A problem shared is a problem sorted! That’s the approach our Patient Advice and Liaison Service (or PALS for short) take. It's the first place people go if they have a question or concern about health or their care.
In just one month the team give advice, information and offer reassurance to more than 250 callers who need their help or just want someone to talk to.
As well as sign-posting people to local services, they resolve issues quickly and are always on the look out for improvements that would make a real difference to patients, based on your experiences.
In a nutshell, PALS is a one stop shop for anyone who needs health related information - whether you’re a patient, familiy member or carer.
Please note the information below gives general guidance only and should not be treated as a complete and authoritative statement of law. If you need further or more detailed advice, please call us on 01372 201759
Access to services
Currently patients registered with GP surgeries in south west Surrey can get a self referral form from their GP. If self referral is not available in your area, you can ask your GP to refer you directly if it is appropriate for you.
No you don’t have to go to your GP. We have a number of Contraception and Sexual Health clinics across Surrey. All of the clinics are confidential no matter what your age, even if you are under the age of 16.
You don’t need permission from your parents or guardian to go, and you don’t need a referral from a GP.
Click here to find a clinic near you.
If you feel you may need a little more help, we would suggest that you make an appointment to see your GP who can refer you on to other services.
You may also wish to contact Surrey and Borders Partnership NHS Foundation Trust which is the main provider of health and social care services for people of all ages with mental health problems, drug and alcohol problems and learning disabilities in Surrey and North East Hampshire.
Need urgent help? There is a dedicated weekend and evening Mental Health Crisis Helpline for people with mental health problems in Surrey and North East Hampshire. In times of crisis or distress please call: 0300 456 83 42. Click here for details.
You are able to choose which hospital provider you want to be referred to by your GP or referrer. This means that you can choose from any hospital in England offering a suitable treatment that meets NHS standards and costs. Patients can also choose to go to independent sector providers who have a contract with the NHS.
This is available for most patients most of the time, but exceptions are made in case of emergency and urgent services, cancer, maternity and mental health services. If you need to be seen urgently by a specialist (for example, if you have severe chest pain), your GP will send you where you'll be seen most quickly.
NHS dentistry charges vary depending on the type of treatment.
Click here for more information.
Yes. Dentistry is one of the few areas where NHS and private treatments can be combined. This can be confusing as NHS patients can sometimes be charged more than the maximum NHS charge because their treatment has included some elements of private work.
Your dentist should give you a personal dental plan which lists the costs and highlights which part of your treatment is to be carried out on the NHS and which are additional private work.
Dental hygienist appointments are not routinely available on the NHS.
However, NHS Band 1 Treatment includes Scale and Polish. If your clinical requirement is for a scale and polish then your dentist can provide this as part of a Band 1 course of treatment.
If, however, following a full examination, your dentist feels that you’d benefit from a higher level of treatment (periodontal treatment), the options and choices should be discussed. These could include a Band 2 NHS treatment, or treatment on a private basis (with a dental hygienist).
If you are at all unsure about the amount you have been charged you should, in the first instance, discuss this with your dentist. If you are unable to resolve it with them, you should call NHS England on 0300 311 22 33
Your NHS dentist should provide all treatment that is clinically necessary and this includes root canal work. When there is an infection in the root canal system of a tooth the options are either extraction or attempting to remove the bacteria through root canal treatment. Your dentist will advise you on the best clinical option.
If your dentures are new and don’t fit comfortably, tell your dentist immediately.
Over time dentures can become loose fitting. If this happens arrange an appointment with your dentist to have them adjusted.
Your NHS dentist should carry out any work needed to adjust your dentures free of charge up to 12 months afterwards. However, if you lose or damage them or they need replacing due to wear and tear, you will have to pay the full cost of a replacement. You should return to the same NHS dental surgery that did the original work.
The Department of Health website has information about NHS eligibility.
If you are not ordinarily a resident or you don’t come under the NHS Charges to Overseas Visitors Regulations 2011 (how would I know?), charges will apply for any hospital treatment you receive and cannot be waived.
If this is the case you are strongly advised to take out private healthcare insurance that would cover you for the length of time you are in the UK. There is no facility to purchase healthcare insurance from the NHS therefore any necessary insurance must be organised privately.
If you are not eligible for free NHS treatment, most treatment given by staff at a hospital may be subject to a charge.
But there are exceptions, which are free to all, as follows:
• Treatment given in an accident and emergency department (excludes emergency treatment given elsewhere in the hospital)
• Treatment given in a walk in centre providing similar services to those of an accident and emergency department of a hospital
• Treatment for certain communicable diseases (excluding HIV/AIDS where it is only the first diagnosis and connected counselling sessions)
• Compulsory psychiatric treatment
• Family planning services.
