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The NHS Constitution - the NHS belongs to us all

The NHS Constitution

The NHS is there for us from the moment we are born. It takes care of us and our family members when we need it most. The NHS was founded on a common set of principles and values, and the NHS Constitution establishes the principles and values of the NHS in England. It sets out rights to which patients, public and staff are entitled, and pledges that the NHS is committed to achieving. It also sets out responsibilities, which the public, patients and staff owe to one another to ensure that the NHS operates fairly and effectively.

These rights cover how patients access health services, the quality of care you’ll receive, the treatments and programmes available to you, confidentiality, information and your right to complain if things go wrong. In return, the NHS expects you to take responsibility of your own health and use the NHS with respect. This includes:

  • registering with a GP practice
  • following courses of treatment you’ve agreed to
  • always treating NHS staff and other patients with respect
  • keeping GP and hospital appointments – or if you have to cancel, doing so in good time
  • giving feedback – both positive and negative – about treatment you’ve received

No government can change the Constitution without the full involvement of staff, patients and the public. The Constitution is a promise that the NHS will always be there for you.  

You can download the full NHS Constitution, as well as the Handbook to the Constitution and any Easy Read formats, from the GOV.UK website.

The NHS in England underwent a major reorganisation in 2013. To find out how the NHS Constitution reflects these changes read the guidance The NHS Constitution: what does it mean for the public health system? (PDF, 89,87kb)

Read more about the NHS in England and its new structure. 

Your rights to choice in the NHS

Everyone who is cared for by the NHS in England has legal rights that cover:

The NHS Constitutions sets out all of the above in detail. You can view these rights in detail on the GOV.UK website.

Your right to choice is also set out in the NHS Choice Framework, which explains when you have a legal right to choice about treatment and care in the NHS. The legal right to choice doesn't apply to all healthcare services; however, where you do not have a legal right to choice, you should at least be offered some choices, depending on what’s available locally. Download the NHS Choice Framework from the GOV.UK website.


The 39 comments posted are personal views. Any information they give has not been checked and may not be accurate.

JanandGerard said on 06 August 2015

The Constable Country Medical Practice in East Bergholt has recently come in for a fair amount of adverse criticism. Yes there have been problems with getting appointments & yes it's been upsetting to lose two very good doctors but this practice is not alone in suffering these matters and improvements have been made and new doctors recruited. My wife & I have never found the staff or doctors at this practice other than polite & caring. Of particular note is the doctor - an excellent doctor who is a major asset of this practice. We look forward to the doctor being our doctor for many years to come.

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Kirstie36 said on 10 June 2015

Pretty disgusted with ambulance service .sunday 3rd june my son took overdose. Phoned 999 was talked through breathing ect and was told help was on its way .......kept on hold please say if any difference in breathing.was still told help was on its way .....then was told ambulance is on its way but ihave to hang up take another call any changes pls call bk .... 1 1/2 hrs later was still waiting!2 hrs had to take my son to hospital in family car!! Luckily he was ok! Not happy

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User141093 said on 03 June 2015

This page is overdue it's update scheduled on the 19/04/2015.

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db2015 said on 07 May 2015

Just rang up my local GP to make an appointment 3rd attempt finally got an appointment for the 18th May 2015, 11 days to see the doctor just so I can get a referral to a foot specialist. The weekend before I end up in hospital in pain yet I got sent away nothing they can do until I see my GP , The hospital have told me I have plantar fascists and advised me to buy some strong pain killers. Anyway since its not a life threatening situation I have to suffer in pain and drug myself while I work on my feet, so thanks NHS you make me feel proud to be a working British sitisen thst can't get a bloody appointment. Not happy I do understand that the government are leeching the system but still maybe put tax payers first .

