Can I choose where I am treated?

Can I choose where I am referred to?

If you live in England, then you have a right to:

• Decide which provider (hospital) you would like to receive care from as an outpatient.
• Choose the clinical team who will be in charge of your care within that provider organisation.

Information from NHS choice framework

This only applies the first time you are referred from a GP to a consultant for a particular condition.

If you live in Northern Ireland, Scotland, or Wales you do not have a legal right to choose. But you can still ask your GP to refer you to a particular service or consultant.

If you live close to a border in England and you are registered with a GP in Wales or Scotland, the rules for Wales or Scotland will apply.

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How can I decide?

Even if you have a legal right to choose your care, it might not be easy to find out about your options.

It is hard to get detailed information on the quality of different services.

In England you can look at the care quality commission website. This will give information on hospital inspection reports. But it usually puts services into quite big groups. For example, all outpatient services are looked at together. So it is hard to know how well the rating applies to the services for liver disease.

The best person to ask is usually your GP. They should know which services are available in your area. And may have heard feedback on them from other patients.

Waiting times

Your GP should be able to access information about waiting times.

You can also get some information on waiting times from  the NHS. But this only shows averages. You may have a longer or shorter wait depending on how urgent your case is.

In England you should see a doctor within 2 weeks if you are referred because you might have cancer. This does not apply for suspected liver cancer in Northern Ireland, Scotland, or Wales. But your referral should be classed as urgent.

For other problems, only England has a target covering all referrals. This states that you should be seen within 18 weeks. And if this does not happen you have the right to ask to be referred somewhere else.

But unfortunately in many places, including in England, the waiting time can be longer than this for things not classed as urgent. So if you have a choice of services, it is worth asking your GP about the waiting times at each of them.

Gastroenterology, liver unit or more specialised care?

Many types of liver disease are treated by gastroenterologists. These are doctors who specialise in the whole digestive system. Doctors who specialise in the liver itself are called hepatologists.

If your condition is severe or complicated, you could ask your GP about referral to a specialist liver unit. You might hear these called hepatology units or departments There are not as many of these so you may have to travel further to get to one. You can find a list of liver units here. 

If your condition is very rare you can ask to be referred to someone with experience of treating it. Some liver conditions are so unusual that even specialist liver doctors do not see them very often. These conditions are usually only diagnosed once you are already seeing a hospital doctor. You can ask them how much experience they have of your condition. And if there is anyone you can be referred to for specialised treatment.

If your hospital doctor thinks that you may need a liver transplant, you will be referred to a transplant centre. You can find a list of transplant centres here.

Practical considerations

For most people, the decision about where to get medical care is limited by practical issues. If there is only one hospital in your area, then this is usually the most practical choice.

If a friend or family member has agreed to help care for you, you could ask to be referred to a hospital near them.

If you are a student living away from home and needing regular appointments, it might be easier to be referred to a hospital near where you are studying.

Limitations on choice

Even if you have a right to choose, you may not always get your choice.

Your legal right only applies the first time a GP refers you for a condition. You do not have a legal right to choose if you are already seeing a hospital doctor for your condition and this is an onward referral.

You also might not be able to choose if you need an urgent appointment. For example to a cancer service where you need to be seen within 2 weeks.

You can only ask to be referred to a service, consultant, or team that provides the service you need.

Although you might not get your first choice, if you have a preference it is always worth asking.

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Can I get a second opinion?

There is currently no legal right to a second opinion. But you can ask for one. And most doctors should agree to this.

When should I get a second opinion?

There are several reasons why you might want a second opinion.

If you have been told you have a serious medical condition you might want to get this confirmed by a second doctor.

If you are unhappy or unsure about your treatment options, it might help to talk to someone else.

If you are not happy with the care you are getting. Or feel that you cannot talk to your current doctor.

The downsides of second opinions

Asking for a second opinion will not give you any kind of priority on waiting lists. So you might have a long wait to speak to the new doctor. This could be risky if it means you delay starting treatment.

There might not be another suitable specialist in your hospital or area. So you might only be able to get a second opinion if you can travel some distance.

If you are hoping to get more or different information then it can be upsetting if the new doctor tells you the same things.

How do I get a second opinion?

The first thing to do is to ask your current doctor. If possible, talk to your consultant. Most should be happy to talk to you about getting another opinion. They should understand your need to find out about your condition and make informed decisions about your care. They will also be able to send information about your test results, and medical history, to the new doctor.

If your specialist will not help, you can go back to your GP.

If you have tried both of these and still cannot get a second opinion, you can try going through the hospital’s PALS or complaint’s procedure.

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Special thanks

We would like to thank Lindsay Chalmers, British Liver Trust helpline specialist liver nurse, for all her help with this page.

Published January 2024
Review Due January 2027