Can I choose where I am treated?

How can I decide?

Even if you have a legal right to choose your care, it might not be easy to find out about your options.

It is hard to get detailed information on the quality of different services.

In England you can look at the care quality commission website. This will give information on hospital inspection reports. But it usually puts services into quite big groups. For example, all outpatient services are looked at together. So it is hard to know how well the rating applies to the services for liver disease.

The best person to ask is usually your GP. They should know which services are available in your area. And may have heard feedback on them from other patients.

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Waiting times

Your GP should be able to access information about waiting times.

You can also get some information on waiting times from the NHS. But this only shows averages. You may have a longer or shorter wait depending on how urgent your case is.

In England you should see a doctor within 2 weeks if you are referred because you might have cancer. This does not apply for suspected liver cancer in Northern Ireland, Scotland, or Wales. But your referral should be classed as urgent.

For other problems, only England has a target covering all referrals. This states that you should be seen within 18 weeks. And if this does not happen you have the right to ask to be referred somewhere else.

But unfortunately, in many places, including in England, the waiting time can be longer than this for things not classed as urgent. If you have a choice of services, it is worth asking your GP about the waiting times at each of them.

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Gastroenterology, liver unit or more specialised care?

Many types of liver disease are treated by gastroenterologists. These are doctors who specialise in the whole digestive system. Doctors who specialise in specifically in the liver are called hepatologists.

If your condition is severe or complicated, you could ask your GP about referral to a specialist liver unit. You might hear these called hepatology units or departments. There are not as many of these so you may have to travel further to get to one. 

If your condition is very rare you can ask to be referred to someone with experience of treating it. Some liver conditions are so unusual that even specialist liver doctors do not see them very often. These conditions are usually only diagnosed once you are already seeing a hospital doctor. You can ask them how much experience they have of your condition. And if there is anyone you can be referred to for specialised treatment.

If your hospital doctor thinks that you may need a liver transplant, you will be referred to a transplant centre. 

Specialist liver units and transplant centres in the UK

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Practical considerations

For most people, the decision about where to get medical care is limited by practical issues. If there is only one hospital in your area, then this is usually the most practical choice.

If a friend or family member has agreed to help care for you, you could ask to be referred to a hospital near them.

If you are a student living away from home and needing regular appointments, it might be easier to be referred to a hospital near where you are studying.

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Limitations on choice

Even if you have a right to choose, you may not always get your choice.

Your legal right only applies the first time a GP refers you for a condition. You do not have a legal right to choose if you are already seeing a hospital doctor for your condition and this is an onward referral.

You also might not be able to choose if you need an urgent appointment. For example to a cancer service where you need to be seen within 2 weeks.

You can only ask to be referred to a service, consultant, or team that provides the service you need.

Although you might not get your first choice, if you have a preference it is always worth asking.

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