If the doctor feels he can't help you, and you need referral to a specialist, then he will arrange an appointment at a Community Clinic (run by GPs with a special interest in that subject and visiting Consultants) or write a letter to the specialist direct. We are obliged to use a government sponsored scheme called Choose and Book.
You Choose where you wish to be seen and you Book the appointment yourself at a mutually convenient time. Our medical secretary will write to you within a week or so with your paperwork, which will include a telephone number for you to ring and arrange your appointment and also a personalised password. It can even be done online!
Even if you prefer to use StHeliers, you still need to use the Choose and Book system. You will find that some hospitals can see you much quicker than others, though we do believe StHeliers gives a great service and is dependable.
The Community Clinics (if they exist for that particular specialty) can see you much quicker. Some clinics will require you to ring and arrange your referral. If you haven't heard, please ring them 020 8661 3902
It should be no surprise to you that most PCTs (health authorities) are overspent in their budgets, and as well as trying to cut down on our prescribing, we are regularly audited to make sure we are referring appropriately and not simply because the patient needs reassurance. The doctor will not always refer you at the onset, but will try his/her best to sort out your problem with medications and your help, as well as ordering tests. This will be the same with all surgeries in England, as they are all under the same financial pressures. As you are aware from the news, our Consortium (group of GPs given the responsibility of managing this difficult budget!) will be directly responsible for this budget. We will only be able to refer and prescribe what we are allowed. Any more and we are in trouble.
This means that patients will see a necessary change in the way things are done. We have no choice. And all surgeries will be under the same pressures, whatever they promise you! If WE feel that we cannot manage your problem in Primary Care, ie at the surgery with the help of hospital tests, then we will refer you. If we aren't sure, then we have a weekly GP meeting on Fridays at the surgery, where we discuss grey-area cases on whether or not to refer. You are of course urged to come back to discuss your case if there is no improvement and you've actually been good with taking our advice and medicines. And of course, you're entitled to a second opinion with another GP.
Missed Hospital Appointments . Patients who forget to attend appointments at the hospital are responsible for their own health. Even with the best reason in the world for not attending a hospital appointment, you can always ring to cancel. Hospitals, under similar pressures, will discharge you if you do not attend. Out of politeness, they will simply tell you to ring your GP to be re-referred. This will not happen. We only have a certain number of referrals we can make and we have a moral duty to save those for whom we feel are genuine cases. If we are keeping to target, we may consider another referral. It is up to our discretion. Sorry if it seems harsh to have to point this out, but the minority of patients who habitually miss appointments have absolutely no idea of personal responsibility for health, and they may not even realize it is they who I am referring to in reading this sentence. Simply put, it is our moral responsibility as doctors to give EVERYONE the best possible care available with the funds that the government has given us. This can mean that the irresponsible individual may have to wait longer.
Community Clinics GPSI's
These are essentially clinics in the community run by specialised GPs seeing patients alongside visiting hospital consultants. We are obliged to refer, currently in this area, any patients Muscular/Joint problems.
MusculoSkeletal Clinic (Jubilee Centre, Wallington shotfield), 020 3458 5555 .
They will send you an appointment for 4-6 weeks time.