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Hospital Expedite letters
Due to increased waiting times for outpatient appointments, GPs have seen a rise in patient requests to “expedite” their appointments. We urge all our patients awaiting hospital appointments to be patient and wait to be contacted.
As a GP surgery, we are not notified of any waiting times for clinics or provided with hospital hotline numbers. If your appointment has been delayed please contact your consultant secretary for any updates. If you are waiting for your first appointment with a consultant and have not heard for a long time, please contact the outpatient department in the first instance and then the consultant secretary. If you have been unable to contact outpatients or the secretary, please contact the Western Trust https://westerntrust.hscni.net/
Written Requests to Expedite Appointments
Patients are often requested by the Hospital to obtain a letter from the GP so their appointment can be expedited.
Please note that waiting a longer time for an appointment does not deem your request urgent.
The waiting times for out-patient appointments have exponentially increased over the last few years. As a result, we are unable to write letters to expedite your appointment for this reason. Further information can be found on https://datavis.nisra.gov.uk/health/ni-outpatient-waiting-times-dec-22.html
If you are experiencing worsening of your symptoms, we advise you to contact your specialist directly so they can assess your condition and make the necessary arrangements if an expedite of your appointment is appropriate. If you have difficulty in accessing your consultant, we advise you to contact the Trust (often the Western Trust) you have been referred to https://westerntrust.hscni.net/
However, if the hospital are insistent they require a letter, we have created the below templates for you to complete.
Once you have completed this, you can post your letter to Outpatient Appointment (first appointments) or your consultant secretary (booked appointments or follow ups).
Request for a copy of your medical records
Some people request a copy of their medical records to assist them to apply for specific benefits etc. As a practice we provide ONE copy of your medical record by email under SAR legislation for free. Further requests for the same information incur a charge.
Sick notes
If you are unwell and unable to work you can self-certify for the first 7 days (3 days in RoI). This form can be obtained from your employer or printed here Employee’s statement of sickness to claim Statutory Sick Pay – GOV.UK (www.gov.uk)
Sick notes/MED3/fit notes are a statement that a patient is unfit for ALL work for a specified period of time due to a specified condition. We have to periodically reassess that you are unable to work, and so will advise you to make a review appointment at times. If you are on universal credit due to ill-health the benefits office also periodically reassess this. We are able to complete forms regarding your medical condition but often are unaware how it affects you on a daily basis so it is important to engage with the reassessment process also.
A “may be fit for work note” can also be provided suggesting adaptions that would be considered to facilitate a return to work such as altered hours, light duties, phased return. However NHS GPs are not trained in occupational medicine and your employer may ask to a fuller assessment of what elements of your job are and are not possible. This would involve a referral by your employer to occupational health. If you are on illhealth benefits but feel able to explore a partial return to work there is support from the condition management team. Please ask us if you would like a referral to them.
MED3 notes can be completed by any doctor and recently this has been extended to other professions such as nurse practitioners and physiotherapists. Specifically hospital doctors are able to complete these and for inpatient stays, postoperative recovery and after a fracture should be completed by the hospital.
Statement of fitness for work: a guide for hospital doctors – GOV.UK (www.gov.uk)
Mental Capacity assessment
GPs are often asked to make Mental Capacity Assessments for patients. These assessments can be requested for a variety of different reasons. As GPs it is an essential part of our role that we are able to perform capacity assessments which relate to decisions regarding medical investigations, treatment and care. However capacity assessments relating to overall welfare, finances and property are often more complex and sit outside our expertise.
The level of risk and responsibility linked to capacity assessments can be extremely high. Decisions such as whether someone’s house is sold or how their life savings are spent can depend on capacity assessments. It is therefore essential that adequate time and attention is dedicated to these assessments. It is also essential that those carrying out these assessments for legal purposes are highly trained and experienced in this area.
Legal capacity assessments do not fall within the NHS duties of GPs. Some GPs do agree to perform these assessments privately at a fee, but many others feel the risks of doing so are too high or that the time needed to perform an adequate assessment is not available to them. There are other professionals who can perform mental capacity assessments including solicitors and psychiatrist.
As a surgery we do not feel we have the capacity to offer Mental Capacity Assessments for legal purposes for our patients. To do so would require significant resources being diverted from our core duties as a health care provider. It would also pose a significant legal and financial risk to our GPs. We feel there are other professionals available with more appropriate training, legal protection and expertise who can perform these assessments.
We realise that this practice policy may cause some inconvenience to our patients but hope you can understand that our priority must be to our core NHS duties as a health care provider. If, in the future, the funding crisis in General Practice is adequately addressed by government we may find ourselves able to reconsider our position.
