Citizens' rights in the NHS
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ScopeThis statement covers the rights of individuals to be treated by the National Health Service. The word "citizen" is used in preference to "patient", mainly to include people who might be rejected as patients. We do not intend to exclude from the rights set out here other people who may be in the UK, whether they are foreign nationals working in the NHS or failed asylum seekers. Governance of the National Health Service is covered separately in Objects. The Healthcare Commission's 24 Core Standards are addressed to NHS bodies. Where they are relevant to citizens' rights they are mentioned in the supporting notes. AccessEvery citizen should have direct access to primary care services and be registered with an NHS general practice and an NHS dental practice. Any citizen who has lost confidence in an NHS practice should be entitled to registration with another practice. Under no circumstances should a citizen be refused registration with an appropriate practice. A citizen needing an urgent consultation should be able to see an appropriate professional the same day. A citizen needing a non-urgent consultation should be able to book an appointment not later than the next working day, or if appropriate at an agreed date during the following weeks. If a citizen needs assistance to reach a surgery or other NHS premises, that assistance should be provided. If a citizen needs to be visited by an NHS professional at home, a home visit should be made. A citizen needing specialist attention should be referred to the most appropriate consultant by the general practitioner, after discussing the implications of specialist facilities and treatments, waiting times, travelling difficulties and accessibility to relatives and friends (which may make travelling a long distance the best option). A citizen needing specialist treatment should get the treatment as soon as possible according to its clinical priority. With limited exceptions no charge should be made to people using NHS services, either by NHS bodies or by their contractors. Where a charge is permitted, it should be at a reasonable level and relief should be available to people who cannot afford to pay. Safety and appropriate treatmentA citizen receiving attention from the NHS should be advised of any risks, precautions, action to take if there are adverse effects, and how to get more information. NHS procedures should be designed to minimise risks and to detect early any infection or adverse reaction to treatment. The treatment that is most effective for the individual should be used, unless a democratically accountable decision has been made to limit the availability of an effective treatment. Legitimate reasons to limit such availability might be:
Where a treatment is ineffective to many people but extremely beneficial to some, tests should be developed to target the treatment at the people who will benefit. Joined up servicesIf a citizen who is unfit for normal activities has responsibilities that must not be neglected (such as caring for family members), alternative arrangements that minimise disruption to everybody involved should be made. If a citizen needs assistance in daily living, that assistance should be available. Citizens should be able to have visits when they are in hospital from a reasonable number of people at reasonable intervals, even if transport has to be provided over a long distance. Citizens should not be put to disproportionate inconvenience to facilitate reorganisation or rationalisation of services. RedressAny disputes or misunderstandings are best resolved informally. Every complaint should be considered individually and kept open until all affected parties agree that it has been resolved. Numbers of complaints that have been open for long periods should be published. Complaints that are closed other than by agreement (such as if the complainant dies or goes away without trace) should be summarised separately from those that are resolved. Nobody that is implicated in a complaint should have any influence on the outcome of the complaint except by giving evidence to an enquiry. If a complaint implicates anybody who is influential in the management of an NHS body, the complaint should be investigated by an independent body. The complainant should always have the right to request this. A complainant's wishes (such as not to have further dealings with a particular NHS professional) should be respected, whether or not the complaint is resolved. |
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Sheila
Porter-Williams |