:-

Action for Sick Children (Scotland)
22 Laurie Street
Edinburgh
EH6 5AB

Tel: 0131 553 6553
Website: www.ascscotland.org.uk

A child should usually be admitted to a children’s ward under the supervision of a consultant paediatrician. If your child is in an adult ward, you may wish to complain.

For information on making a complaint, see NHS complaints.

The Scottish Government Health Department has strongly recommended to hospitals that they allow unrestricted visiting on children’s wards. Hospitals should also allow parents to be with their children as much as possible. This could include allowing you to stay overnight at the hospital. You should make enquiries before your child goes into hospital about what arrangements can be made.

If you are finding it difficult to visit a child in hospital, for example, if you have other children at home, you may wish to discuss this with the medical social worker at the hospital.

Single sex wards

You do not have the right to be cared for in a single sex ward. However, you do have the right to be informed before you go into hospital (unless it is an emergency or you are admitted to an intensive care unit) whether you will be in a mixed ward. You should have your privacy and dignity protected when in hospital with private washing areas and screens available where appropriate.

If you wish to be cared for in a single sex ward, you may have to delay your admission to hospital if this is not available immediately.

Patients who die in hospital

If a patient dies in hospital, NHS staff should inform relatives and the patient’s GP as soon as possible, and advise the relatives of the arrangements that need to be made.

An NHS Board may be responsible for the funeral arrangements if there are no relatives or the relatives are unable to afford the cost and do not qualify for a funeral payment from the social fund.

For information about funeral payments, see Help for people on a low income – the Social Fund.

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Using mobile phones in NHS hospitals

You should be allowed to use your mobile phone in hospital as long it does not interfere with medical equipment or cause a nuisance to patients. You will generally not be allowed to use your phone in ward areas.

You can ask to see the hospital's written policy on the use of mobile phones and there should be signs up in all hospital areas which state whether you can use a mobile phone. You can see a copy of NHS guidelines on using mobile phones on the Health Facilities Scotland website at www.hfs.scot.nhs.uk.

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Hospital charges

There is no charge for most hospital treatment for NHS patients who live in the United Kingdom. However, there can be charges for the emergency examination and treatment of people involved in road accidents. There are also charges for certain services, for example, beds with more privacy and alternative menus.

For information about charges for people involved in road accidents, see Traffic accidents.

There are charges for visitors from overseas, except in the case of most emergencies.

For information about charges for overseas visitors, see NHS charges for people from abroad.

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Financial help for hospital patients

If you're getting certain social security benefits, your entitlement may be affected if you go into hospital.

If you are concerned about the effect of hospitalisation on benefits, you should consult an experienced adviser, for example, at a Citizens Advice Bureau - where to get advice.

If you are on a low income, you may be able to get help with travel costs to hospital and with the cost of prescriptions, wigs and fabric supports.

For more information about help with NHS costs, see Help with health costs.

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Transport for patients

If you have medical needs that mean you need help with transport to and from a hospital appointment or when you are being admitted to, or discharged from, hospital, you may be able to get help from the Patient Transport Service. The service is run by the Scottish Ambulance Service and you can find more on its website at www.scottishambulance.com.

If you don’t qualify for help from the Patient Transport Service, there may be a local scheme that you can apply to. Your GP or NHS Board should be able to give you more information about this.

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Discharge from hospital

You should not be discharged from hospital until your care needs are assessed and arrangements made to ensure that you will receive any necessary services when you are discharged.

Any assessment should take into account your wishes, the wishes of your family and of any carer. You should be kept fully informed and involved, be given sufficient time to make decisions, and be told how to seek a review of any decisions made. You can ask for a reassessment of your needs if circumstances change in the future.

Unsatisfactory arrangements before or after discharge

You may not be satisfied with arrangements for your discharge from hospital because, for example:

  • you feel that you need to remain in hospital for further in-patient treatment
  • you are not satisfied with the community care services that have been arranged for you when you are to leave hospital
  • you do not want to be sent to a care home.

Before discharge takes place, you, or your family, carer or representative, have the right to ask for a review of the decision which has been made about your eligibility for continuing NHS care.

If you are not satisfied with arrangements that have been made for you after you have been discharged, you can complain. If you are not satisfied with any medical services you are receiving from the NHS, you should use the NHS complaints procedure. If you are not satisfied with community care services which have been arranged or provided by the local authority, you should complain to the local authority using its complaints procedure.

If you are unhappy with your discharge from hospital or with the arrangements made for you after discharge, you should consult an experienced adviser, for example, at a Citizens Advice Bureau - where to get advice.

For information on making a complaint, see NHS complaints.

For information about community care, see Community care.

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Examination and treatment

You should not be examined or given any treatment or operation without your consent, unless:-

  • you have a notifiable disease that must, by law, be reported to the public health authority, or are a carrier of a notifiable disease
  • you have been detained under mental health legislation and may lack capacity to give consent
  • you lack capacity to provide consent because of an impairment caused by dementia, brain damage or intoxication through drink or drugs
  • your life is in danger, you are unconscious and you cannot indicate your wishes
  • a court or someone who has parental responsibility authorises treatment. A person whose treatment is authorised by a court must be given an opportunity to defend their case against treatment in court.