Nationality or past or present payments of UK taxes and National Insurance contributions are not taken into consideration when establishing residence. The only thing relevant is whether you ordinarily live in the UK.
Ordinarily resident means, broadly, living here on a lawful and properly settled basis and that your centre of interest is the UK.
Under the current Regulations, anyone who is taking up or resuming permanent residence in the UK is entitled to free National Health Service (NHS) hospital treatment in England. If your intention is to live permanently in the UK you will be exempt from hospital charges from the date of your arrival in the country, but you should expect to be asked to prove your intention and that you are legally entitled to live here.
Any person living here lawfully and on a settled basis is regarded as resident in the UK and therefore entitled to free primary medical services – this includes seeing an NHS GP or dentist and hospital treatment.
On taking up residence in the UK it is advisable to register at your local GP practice as a patient. The practice may choose to accept or decline your application. An application may be refused if the practice has reasonable grounds for doing so, such as if you are living outside their practice area. A practice would not be able to refuse your application on the grounds of race, gender, social class, age, religion, sexual orientation, appearance, disability or medical condition.
Under the current Regulations, anyone who comes to the UK to pursue a full-time course of which lasts longer than six months, or a course of study that is of any duration but is substantially funded by the UK Government, will be fully entitled to free NHS hospital treatment in England. This will also apply to your spouse, civil partner and children (under the age of 16, or 19 if in further education) if they are living permanently with you in the UK for the duration of your course.
Anyone who is not ordinarily resident is subject to the National Health Service (Charges to Overseas Visitors) Regulations 2011. These regulations place a responsibility on NHS hospitals to establish whether a person is ordinarily resident, exempt from charges under one of a number of exemption categories or liable for charges.
UK Elderly Dependent Visa
This visa exists for individuals who are present and settled in the UK to bring their elderly dependent relative (parent or grandparent), in certain circumstances, to join them in the UK.
Elderly Dependent Requirements
• The elderly dependent is a parent or grandparent
• The elderly dependent is wholly financially or mainly dependent on the relative present and settled in the UK and has no other relatives; in their home country with the ability to provide adequate support
• If widowed/made widower the elderly dependent is 65 years of age or older
• If travelling as a couple one of the elderly dependents is 65 or older
• The relative present and settled in the UK must be able to support and accommodate their elderly dependent without recourse to public funds.
Most GP practices take patients from a set geographical area around their practice. The postcode where you live will denote which GP practice or practices you could join. In most areas patients will have a choice of at least two practices.
Each practice has its own registration procedure. Be prepared to fill in a registration form, produce any proof of address that might be requested and possibly attend a welcome consultation with the Practice Nurse.
You do not need to tell your previous surgery why you are leaving.
If you are having difficulty in registering with a GP, contact the Primary Care Support Service.
Primary Care Support Service - Surbiton
187 Ewell Road
Switchboard: 0208 335 1400 Fax: 020 8335 1401
It is the discretion of the GP as to who he or she registers as an NHS patient, but the GP must have reasonable non-discriminatory grounds to refuse someone.
A GP practice can register patients as a temporary patient - when they are in the area for more than 24 hours or less than three months, or as a permanent patient - when they are here for more than three months.
Contact the GP practice and ask what information/proof of identify they would consider to be appropriate.
If you disagree with the way your GP wants to treat your health problem, or you're unhappy about the service provided by your GP surgery, tell them openly. However, if you feel unable to do so or you're unhappy with the response you receive, as a first step, speak to the practice manager. You may then wish to make a complaint.
All GP surgeries have a complaints procedure. You will find this at the reception or on the practice website. You can contact the practice in writing or by email.
You have the right to:
• have your complaint dealt with efficiently, and properly investigated
• know the outcome of any investigation into your complaint
• take your complaint to the independent Parliamentary and Health Service Ombudsman if you're not satisfied with the way the NHS has dealt with your complaint
• make a claim for judicial review if you think you've been directly affected by an unlawful act or decision of an NHS body
• receive compensation if you've been harmed.
NHS Surrey has recommended to GPs that they prescribe in quantities of a maximum of 28 day supply wherever appropriate due to the amount of money wasted yearly on prescriptions that go unused.
GPs may, at their discretion, choose to prescribe a longer period of medication. When doing this, consideration should be given to the likelihood of any adverse events which may go unnoticed, or alterations in therapy which could result in wastage.
You may find (according to the medication that you take) a pre-payment certificate is a cost effective option. Someone regularly receiving 4 or more prescription items in 3 months or 14 items in 12 months could save money by purchasing their prescriptions in this way.