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shonaeuphamia said on 26 April 2015

My daughter was diagnosed with a hole in the heart. She fainted at work in january this year. Im not happy at all with the waiting time . She is unwell every day with palpitations dizzyness and short of breath. I am concerned as it seems to be getting worse.I have had to call ambulances out 3 times. I feel she needs an operation asap. She is only 19. We cannot go on like this. A doctor in the hospital has asked the London heart hospital if they can see her asap.I dont personally think she can wait. She is scared she wont go out anywhere anymore she is scared of these heart palpations she wont eat much. Im worried
sick as a mother.she says the air is thin. She cant breath properly when she has these attacks.she has two appointments which we have waited since jan.It seems no one seems to care. I feel alone The NHS im not happy with. How much longer does she have to go through with this
Mrs S D

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ATM_is_alive said on 20 August 2014

I am in awe of the NHS, it's staff and its ethos. I walked into a hospital in London with chest pains and two days later I was given a quadruple heart bypass operation to save my life at another London hospital. The medical care I received was outstanding and the nursing and general care that I received was also outstanding. The NHS is our country's greatest treasure and we should all protect it from political attacks abuse and corruption.

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wassname said on 08 August 2014

To: Paradise34. You could put your complaint in writing to the GP and suggest you taper off the medication and have regular blood tests.

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paradise34 said on 25 April 2014

I have been on medication for 14 years, I now think they are doing me more harm than good! Not that they ever helped anyway!
I want to be weaned off them, I have repeatedly asked my gp to get me off them, he totally ignores my request! What can I do about this?

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Abilash P Achenkunju said on 26 March 2014

Hi my name is Abilash Achenkunju, l had an emergency appointment with a dental practise. Then after that l gone under NHS treatment in same dental surgery on 13/03/14 l paid £49 under band 2 for the extraction .On 24/03/14 l went for the extraction,after the procedure the practitioner asked me to sign in a form and said its done as private and to be pay £150 for the extraction and £49 which l paid earlier (band 2) taken for the filling so total they charged me £199.The next day l went to the surgery (25/03/14)to find out the reason why they changed me as private said,it was difficult to do the extraction and took nearly 45 minutes,they are not happy to refund or do any action finally the receptionist asked me wait untill Friday 28/03/14 to speak to their manager but no appointment said they will contact me when the manager is available.So here l would like to know is the dental surgery able to change to private?

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Anonymous said on 30 October 2013


I want to point people in the direction of Patient Opinon ( I've read the comments below and noticed that no one from the NHS, Department of Health etc. has responded. However if you go to Patient Opions and leave a comment there you often get a response within a week or so. This is because many organisations in the healthcare industry use it regularly, so for instance the NHS Constitution Team at the Department of Health comments on Constitution related issues if you mention them there, whilst if you have an issue relating to a specific Trust, the Trust may well read it and respond directly. It may no longer be of interest to some of you who've commented below, but I'd certainly recommend it for anyone who wants information on their rights under the Constitution.

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newpatient88 said on 16 August 2013

I moved house in May and have tried to register with a local Doctor since then. Today I downloaded a form from a Practice accepting new patients, walked there to deliver it. Was then told there were two more forms to fill out that weren't downloadable on the website (both had repeat information that I had already filled out on the first form). I asked for an appointment with a GP and was told the next available is in one month! But I have to see a nurse first to assess my health as my medical records may take 2 months to get there (6 miles and on the electronic system). What a waste of resources. They will repeat all the blood tests and assessments that I had when I started with the previous GP only a year ago, just because my records may not show up before my appointment in a month's time!

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barkyone said on 28 October 2012

It is so easy to be negative. My local practice has the best of both worlds. Between 800am and 1000am patients can turn up wait to see the doctor or can book appointments in the afternoon and evenings. All normal clinics in addition and a wonderful staff of nurses, pharmacists and receptionists.

Why can't all practices be like this. I really feel that the doctors consider the needs of their patients rather than their own convenience.

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tidgey123 said on 19 October 2012

my recent visit to the doctor has helped a little, but as i sit here in so much pain and knowing i cannot take 2 more DHC tablets till seven to night i am upset and wonder if this is how its meant to be. a year ago my pain would not be continuous allday, everyday but now it just wont quit and i could barely dress myself this morning. i can not carry on like this. i cant help thinking that more could be done. i just want out, i have had enough of my hips and knees and barely being able to walk. my xray tw years ago this coming february apparently reveale nothing, but would it show something now two years later. i asked my gp to refer me twice recently but she declined and i dont know why.

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diclidophora said on 05 October 2012

Having regard to:

If your GP refers you to see a consultant you may have a choice of a number of hospitals. You might want to choose a hospital that has better results for your treatment than others, or one near your place of work. Ask your GP for more information or search and compare hospitals using the Find and choose services option.

