Guide to NHS planned care from referral to treatment

Step 1: Your GP, optometrist or dentist refers you to hospital

Step 2: The hospital reviews your referral and contacts you to confirm the next steps

Step 3: You attend appointments (which may include tests)

Step 4: You prepare for treatment while you wait

Step 5: You receive your treatment

Step 6: You recover with appropriate follow-up care

Being referred for hospital treatment can often be a worrying time, especially if you're unsure what to expect. This guide explains what happens after you have been referred and how you can help make your treatment a success.

Your treatment is a partnership between you and the NHS. Here's what we need from you to help ensure you get the most of your care.

Keep your details up to date

Make sure the hospital has your correct address, phone number and email. If your details change, let them know straight away. Missing letters or calls could mean you miss appointments, and you could be removed from the waiting list.

Attend your appointments

When you agree to an appointment, make every effort to attend. If you can't make it, contact the hospital as soon as possible using the number on your appointment letter.

If you don't attend without telling the hospital, your treatment may be delayed or you may be removed from the waiting list.

Be flexible about where you're treated

Sometimes you may be offered treatment at a different hospital, a regional centre, or a private provider (paid for by the NHS). This is often because you'll be seen sooner or the specialist care you need is provided there.

If you refuse without a good reason, you may have to wait longer for treatment.

Depending on your personal circumstances, you may be eligible for help to attend your appointments. Ask the hospital about this.

Complete any questionnaires

The hospital may send you questionnaires about your condition. These help them understand how your condition affects you and plan the right care and support. It is important that you complete them as fully as you can. Help is available if you need it, either from hospital staff or via your health board’s Waiting Well service.

Get yourself ready for treatment

Start preparing as soon as you're referred. Small changes can make a big difference to your treatment success:

• stop smoking
• reduce alcohol
• eat well and reach a healthy weight
• exercise more

People who prepare well often recover faster, spend less time in hospital, and are less likely to have their treatment delayed.

The hospital’s Waiting Well team can help you prepare for treatment. Details on how to contact them will be provided in your referral letter.  It will also include a link to the hospital’s website where you can get more information on how to prepare for your treatment.

Tell the hospital about your needs

Let them know before you attend your appointment if you:

• need an interpreter
• have a disability or sensory impairment
• have difficulty travelling
• are ex-military (you may be prioritised for some conditions)
• have any other circumstances that might affect your care

Follow medical advice

Take any prescribed medication and follow your GP's advice. If your condition changes while you're waiting, contact the hospital.

Let the hospital know if you change your mind

If you no longer want treatment, speak to the person who referred you or the hospital. They can discuss other options with you.

In return, you can expect to:

• be treated with respect and dignity
• be kept informed about your care
• be involved in decisions about your treatment
• be seen in the shortest time possible based on your clinical needs
• receive support to prepare for treatment through the Waiting Well service
• be contacted every 6 months while you're waiting

Your GP, optometrist or dentist will explain why they're referring you to hospital. This might be for tests, treatment, or an operation that can't be done at your local clinic.

What happens next:

A hospital specialist reviews your referral and decides the best next step. This might be:

• a test to help plan your treatment
• an outpatient appointment
• going straight onto the surgery waiting list
• your GP managing your care with specialist advice (meaning you don't need hospital treatment)

You'll receive confirmation by letter, text or phone call telling you:

• that your referral has been accepted
• how long you might wait
• where you might be treated
• how to contact the Waiting Well support service

Your waiting time starts when the hospital receives your referral. The target for routine treatment is 36 weeks, though this may vary.

There are a number of types of appointment you might have, which are: 

• face-to-face appointments at the hospital
• telephone appointments
• video appointments

Phone and video appointments save you travel time and can be more convenient.

Booking your appointment

The hospital will contact you to arrange appointments. You'll usually be offered up to 2 date options.

An appointment offer is reasonable if:

• it is at least 2 weeks away
• the location is suitable for your needs

You should tell the hospital about:

• dates you can't attend (holidays, other appointments, caring responsibilities)
• any disabilities or additional needs
• if you need an interpreter
• if you need help with travel

Preparing for your appointment

Before you go, write down:

• your symptoms
• medicines you're taking (or bring the packets)
• any allergies
• questions you want to ask

You can bring a friend, relative or carer with you.