Click here to find out more
If you are off sick for up to 6 days you don’t need to produce a sick certificate but you can fill out a self- certificate. However, some employers will not accept self certification and insist on a doctor’s note.
Certificating someone who has been sick for less than 6 days is not part of the essential core GP work and can therefore be issued at a cost. Similarly filling in insurance reports and validating passports is not essential NHS / GP services and may attract a cost. How much is charged is entirely up to the practice to decide.
Following a public consultation on the future use of 0844 numbers in the NHS, the Department announced that it would be prohibiting the use of telephone numbers which charged the patient more than the equivalent cost of calling a geographical number to contact the NHS. Further information and the findings of the consultation can be found on the DH website.
As a result of the consultation, directions were issued which instruct organisations not to use contact telephone numbers which have the effect of the patient paying a premium above the cost of a call to a geographical number.
The difficulty for practices is that they could not have anticipated the specific packages that individual patients may have agreed with their telephone provider (many make little or no charge at all for local calls).
Many practices who adopted the 0844 number did so believing that this would provide a better service for their patients. To change back to a local number again, may mean incurring an additional cost (for cancelling a contract) and would definitely mean investing time and money to advertise new numbers when resources are already scarce.
If your practice has an 0844 number you should let them know how you feel about it by writing either to your Practice Manager or by contacting your practice’s Patient Participation Group.
Not all travel vaccinations are available free on the NHS, even if they're recommended for travel to a certain area. As a general rule, the following travel jabs are usually free:
• tetanus, diphtheria and polio booster
• hepatitis A and some combined vaccines, such as combined hepatitis A and B
Your practice may be able to give you travel vaccinations, but it is not part of their core NHS business
Some vaccinations take time to become effective, so consult your doctor at least two months before you plan to travel for advice and to arrange any vaccinations that you may need.
If your practice do not offer travel vaccines, or are temporarily unable to provide this service, you may be advised to attend a specialist travel clinics.
Click here for information on travel vaccinations
This could be for any number of reasons but should never happen without good cause. To find out why you have been removed from your GPs register call the Primary Care Support Service on 0208 335 1400.
Under the terms of their contracts GPs are required to de-register someone if they are out of the country for more than three months.
Screening is organised according to your GP practice. Once every three years your GP practice will be contacted and all women eligible for screening will be invited. Not every woman will receive an appointment as soon as she is 50. However you should receive your first appointment by your 53rd birthday and therefore there is no need to contact them for an appointment. To find out when women from your GP practice are due to be screened, please telephone the Jarvis Breast Screening and Diagnostic Centre on 01483 783211.
Women over the age of 70 are encouraged to continue with breast screening but must contact Jarvis Breast Screening and Diagnostic Centre on 01483 783211 for an appointment.
The age range for automatically called for screening appointments will be extended from 47-73 years by 2012.
Please ensure that if at any time you notice any changes in your breasts or have any breast symptoms of any kind then please contact your GP practice immediately.
If you have notified your GP practice of your new address or if you have changed your GP practice you will be invited for screening when your GP practice is invited. If this is likely to be over three years since your last invitation you will be invited separately from your practice to ensure you are screened on time.
If you have moved house and fear you may have missed a screening appointment please contact
Jarvis Breast Screening and Diagnostic Centre on 01483 783211 (9am - 5pm Monday – Friday).
Services can vary between practices. Contact your surgery or talk to your GP to find out which health screening services are available and appropriate for you.
Yes, The Surrey Bowel Cancer Centre is part of the National Screening programme. Click here for more information
The NHS Bowel Cancer Screening Programme offers screening every two years to all men and women aged 60 to 69. People in this age group will automatically be sent an invitation, then their screening kit, so they can do the test at home. After your first screening test, you will be sent another invitation and screening kit every two years until you reach 69. If you are aged 70 or over, you can ask for a screening kit by calling the Freephone number: 0800 7076060
Will the NHS fund my treatment
Recently we have seen a substantial rise in referrals for non urgent or low priority procedures. In addition, there is increasing evidence that for some procedures significant numbers of patients report no clinical benefit. By stopping doing things which aren’t clinically necessary, we can safeguard and continue to do what’s clinically essential or urgent, such as cancer referrals and life-threatening trauma cases in A&E.
Medical needs are always at the heart of decisions about our priorities. Going forward it is clear that the NHS cannot continue to offer treatments where there is no or very limited clinical evidence or which are predominately cosmetic, rather than on health grounds. In other parts of the country, primary care trusts already prioritise treatments and following NHS Surrey Board agreement, we have adopted the same approach in Surrey.