I was referred to a consultant cardiologist in March 2012. I preferred my local hospital (an option on my appointments list), so they gave me an appointment in early September. The consultant missed the appointment by nearly an hour, so they have given me an appointment in December 2012. When I complained, they said they had offered me an appointment within 6 weeks at the main hospital (Musgrove Park), which is about 16 miles away (no buses), and that opting for the local hospital (and a lengthy appointment time) was 'patient choice' . I have a severe mobility disability (RA for 34 years).

So much for NHS promises and the 'constitution'

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Liz299 said on 16 September 2012

My husband recently received a letter from our GP Practice notifying him that the doctor he is currently registered with is over-subscribed and he will be moved to the list of another doctor. My husband has been registered at the practice for only 1 year and has not yet even met his doctor so has no preference.

However, the letter went on to say that all family members registered at the same address will also be moved. The doctor we are being moved from has been my family doctor for over 30 years and we have a trusting relationship on a professional and personal level.

When I rang to ask for re-consideration, I was clearly told (and this is stated in the letter received) that the decision will not be reviewed under any circumstances and that I was moved solely because of my relationship to my husband.

This is discriminatory. Where is the freedom of choice that the NHS keeps going on about? Not since Victorian times have we had to follow in the footsteps and directions of our husband's yet I am now being told that because my husband is being moved, I must be moved too. The NHS guidelines clearly state that there is no need for families to be registered with the same GP - so why is my practice insisting on this?

The Practice need to read the NHS Values and in particular the 'working together for patients' section which states " We put the needs of patients and communities before organisational boundaries."

How is this meeting my needs? My doctor was not over-subscribed when I registered with him over thirty years ago - in fact, I was one of his first patients registered.

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ALBERT169 said on 04 September 2012

When I phoned up for an appointment with a GP in my practice, I was given a date one month later. This has happened twice. How about a commitment through the NHS to an appointment within at most four working days for the practice, say, rather than waiting a month?

And with the break-up/greater privatisation of NHS services, is it too much to ask that each GP practice should be committed to providing a patient info leaflet with timescales for appointments, standards, services provided, etc? It's expected of other business. I don't routinely get copies of correspondence between other practitioners/services about me.

And ... when will services catch-up to modern life? I can't contact my practice by email - has to be in person, phone or landmail.

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Julie Shrive said on 09 July 2012

My health & safety are at risk as I have spina bifida occulta the so called mild form I experience otherwise.  Is medicine an exact science?

The NHS neglect the need  for  appropriate assistance & procedure  as cannot cure eg: my utis 3 weekly which go out of control if left too long then have excrutiating pain & near paralysis ignored by Nurses, physios  & Doctors on remits running A&E Depts & GP surgeries  not testing.

This can be cured in hours if adjust the already prescribed uti medication but GP refuses to acknowledge & provide diagnosis giving me medication that doesn't work using fact have normal amount of arthritus to hoodwink likewise specialist says not his remit when A&E deferred to him.
ignoring disability found because of this - spina bifida occulta. .

I have already had sudden cardiac arrest when crucial evidence including stroke symptons  ignored by A&E specialists & GPs for 2 years prior saying they were rationing.

This would not be happening if NHS Constittion was followed & GPs still had to do the hippocratic oath rather than defer to a corporate contract.Of course they are no longer to be found.

Surely this stress is not good on my fibrillation - unstable heart caused because of this inappropriate care . If I had a social worker this would not be happening . Or would it?

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andy559 said on 14 June 2012

