Referrals

Referrals to Secondary Care

The government has advertised extensively that patients have choice about where they have their hospital treatment. We applaud the desire to provide the best possible service for the convenience of patients. In our experience, patients mainly want to be treated in hospitals that are local to their homes, as soon as is practicable, and within a caring and high quality health environment. 

Once the doctor has indicated that a referral is appropriate, he/she will inform the patient that a choice of hospitals or clinics is available. At that point, the patient can decide where they would like to go for treatment.

Patients should call the booking centre to make an appointment convenient to them. Alternatively a booking can be made over the internet. 

Adult ADHD Referrals and Shared Care Agreements

Shared Care Agreements

You may prefer to be referred to a private provider (or in some cases be eligible for an NHS referral to a private provider). If this is the case, please be aware that there is no automatic shared care arrangement in place for follow up, prescribing, etc.

Adult ADHD Referrals and Shared Care Agreements

After careful consideration the position of the GP Partners at Beech House Surgery is as follows:                                        

If a patient is diagnosed on the NHS and started on medication, we will consider entering into a shared care agreement with the provider after the patient has been stabilised on treatment and if we have confirmation that they will review the patient regularly. If our NHS ICB were to stop commissioning their services we would need to consider whether an appropriate alternative was commissioned before agreeing to an ongoing shared care agreement.

If a patient is diagnosed by a private provider (including those under the NHS Right to Choose) and started on medication, we will not prescribe medication and will not enter into a shared care agreement with the provider but will refer the patient into the NHS ADHD services. We are under no obligation to share care with private providers and in general the BMA and our LMC advice against this.

For the avoidance of doubt, we would not be able to perform any investigations, physical health checks or ongoing monitoring on behalf of the provider, this is their responsibility. Also, we would not be prepared to enter into any prescribing agreement with the provider, either initiation and titration of medication or ongoing shared care prescribing, again this is the providers responsibility


If a patient or their family requests a referral to a private provider under the NHS 'Right to Choose' regulations, we will make a referral provided the service is led by a named consultant or named healthcare professional and has an NHS England contract for the required service.

No prior commissioner approval and no application to the Individual Funding Panel are required if the above criteria are met.

We are not obliged to organise physical checks, blood tests, ECGs at the request of the private provider. It is their responsibility.

We will not be providing NHS prescriptions for the patient. It will be the responsibility of the provider to initiate, titrate and stabilise the patient on any medication. It is likely that the provider will need to provide the patient with a private prescription as the commissioners will not provide them with a facility to provide NHS prescriptions. We will not enter into a shared care agreement with the provider.

Harrogate and District NHS Foundation Trust Update

An increase in the number of people being referred to specialist hospital care, coupled with the ​continued significant impact of the COVID-19 pandemic on NHS services, has meant that some people are having to wait longer than we would like for an appointment or treatment and we know that it can be difficult for those who find themselves in this position. We would like to assure you that your health and well-being are important to us and despite the additional pressure on NHS GP’s and hospitals, we are doing all we can to ensure those people who need our help are seen as soon as possible.  

We know it is important that you have a realistic idea of when you will be seen and the My Planned Care website provides information on current hospital waiting times for many specialities provided by Harrogate and District NHS Foundation Trust. Due to the current situation, it is important that we prioritise treatment for those people who have greater clinical need as determined by hospital specialists, rather than prioritising those who have waited the longest. We know this isn’t ideal for those people who have been waiting some time, but we hope you understand that we must prioritise people with severe medical conditions that require urgent treatment.    

If your clinical condition has not changed, please do not contact the hospital or your GP Surgery to try to bring your appointment forward as they will be unable to alter your waiting time or position on the waiting list, and it may contribute to further delays.