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This page covers:

  • Hospital test appointments
  • Hospital results
  • General hospital queries
  • Hospital prescriptions
  • Fit notes (sick notes) after hospital care
  • Chasing hospital correspondence
  • Private providers

HOSPITAL CARE SHORTCUT ivy.gs/hospital-care

Dear Patient

QUERIES REGARDING HOSPITAL CARE

Your GP surgery is not responsible for any aspect of hospital care. This information page provides some general information about various issues around hospital care, which we are frequently presented with, and informs you how to address your concerns or queries directly with the hospital concerned.

WHAT TO EXPECT WHEN YOU ARE REFERRED TO HOSPITAL

NHS England, the British Medical Association and the National Association for Patient Participation have come together to produce an information leaflet for patients, which provides details on what you can expect to happen before, during or after your hospital visit. This leaflet covers some of the topics on this page and you might find it a useful read.

What to expect leaflet

Please be aware that all NHS organisations are as busy as ever, dealing urgent cases as well as prioritising clinical care. We urge all patients awaiting a hospital appointment or a result to be patient and wait to be contacted by the hospital directly. However, if you have a query about any hospital related matter, please contact the hospital directly.

For information regarding expediting your hospital appointment, please see our other information page:

Expediting your appointment

HOSPITAL RESULTS

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The responsibility for providing results of hospital tests, or acting on hospital tests lies with the hospital directly. This is in line with good clinical practice and GMC guidance.

We do not have any special hotline numbers to the hospital and we are not routinely copied in to results of tests carried out by other services, therefore our staff cannot provide you with results of tests organised elsewhere. Furthermore, our admin staff simply do not have the capacity to ring hospital departments and chase results of tests organised by the hospital.

Indeed, due to hospital contract changes from April 2017, hospitals are now obliged to provide you with results of your tests and also to respond to any queries you might have about your care, in very much the same way that we as GPs respond to patients with queries about the care provided by ourselves. Accordingly, hospital matters should not fall to your GP to resolve.

Please contact the secretary of the consultant whom you are under so that you can put your query directly to the responsible doctor.

 

HOSPITAL PRESCRIPTIONS SHORTCUT ivy.gs/hospital-meds

IMPORTANT NOTE ON URGENT MEDICATIONS REQUESTED BY HOSPITAL

There are no circumstances in which a GP must prescribe urgent medications requested by the hospital. Regardless of what you may have been told at hospital, the hospital itself is responsible for supplying any urgent medications they recommend. Failure of the hospital to supply the required urgent medications represents a breach of the hospital contract. More information is available immediately below.

GPs do prescribe medications requested by hospital, but these are on a routine basis and require written instructions that are sent to us in the form of discharge summaries, outpatient prescriptions or clinic letters. As they are routine requests, they are processed in the normal manner and can take anything from 2-5 working days or more.

For the avoidance of doubt, we do not prescribe medications simply on patient say-so - even if the hospital has told you to approach us - for clinical safety reasons, we always need sight of some form of hospital correspondence.

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URGENT/SPECIALIST MEDICATIONS If the hospital needs you to start specialist or urgent/same-day medications, then as part of the hospital contract, it is actually their responsibility to provide that medication for you, whether this is after a face-to-face appointment or a remote assessment. If you require urgent medication as recommended by the hospital, please contact the secretary of the hospital doctor or the hospital department that has made the recommendation.

In situations where you have already left the hospital without your urgent medication, hospitals must still meet their responsibility of supplying it to you. Hospitals have access to electronic means to send a prescription to your chemist (as we do), as well as paper prescription pads, the postal service and even transport to be able to supply you with the urgent medication that they want you to start. Do not accept any disingenuous claims that you would need to make a special journey to the hospital to collect a prescription and that therefore you should see your GP instead.

The following is an extract from the NHS Standard Contract, which hospitals must work to, regarding the supply of urgent medication:

11.10 Where a Service User [patient] has an immediate clinical need for medication to be supplied following outpatient clinic attendance, the Provider [hospital] must itself supply to the Service User an adequate quantity of that medication to last for the period required by local practice, in accordance with any requirements set out in the A, CR, MH NHS Standard Contract 2023/24 21 | Service Conditions (Full Length) Transfer of and Discharge from Care Protocols (but at least sufficient to meet the Service User’s immediate clinical needs until the Service User’s GP receives the relevant Clinic Letter and can prescribe accordingly)


Hospital contract 2023-24

HOSPITAL PHARMACY PRESCRIPTIONS If you are issued with a hospital prescription at your appointment, please take it to the hospital pharmacy to get it dispensed. Many patients present to us because they do not wish to wait at the hospital pharmacy. Please note, we are under no obligation to convert any hospital issued prescription to a GP issued one. If we do so, it will be at our discretion and the timescale will be in line with the non-urgent medication process as described below. For medications that must be urgently started, these must be supplied by the hospital as previously indicated.