I have been off work for getting on for 2 years, due to a lower back problem, As with Elabren's comment of Mar 2012, I told my GP that i had private health insurance, I was told not to bother with that because i would be seen quickly, at first things did go quick, I was diagnosed with sciatica, and referred to physio, this wasn't working, two months later i was referred to a speicalist, again i told them i had private health insurance and again was told not with that, the appointment within three weeks, he referred me for a scan, told not to bother with private health insurance, the scan came through quickly, and a further follow up appointment came through, the scan did not show anything conclusive, i was referred to a lumber bone speicalist, again impressively the appointment came through within weeks, he told me it looked like my L5/LS1 joint in my spine had no gap in it and the joint was rubbing, suggeted I may need to have a bone fusion operation, but before that he would referred me for a flouriscopic fetal joint injection in my lower back, to work out whether it was that joint, I had the injection on the 1st Dec 2011, there was a month where i had to fill out a pain chart, and send it back to the hospital, then a follow up appointment would be booked, the hospital recieved my pain chart on the 6th Jan 2012, and despite 9 phone calls to the hospital 7 times having to leave a message, and the hospital not calling back, and twice being told we will look into it, I am still waiting for my follow up appointment, that is now 24 weeks. This is the NHS who are working hard for me to be seen as soon as possible, when it is conveinient to me, i don't think so.

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Julie Shrive said on 03 April 2012

Since added comment have now found Choose & Book today blocking me saying not accepting reservation & urgent medication being witheld by surgery since last week re this .
.Still waiting even though called surgery 3 times again & Harmoni.[ Out of hrs] The Pharmacist is refusing hospital script as not usual NHS one yet seeing Dr / Prof via NHS ? Brought some medication but not other. What mentality is this?What is going on?

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Julie Shrive said on 01 April 2012

This is cloud cuckoo land as when you tell them this is not happening they turn tables blaming you because don't know what to do .Choose & Book is not our choice but used by Surgeries to manipulate appts & Complaints . A former GP told me they were rationing & did not have to use the hippocratic oath this was before I died x3 of cardiac arrest.And still this is happening as directed by LAs accountants via contracts.

Now the GP writes a letter marked urgent on 9 th March but hospital said hadn't received until I chased it up & the Secretary surgery used Choose & Book to get May 30 th . This is not good enough. The secretary used Choose & Book surgery & hospital saying didnt receive. When has it come procedure to ignore GPs & Specialists direction or am I being hoodwinked .
My consultant asked for next available appt in Jan & got 25th July . How many die waiting?
The Admin staff need directing, monitoring & overseeing as seem so anarchaic when you ask to speak to a Manager they tell you to leave & send for security who manhandle.They are letting down the good medical practice that happens.

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Elabren said on 13 March 2012

Interesting to note the comment from 'welsh person' in August 2011. In December, after coughing up a blood clot I was sent to a hospital for chest X-ray - which came out clear. GP said would write to consultant to see if he thought it worth seeing me anyway. I told her I have private healthcare insurance but she dismissed this and insisted on my going to a particular consultant on the NHS. I was kept waiting in an overcrowded waiting room at the hospital for 1,1/2 hours past my appointment time. I was told at the last minute that there would be a trainee in on the consultation. I tried to object several times but my objections were ignored. The trainee stared at me throughout the consultation. The consultant was overbearing and patronising - I reached a state of near hysteria but was bulldozed into agreeing to a bronchoscopy the following day. Next morning I rang and cancelled, saw a private GP a few weeks later as no longer trust the NHS one, and got a referral to a consultant of my choice. Will never trust the NHS again. I should never have been bulldozed into going along the NHS route AFTER I told GP I had private insurance. Patient choice? Laughable if it wasn't so tragic!

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Gill8 said on 21 January 2012

The NHS website states we have a legal right to choose the hospital in which we wish to be treated. I have a brain tumour and want to have surgery at the National Hospital of Neurology and Neurosurgery where the neurosurgeon has told me that the longer I put off surgery the more likelihood that I will suffer permanent damage. However I live in Dorset and am told that I have to go to Southampton. I was taken off the waiting list for Southampton when I exercised my right for a second opinion. It is six months since this tumour was discovered and I am not on any waiting list for surgery. My doctor advises I should accept Southampton who previously gave me a time frame well in excess of the 18 weeks between treatment and referral that the NHS pledges. The PCT will only accept an application form for treatment in London from the neurosurgeon in Southampton who clearly is not going to complete it. Am I missing something here? What about my right to choose? Why is it that when someone is feeling stressed and at their most vulnerable they are forced to take on the bureaucracy of the NHS system? I know I am not alone in being denied choices. It appears this is the theory in the NHS but certainly not the practice. I have written to my local MP, the PCT, PALS etc. but in the meantime the tumour is growing.