Individual Funding Requests (IFR) are considered for treatments that are not normally funded by the NHS. The IFR is made by a Dr (either GP or specialist) and heard by a panel. The panel comprises of an independent GP, representatives from Public Health and commissioning and a lay representative. The panel will particularly look for “exceptionality” i.e. why one case should attract funding where others would not. The panel approach does seem to be the fairest way of allocating resources.
Click here for more information
During the last year funding for new cases of assisted conception was deferred. This decision does not affect couples where the female partner is 39 years old and who fulfil all of the remaining eligibility criteria. From April 2012 the deferment will cease and funding will be reinstated for couples who meet the eligibility criteria.
If you are eligible, you are entitled to two cycles of IVF.
Click for more information.
Varicose veins are graded 1-6 according to their clinical presentation, and currently we only fund specialist assessment for cases graded, by a GP, as 3 or above. This decision was made after careful consideration and with the agreement of the South East Coast Policy Recommendation Committee.
For those patients referred to a specialist, and for whom surgery is recommended, there are still considerations. One of these considerations is that non- surgical interventions should have been tried and failed.
We do have a limited budget with which we have to fund all medical treatments for Surrey residents, but financial constraints are not the only reason for restricting the numbers of varicose vein referrals. By ensuring that only the most severe cases are seen by our specialists, we can ensure that these patients receive their appointments (and possibly their operations) much more quickly.
The guidelines for prescribing gluten free foods have recently changed. This means that some items are no longer available or that the requirement for issuing prescriptions has changed. However, many of the items are available to buy without prescription over the counter.
If you’re thinking of going to another country specifically for medical treatment, different rules apply than those for getting necessary care whilst abroad on a trip. It's important to note that your European Health Insurance Card (EHIC) does not cover going abroad for planned treatment.
First, you should discuss your plans with your doctor before you make any travel or medical arrangements. They will refer you to your local health commissioner who will discuss the options available to you and will confirm the following:
• Which treatments they are prepared to fund, and what level of funding would be available.
• Exactly how much you will be reimbursed.
• That you fully understand the conditions under which you will be treated abroad.
• Any programme of after-care or follow-up treatment you might require upon your return to the UK.
Under the current Regulations, anyone who has spent more than 6 months of the past 12 living outside the UK may no longer be entitled to free NHS hospital treatment in England. However, depending on your circumstances, you might still be considered ordinarily resident in the UK even if you have been absent for more than 6 months. (Ordinarily resident means someone who is living in the UK lawfully, voluntarily and for settled purposes as part of the regular order of their life for the time being, with a reason for their residence here which has a sufficient degree of continuity). If you are no longer ordinarily resident in the UK then you will have to be exempt from charges in order to receive free NHS hospital treatment.
If you have a UK state retirement pension and have lived in the UK (or been employed as a UK crown servant) for ten continuous years at some point in the past, you will be exempt from charges for treatment if the need for which arises during your visit to the UK. This means treatment needed where the diagnosis of a condition is made when first symptoms arise during a visit to the UK. It also applies where, in the opinion of a doctor or dentist employed by an NHS hospital, treatment is needed quickly to prevent a pre-existing condition increasing in severity, e.g. dialysis. It does not include routine monitoring of an existing condition such as diabetes.
The National Institute for Clinical Evidence (NICE) provides guidance to all NHS organisations around the safety, cost and clinical effectiveness of treatments. However, the duty to maintain financial balance and preserve essential services lies with individual PCTs.
You have the right to start your consultant-led treatment within a maximum of 18 weeks from referral, unless you choose to wait longer, or it is clinically appropriate that you wait longer. This includes treatments where a consultant retains overall clinical responsibility for the service or team, or for your treatment. This means the consultant will not necessarily be present for each appointment, but will take overall responsibility for your care.
If it is not possible to be seen within the maximum waiting time, the primary care trust (PCT) or strategic health authority (SHA) that commissions your treatment must investigate and offer you a range of suitable alternative hospitals or community clinics that would be able to see or treat you more quickly.
However, you will need to contact the original hospital, clinic or PCT first before alternatives can be investigated for you. Your PCT or SHA must take all reasonable steps to meet your request. All treatments must be agreed in advance, and retrospective claims will not be considered.
The right to be seen within maximum waiting times does not apply:
• If you choose to wait longer
• If delaying the start of your treatment is in your best clinical interests, for example where stopping smoking or losing weight is likely to improve the outcome of the treatment
• If it is clinically appropriate for your condition to be actively monitored in secondary care without clinical intervention or diagnostic procedures at that stage
• If you fail to attend appointments that you had chosen from a set of reasonable options, or
• If the treatment is no longer necessary.
The following services are not covered:
• Non-medical consultant-led mental health services, and
• Maternity services.