For hospital appointments: Plan your journey and allow extra time for parking.

For video appointments: Check your device, camera, microphone and internet connection beforehand.

For phone appointments: Make sure the hospital has your correct number and your phone is charged.

During your appointment

Your doctor or nurse will discuss:

• your symptoms and medical history
• any tests you need
• your treatment options

Don't be afraid to ask questions or say if you don't understand something. Take notes if it helps.

Questions you might want to ask during your appointment

About tests:

• What is the test for?
• How do I prepare?
• When will I get results?

About treatment:

• What are my options?
• What are the risks and side effects?
• How will I know if it's working?

About surgery:

• How long will recovery take?
• How much time off work will I need?
• What can I do to prepare?

Getting yourself as healthy as possible before treatment helps you:

• recover faster
• spend less time in hospital
• reduce the risk of complications
• avoid delays to your treatment
• small changes make a big difference

Consider:

• stopping smoking
• reducing alcohol
• eating well
• exercising more
• reaching a healthy weight

Support is available

Your confirmation letter includes details of the Waiting Well service. They can help with:

• information about your condition
• support to get healthier before treatment
• answering questions while you wait
• completing any questionnaires the hospital sends you

The hospital will contact you every 6 months while you're waiting. Contact them if your condition changes.

Pre-surgery assessment

If you're having surgery, you'll have an assessment to check you're fit enough for the operation and anaesthetic. Your weight, smoking, alcohol intake and other health conditions can all affect this. If you're not yet fit enough, the hospital will help you get ready.

If you can't attend

Contact the hospital as soon as possible. The phone number is on your appointment letter.

Good reasons for cancelling include:

• illness or medical emergency
• family emergency or bereavement
• a hospital admission or other medical appointment
• hospital transport cancelled at short notice

If you don't attend and don't let the hospital know, you may be removed from the waiting list.

If the hospital cancels

They'll rearrange your appointment as quickly as possible.

Treatment locations

The NHS will try to treat you close to home, but sometimes you may be offered treatment:

• at another health board
• at a regional specialist centre
• with a private provider (paid for by the NHS)

Being treated elsewhere often means you'll be seen sooner. Help with travel costs may be available.

If you refuse treatment at another location without a good reason, you may have to wait longer.

Once treatment is complete, your doctor will discuss what happens next. This might include:

• discharge to your GP: your GP takes over your care
• See on Symptom (SOS): instead of routine follow-ups, you contact the hospital if you have concerns. This usually lasts 3 to 12 months
• Patient Initiated Follow-Up (PIFU): for long-term conditions, you book appointments when you need them rather than attending routine check-ups
• Self-management support: training and resources to help you manage your condition yourself
• Rehabilitation: therapies like physiotherapy to help you recover
• Follow-up appointments: to check your progress

Your doctor will explain what to do, who to contact with concerns, and where to find more information.

If your situation changes

If you become unwell while waiting:

• short-term illness (under 6 weeks): Your treatment can be postponed and rescheduled.
• longer-term illness: You may be taken off the waiting list until you're well enough. You won't go to the bottom of the list when you return.

If you're referred for another condition: Your doctors will decide which needs treating first. Your place on the original waiting list is kept.

If you no longer want treatment: Discuss this with the person who referred you or your hospital specialist.

Tell the hospital if any of these apply to you, as extra support may be available:

• Armed Forces personnel (current or former) and their families
• People with dementia or learning disabilities
• People with disabilities or sensory loss
• Local authority looked after children
• Victims of domestic abuse
• Homeless people
• Refugees and asylum seekers
• Gypsy and Traveller communities
• Prison leavers
• People in care homes
• People who are transitioning

• Has your GP, optometrist or dentist explained why you're being referred?
• Do you know if it's urgent or routine? (Your hospital specialist will decide and tell you)
• Are your contact details correct?
• Have you mentioned any special circumstances or additional needs?
• Have you received your confirmation letter?
• Do you know how to contact the Waiting Well service?

• Have you agreed the appointment date, time and location?
• Do you know how to contact the hospital if you can't attend?
• Have you told them about any additional needs?
• Do you know where to get help with travel?