In some cases, it is good practice to ask you, the patient, to sign a consent form, but in other cases consent can be obtained orally. For example, it is good practice to obtain written consent for any procedure or treatment carrying substantial risk or side effects. If you are capable, it is good practice for the medical staff to obtain written consent for general anaesthesia, surgery and certain forms of drug therapy. Oral or written consent should be recorded in your notes with relevant details of health professionals’ explanations. If you are concerned about a specific type of treatment the doctor is obliged to describe other forms of treatment that are available.

When there is doubt about your capacity to provide consent an assessment has to be made by a health professional.

Even if you sign a consent form, the signature may not be a valid form of consent if you have not been given appropriate information to be able to give informed consent. Similarly, consent for one procedure does not imply consent for a further procedure or form of treatment.

The doctor must inform you of the nature, consequences, and any substantial risks involved in the treatment or operation, before you give your consent. It is for the doctor to decide exactly how much to tell you, the patient.

There is a useful NHS fact sheet called Consent – it’s your decision, which is available on the NHS inform website at www.nhsinform.co.uk.

Children

In Scotland, a child under 16 can consent to, or refuse, any treatment if the qualified medical practitioner attending them believes they are capable of understanding the nature and possible consequences of the treatment. Parental consent should be obtained where a child under 16 does not have sufficient understanding, except in an emergency where there is not time to obtain it. If the local authority holds parental responsibility for a child under 16, consent from a parent or guardian does not need to be sought.

There is a useful NHS fact sheet for children and young people under 16 called Consent – your rights. It is available on the NHS inform website at www.nhsinform.co.uk.

Experiments, medical research and teaching

In general, if a doctor wishes to carry out research on you, your consent has to be given. However, if a child under 16 is not competent to decide, a parent or court can consent to research on their behalf.

You should be given a full explanation of the procedures and risks involved. It should also be made clear to the patient that you can withdraw from the research at any time. Appropriate safeguards should always be in place to protect patient confidentiality.

You have the right to refuse to participate in teaching without your treatment being affected. If you do not want to be involved in teaching, it is advisable to inform the hospital in advance.

There is a useful NHS fact sheet called Consent – it’s your decision, which is available on the NHS inform website at www.nhsinform.co.uk.

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Right to refuse treatment

You can refuse any treatment if you wish (but see under heading Consent). Even if you are in the middle of a course of treatment that you provided consent for you can ask for the treatment to be stopped.

When you visit a doctor, this usually implies consent to examination and treatment. The doctor cannot act against specific instructions. You should tell the doctor about any treatment you do not want.

If there are a number of alternative treatments which can be used to treat your condition, you should be given information on these. However, you cannot insist on a particular treatment if the doctor or consultant thinks this is not appropriate.

Forcing treatment on you against your will is assault. If you are assaulted, you should contact your NHS Board to make a complaint. You may also wish to involve the police.

For information on making a complaint, see NHS complaints.

You refuse treatment for your child

If you, as a person with parental responsibilities or guardian of a child refuse to give consent for treatment which a doctor thinks is necessary, the action the doctor takes will depend on how urgently the treatment is needed.

When a child’s life is in danger, the doctor has the right to do whatever is needed to save the child’s life. However, the doctor may need to obtain a court order if you refuse to give consent for your child to be treated. If you or a guardian either fail to provide medical help for a child, or unreasonably refuse to allow treatment, you can be prosecuted for neglect.

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Right to die

The law concerning whether a person has the right to die is unclear. You have a right to refuse or stop treatment at any time, even if this means that you may die. However, it is illegal for a doctor to omit or carry out treatment with the specific intention of inducing or hastening death. If you believe you may become so ill that you could no longer make the decision about treatment, you should tell the doctor beforehand at what stage you would want treatment to stop.

You may wish to draw up a written document setting out what you would want to happen if you became too ill to give consent to medical treatment. Requests for specific treatments are called living wills and advance refusals of treatment are called advance directives, although these terms are often used interchangeably. An advance directive refusing treatment is legally binding on health care professionals.

In Scotland, you can get more information about advance directives from EXIT at www.euthanasia.cc.

If you are thinking of making an advance decision you should consult an experienced adviser, for example, a solicitor or an adviser at a Citizens Advice Bureau - where to get advice.

If you are concerned about being treated against your wishes, you should ensure you make this clear at the time the treatment is proposed.

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Removal of organs after death

Adults and children over 12 can authorise in advance for their organs to be used for transplant or medical research after their death by carrying an organ donor card or registering on the NHS organ donor register, which you can access on the UK transplant website at www.uktransplant.org.uk.

If you don’t give any indication of your wishes, whoever is legally responsible for the body can allow organs to be donated. This will usually be your nearest relative. Before organs can be removed from the body, medical staff must be certain that brain death has taken place, and a death certificate must be issued.

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Access to medical reports and health records

You have the right to see most health records held about you, subject to certain safeguards. You are entitled to be informed of the uses of the information, who has access to them and how you can arrange to see your records.

