Tests, prescriptions and referrals arranged by other services

The service treating you arranges:

• Blood tests they’ve asked for, including repeat and monitoring tests
• Any radiology tests such as X-rays, CT scans or MRI scans
• ECGs, including any needed before starting a new medicine
• Height, weight and blood pressure monitoring
• Medicines you need to start straight away, including antibiotics
• Referrals to another specialist, where these relate to the reason you were seen or are urgent
• Your test results and an explanation of what they mean

The clinician who requests a test is responsible for reviewing the result and acting on it. They’ve assessed you and they know what they’re looking for.

If we carry out a test on their behalf, the result comes to us rather than to them. That can lead to delays, repeated tests, or something being missed. Keeping the test with the team who ordered it is the safest way to manage your care.

This reflects NHS England guidance and agreed local pathways.

If a hospital or clinic decides you need to start a medicine immediately, they should provide it or write the prescription before you leave.

Under the NHS Standard Contract, hospitals must supply enough medicine to last until their letter reaches us and we can safely take over prescribing. This is normally at least seven days.

Medicines a specialist wants us to prescribe long term, that are not needed urgently and do not require ongoing secondary care oversight, are handled differently. If the specialist doesn’t give us enough information, or there’s no clear follow-up plan, we won’t be able to prescribe until we have got this information from them.

Choosing private care is entirely your decision, and it doesn’t affect the NHS care you receive from us.

The private provider arranges and covers the cost of anything they recommend, including blood tests, ECGs and scans. NHS policy means the private sector can’t request tests on the NHS to support private treatment, and follow-up appointments after a private procedure form part of the private care package.

If a private specialist has seen you and you want to transfer to NHS care, they can refer you directly to the NHS hospital. You don’t need to come to us first.

Coming to us first usually delays things. We’d have to write a referral without the assessment, examination or investigations the specialist has already carried out, so it’s more likely to be returned or rejected than a referral sent directly from one specialist to another. It also uses an appointment that another patient is waiting for. Going back to the specialist who saw you is the faster route.

We consider every request individually. We’ll arrange tests where:

• A shared care agreement is in place with your NHS specialist
• Your care has been formally transferred back to us and the test is appropriate for primary care to organise
• The hospital team has put the request on the online test system (ICE) and our nursing team can access this

We don’t hold shared care agreements with Right to Choose providers or private providers. If you’re under one of these services, they arrange and carry out their own tests and monitoring.

The service has told me my GP has to do it. What now?

Please contact them again and explain that we’ve advised that they need to arrange it. If this doesn’t resolve it, their Patient Advice and Liaison Service (PALS) can help. Every NHS trust has one, and the details are on their website.

I can’t get through to them.

Start with the department secretary or the number on your appointment letter. If you’re not getting a response, contact their PALS team.

Will this delay my care?

It shouldn’t. These services have their own clinics and are contracted to provide them. If you’re concerned about a delay, contact the service treating you, as they’re the only ones who can bring your appointment or test forward. Their PALS team can help if you’re not getting anywhere.

The hospital has told me to see my GP today for antibiotics.

Please go back to them, as they made the decision to prescribe. If you become more unwell while this is being resolved, call 111, or 999 in an emergency.

My specialist wants me to continue a medicine long term.

We can often take this on, but it needs to be agreed first. The specialist writes to us formally, we confirm we can prescribe and monitor safely, and we agree responsibilities on both sides. Where these are medications that require ongoing secondary care oversight, our shared care policy sets out how this works. If we don’t receive enough information, or there’s no clear follow-up plan, we won’t be able to prescribe, and the specialist continues prescribing until we can.

Does this change my care with you?

No. You remain our patient, and your NHS care with us continues as normal. This page is only about who arranges tests, prescriptions and referrals that another service has requested