Problems with doctors

Regardless of which health care professional you are consulting with you have the right to:

• Be treated with respect and confidentiality
• Have your medical records stored securely
• See your medical records on request. See access to records
• Be seen immediately for treatment in the case of an emergency
• Be fully informed and involved in all aspects of your treatment and care
• Have all treatment options and procedures explained fully to you, including the risks and benefits of each option
• To request a second opinion (though this may not always be granted)
• Refuse to take part in medical research or medical student training
• To nominate any relative or friend you wish to be kept informed about your condition
• To change your doctor or care provider without it affecting your future care
• To make a complaint about your treatment without it affecting your future care

You should not expect

• To experience discrimination of any form
• To be refused access to essential treatment
• To have any breach in patient/doctor confidentiality
• To be refused access to your medical record
• To be subjected to any procedures you do not consent to
• To be subjected to examination by medical students without your permission
• To be given treatment that is inappropriate for you

You may change your GP at anytime. You are not obliged to inform your doctor of your decision to change. If you move outside of the practice area, but wish to remain with your GP, you should ask whether they allow you to remain on their register. If you are staying in another part of the UK, for up to a period of three months, you can ask to be registered with another GP on a temporary basis, as long as you are able to produce your medical card or know your National Health number.

If you want to change your GP, in the first instance you may consider changing to another doctor in the same practice. If you wish to change the practice, in theory this should be simple. You can approach any GP practice of your choice and ask to be registered. However, GPs are under no obligation to accept anyone for registration; some GPs will simply have no room left on their books to register you.

Having an infectious disease should not make any difference to registering with a GP. You are under no obligation to disclose any of your previous or current medical conditions prior to registration. No medical examination or questionnaire should be undertaken prior to agreement or refusal of registration. If you have difficulty registering with another GP your local Primary Health Care Trust (PCT) is obliged to find you a doctor. If, for any reason, you feel you have been unfairly treated in the process of registering with a GP, you can consider entering into the complaints procedure. See how to complain below. Initially, however, you could try discussing your concerns with the practice manager to see if the problem can be resolved.

All newly registered patients are entitled to a general health examination when they join a GP practice.

There are procedures, set up by the NHS, for patients who have concerns or complaints about any aspect of their care. All NHS Trusts, Primary Care Trusts, GPs, dentists, opticians and pharmacists have a complaints procedure. Your GP should have a leaflet in the surgery on making a complaint and your local Primary Care Trust (PCT) can also advise you who to contact in order to make your complaint.

The Complaints Process
Although local arrangements for complaints to your PCT may vary, in general the process remains the same across the country and is separated into various stages. If you require some assistance in making a complaint you can contact your Patient Advisory Liaison Service ( PALS ), located at your PCT who will be happy to support or advocate on your behalf.

Local Resolution
In the first instance you should perhaps consider discussing your concerns with the specialist, doctor, nurse, receptionist or practice manager, etc. to see if they can be resolved.

Alternatively, you may feel more comfortable discussing your concerns with someone who is not involved in your care. The Hepatitis C Trust offers an Advocacy Service for patients who are experiencing difficulties - call the Helpline on 0845 223 4424 or email helpline@hepctrtust.org.uk. Alternatively, you can contact your local Patient Advocacy and Liaison Service (PALS) at the Hospital Trust or Primary Care Trust. This is a new service that replaces the Community Health Councils and operates in every NHS Trust. Their role includes supporting patients, carers and relatives, representing their views and resolving local difficulties on the spot. PALS do not replace the existing complaints system, but work alongside it providing an alternative, especially for difficulties that may be easily remedied at a local level.

In addition, NHS Direct on 0845 4647 will be able to provide you with information about how to complain about any aspect of your care.

If a discussion hasn't been helpful, or you don't want to do this, then the next step is to put your complaint in writing. It is advisable to make your complaint quite quickly to either the practice manager of your GPs surgery or if your compaint is with your hospital to PALS

You can expect a full and prompt rely to any complaint made against any NHS trust, normally within 20 working days. GPs, dentists, pharmacists or opticians should reply within 10 working days. In some instances the matter is resolved and the complaints procedure will end here, in other instances, and with your agreement, a conciliation process may be commenced, or you can request an independent review.

Conciliation
Both you and the organisation you are complaining about can ask for conciliation, but both sides must agree to it taking place. By bringing the two sides together with a neutral third party, conciliation aims to reach a mutually satisfactory conclusion and may be a way to avoid the situation from deteriorating any further. If a satisfactory conclusion has not been met and you are still unhappy, you can request an independent review.

Independent Review
An independent review must be requested within 28 days of the outcome of a local resolution. Each request is considered by a convenor, a specially trained member of the hospital Trust or Primary Care Trust. It will be necessary for you to explain, in writing, why you feel the local resolution was unsatisfactory and your request for a review will be considered. At this stage further local resolution may be suggested.

If a review is considered appropriate, then an independent review panel may be set up. This panel will consist of three people: a lay chair person, the convener and a third person, either from the PCT or from a list of people held by the Department of Health. If the issue is of a clinical nature then the panel will ask for expert advice. Following an investigation, the panel will prepare a report on their findings, conclusions and any recommendations. A copy of this report will be sent to you. You will also receive a letter outlining any action that is being taken following the report. If your complaint is about a GP, dentist, optician or pharmacist they will usually write direct to you, if the complaint relates to a hospital or PCT this will come from the PCTs Chief Executive. If you still feel that the matter is unresolved you can request that your case to be referred to the Health Service Commissioner or Ombudsman who is independent of the NHS and the Government.

Health Service Commissioner
The Health Service Commissioner will not usually consider a complaint if you have not previously tried to resolve the matter through the NHS complaints procedure.

The Commissioner can be contacted at:

The Health Service Commissioner for England
11th Floor
Millbank Tower
London
SW1P 4QP
0207 217 4051