You have a right, subject to certain safeguards, to see any medical report written for an employer, prospective employer or insurer, by a medical practitioner who has responsibility for your ongoing care, for example, your GP or consultant and any medical practitioner who has treated you in the past.

There is a useful NHS fact sheet called How to see your health records, which is available on the NHS inform website at www.nhsinform.co.uk.

Information about your medical history should be kept confidential, and should not be released to people who are not involved in your medical care without your consent. This includes your relatives, unless you are unable to give consent yourself. There are some exceptions to this rule.  For example, medical information about you may be disclosed if it would prevent serious harm to others.

There is a useful NHS fact sheet called Confidentiality - your rights, which is available on the NHS inform website at www.nhsinform.co.uk.

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Getting information from your health care provider

You have a right to ask for and receive information from a Scottish public health authority, including NHS boards, hospitals, GP’s, dentists, opticians, pharmacists and other health professionals. You might, for example, want to access information about services, decision making processes, the use of public funds and service standards. In most cases, the health authority must provide you with the information within 20 working days.

Health care providers such as doctors, nurses and other practitioners must try to make sure that things are explained to you in a way you understand. If they don't do this, it could be argued, for example, that you have not given proper consent to treatment – see under heading Consent.

If it's difficult for you to communicate for any reason, for example because you don't speak English or you have a disability which affects your communication, they should take steps to present the information in a way you will understand. This could mean, for example, providing a language interpreter or a sign language interpreter.

In some circumstances, if a health care provider doesn't take steps to communicate with you properly, you can complain that they have discriminated against you. It might be race discrimination if you can't understand what they are telling you because English isn't your first language. Or it might be disability discrimination if you can't understand what they are telling you because you have a disability, for example, if you're deaf.

If you need to talk about something of a personal medical nature which affects only women or men and you need an interpreter, you can complain about sex discrimination if the interpreter is not the same sex as you.

The Health in my language website at www.healthinmylanguage.com provides information about health and health-related services in Scotland, translated into a range of languages.

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Further information about the NHS

Health advice and support is available from NHS 24. There is also information for patients, carers and the public on NHS inform.

The Scottish Government’s plan and targets for the NHS in Scotland are contained in the Better Health, Better Care: Action Plan, which is published on the Scottish Government’s website at www.scotland.gov.uk. You can find a summary of the plan and the key targets in a leaflet called Better Health, Better Care: What it means for you, which is also available on the Scottish Government website at www.scotland.gov.uk.

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The Patient Advice and Support Service (PASS)

The Patient Advice and Support Service (PASS) is an independent service which provides free, accessible and confidential advice and support to patients, their carers and families about NHS healthcare. The service is provided by the Scottish CAB Service and you can access it from any Citizens Advice Bureau in Scotland. PASS promotes an awareness and understanding of the rights and responsibilities of patients and advises and supports people who wish to give feedback, make comments, raise concerns or make a complaint about treatment and care provided by the NHS in Scotland.

The Service:

  • helps you understand your rights and responsibilities as a patient
  • provides information, advice and support for anyone who wishes to give feedback or comments, or raise concerns or complaints, about health care delivered by NHS Scotland
  • provides practical help with making a complaint, including writing letters, making phone calls and supporting you in preparing for and attending meetings
  • works with the NHS by using feedback to improve your healthcare and NHS service provision.

You can find more information about PASS on the Citizens Advice Scotland website at www.cas.org.uk.

You can also get help from a Citizens Advice Bureau - where to get advice.

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Discrimination

Organisations and people providing health services are not allowed to discriminate against you for example, because of your race, sex, disability, religion or belief, or sexuality. Your NHS Board might also have an equality policy which says it will not discriminate against you for other reasons, for example, if you have HIV.

If you're disabled, a health service provider must make 'reasonable adjustments' to allow you to use their services. If they don't do this, they must be able to show that their failure to do so is justified, otherwise they will be discriminating against you. Examples of making reasonable adjustments include providing information on audiotape as well as in writing, or installing a ramp to allow wheelchair access.

I have hearing difficulties and it is embarrassing when I go to the dentist – I can never hear them when the receptionist calls out my name.

You could ask your dental surgery to keep a record of all their patients with hearing difficulties. Receptionists can then come over and let you know when the dentist is ready to see you, rather than calling out your name. The surgery should agree to this. If they don't agree and they don't have a very good reason, they are probably discriminating against you and you should make a complaint.

If you think that a doctor, dentist, nurse or other health care professional is discriminating against you, you can complain about this. Ask to see a copy of the equality policy of the organisation they work for and point out where they are failing to keep to it.

For information on making a complaint in Scotland, see NHS complaints.

For more information about discrimination see our discrimination pages.

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NHS services for the armed forces, family and veterans

The government has set out the entitlement to healthcare services that the armed forces, family and veterans can expect as part of the armed forces covenant. The armed forces covenant is available on the GOV.UK website at www.gov.uk. The NHS should give priority, based on clinical need, to all veterans whose injuries or ill-health, including mental health, result from their service even when the symptoms are not apparent for some time after leaving service.

For more information see healthcare for people injured in the armed forces and veterans.

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Citizens Advice

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