NON-URGENT MEDICATIONS Where the hospital wishes us to commence you on non-urgent medication, they will send us an outpatient prescription. These will be processed routinely as per our normal prescription process, which may take anything from 2-5 working days (as indicated on the outpatient prescription itself). These are not urgent and in any case, urgent medications must be supplied by the hospital as described above. Therefore, please do not be offended if the processing of your non-urgent prescription does not meet with your expected timescale.

MEDICATIONS AFTER PRIVATE CONSULTATIONS Please note we are under no obligation to issue medications following a private consultation or convert a privately issued prescription to a GP issued one. Requests will be reviewed on an individual basis and if agreed, will be processed in line with the non-urgent medication process and timescale as described above.

MEDICATIONS IN RELATION TO HOSPITAL PROCEDURES Responsibility for advising on and prescribing medications in relation to hospital procedures or operations lies with the hospital. For instance, the hospital will advise you on stopping blood thinners before an operation, or whether you need a loading dose of antibiotics or blood thinners before a procedure. Responsibility for issuing such medication lies with the hospital, therefore if you have any queries regarding these matters, please contact the hospital.

Download info leaflet
 

FIT NOTES AFTER HOSPITAL CARE SHORTCUT ivy.gs/hospital-med3

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For fit notes (sick notes) following hospital admission, outpatients or operations, please ask your hospital doctor to provide you with one before you leave hospital. Despite what the hospital might say about seeing your GP for a fit note, it is the legal and contractual duty of the hospital doctor treating you to provide a fit note should you require it.

If you have already left hospital without your fit note, please contact the secretary of the consultant whom you were under. It remains a hospital responsibility to issue the first fit note after any hospital attendance. When asking for your fit note please ensure that it is for the correct/required duration - there is no legal requirement for the first note to be only two weeks if your consultant has already advised that your absence from work is going to be a lot longer (see extract from hospital contract below).

Hospitals have access to paper fit note pads, the postal service and electronic means to get your fit note to you.

UPDATE: From November 30, 2023, as part of hospital contract changes, all hospital must have in place facilities to be able to send a fit note to any patient electronically. There is therefore no excuse for the hospital not to be able to issue a fit note for you ahould you require it.

Download info leaflet eMED3 (fit note) in secondary care

The following is an extract from the NHS Standard Contract, which hospitals must work to, regarding the supply of urgent medication:

11.12 Where a Service User [patient] either:

  • 11.12.1 is admitted to hospital under the care of a member of the Provider’s [hospital's] medical Staff; or
  • 11.12.2 is discharged from such care; or
  • 11.12.3 attends an outpatient clinic or accident and emergency service under the care of a member of the Provider’s medical Staff,

the Provider must, where appropriate under and in accordance with Fit Note Guidance, issue free of charge to the Service User or their Carer or Legal Guardian any necessary medical certificate to prove the Service User’s fitness or otherwise to work, covering the period until the date by which it is anticipated that the Service User will have recovered or by which it will be appropriate for a further clinical review to be carried out.

You will notice the contract states the fit note supplied should cover the full period until recovery (or until next review), not for two weeks or other arbitrary time period. If your fit note is not for the correct duration, please contact the hospital.

If you still have difficulty obtaining your fit note from the hospital, please contact the PALS (Patient Advice and Liaison Service) of the hospital concerned and they can assist you (see bottom of page for link).

CHASING HOSPITAL LETTERS

Please note that we have no control over how quickly (or slowly), it takes for the hospital to write to us. Unfortunately we are not in a position to have our already extremely busy admin staff ringing the hospital to chase letters and as indicated above, we have no special hotline to the hospital in order to do this.

We therefore kindly ask that patients ring the hospital secretary to chase up any letters that are not yet with us.

REFERRALS TO A PRIVATE PROVIDER

If the GP was going to refer you to an NHS hospital, but you wish to go private instead, we can supply a referral letter to facilitate this, without charge.

However, if you have decided yourself to see a private provider, but that provider requires a referral letter or form completing to enable this to happen, please note that such work is chargeable, in line with our current fees policy.

If you wish to avoid this fee, you can self-refer to the private provider and we can supply a summary printout of your record free of charge to help you with this, if required.

Fees for non-NHS work

INVESTIGATIONS OR TREATMENT REQUESTED BY A PRIVATE PROVIDER / CONSULTANT

Where a patient is under a private consultant, the responsibility for carrying out tests and prescribing medication lies with the private provider. The following document provides more information.

Download info leaflet

Yours sincerely

Ivy Grove Surgery

STILL HAVING ISSUES WITH HOSPITAL CARE?

If you are not getting anywhere with your query regarding hospital care, please contact the hospital and ask to speak to the Patient Advice and Liaison Service (PALS). They can investigate and escalate matters for you.

Derby PALS

COPYRIGHT NOTICE

This page including all linked content is © 2020- Dr Michael Wong and may not be reproduced without permission. Practices wishing to adapt or use any of our information should get in touch first