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colstuart1872 said on 20 January 2012

I owe my life to the wonderful and skillfull actions of the Basingstoke North Hampshire Trust.
This hospital rolled out he red carpet to save my life.
It took them five months and several operations but they allowed me to cheat death
Many thanks
Thank you all for my life
God Bless you all
Keep up the good work

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colstuart1872 said on 20 January 2012

I owe my life to the wonderful and skillfull actions of the Basingstoke North Hampshire Trust.
This hospital rolled out he red carpet to save my life.
It took them five months and several operations but they allowed me to cheat death
Many thanks
Thank you all for my life
God Bless you all
Keep up the good work

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User626357 said on 21 December 2011

My partner has completed her stem cell treatment @ MRI Manchester. We are very pleased.
The problem: we arrived on time for all our appointments 30+ NHS was late for all of them and a cancelled stem cell.
Very new swish hospital, very sad that the old culture, practice and delivery has continued from the old hospital
New building old habits

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S Rees said on 27 November 2011

I have had wonderful treatment from the NHS. My uncle was treated for stroke, my cousin had nuclear medicine for thyroid problems and it changed his life immeasurably, my mother had her life saved by a consultant geriatrician who told me he thought she wouldn't make it, my mother in law had heart surgery, my cousin's daughter had brain damage and was in a coma for days and had brain surgery and part of her skull was removed as her brain swelled up and she had a metal plate attached where the bone had been removed, my eighty year old neighbour has had tons of NHS treatment, they are all very grateful for the treatment they have had.

The NHS is fantastic. I am so proud of the NHS and so grateful for it. Thank you to all the doctors and nurses.

I do not decry the problems outlined in previous posts - obviously people who are feeling quite desperate some of them - but I am puzzled because I know more people who are grateful for the NHS and have had good treatment, than I do people who have had poor treatment. But we don't hear from them.

An engineer I work with said that when she saw contractors in other countries, they would tell her how wonderful they were and when she went saw British contractors, they only told her what they did wrong, even though the British contractors were actually very good.

She wondered if we just tend to do ourselves down and not realise when we are doing a very good job.

Is part of the problem that in Britain, we don't tend to have a lot of confidence in what we do, even if we are doing it quite well? We listen to people who tell us we are no good and then believe them. We need to have more confidence in ourselves. We are a lot better than we think we are.

But one lady said that she was in hospital recently and she noticed that people don't say "thank you" to the nurses.

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angelglory said on 24 November 2011

I went to see my neurologist who told me I needed antidepressants becuase of side effects of the tablets I take for epilepsy. He said I needed a specific one and that my GP would have to prescribe it. I went back to my GP and he put me on a different antidepressant, he said he hadn't received the letter, I was ill for 2 months because of this, at my next appointment on the advice of the Epilepsy Nurse I took a copy of the letter from the neurologist stating the drug I needed, he said just because the neurologist said it was the right one didn't mean it was and he refused to give it to me. I discovered that the one I was supposed to be on was very expensive compared to the 2 he tr ied which both made me really ill. I have now changed GP surgery and the doctor there didn't quibble at all about prescribing the drug. The surgery I was at lost 5 doctors in one go, they all left at the same time and we never found out why, I found this very suspicious and a bad omen, it was bad before then it got worse, I am just glad I have changed to one that treats me with respect well at least so far, I have only had 1 appointment but already I have been told that I should have been having regular blood tests for a drug I've been on for 2 years, nobody mentioned it.

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Beam10 said on 25 October 2011

The second tip above says that we have a right to choose a hospital for treatment. Fine to say that but what GPs may do can be different.

My GP refused me my choice only 16 miles away and just offered me the three hospitals in their local hospital trust. This is for general surgery which all hospitals do.

The local NHS trust via PALS could not suggest why he would do that. I suspect its a funding issue.

The PALS is a joke. They rarely answer their telephones and are mostly volunteers with no detailed knowledge of the NHS. They have no executive powers and will not intervene with your problems.

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Matelot said on 02 October 2011

I made an official complaint about a member of staff at my local hospital (non-medical staff I may add) and even after several reminders I have had no, repeat no comeback from the NHS or anyone connected with the complaints Dept for the NHS. A complete and utter whitewash. They protect their own. They ask to be trusted. Well, not by me they won`t, ever.

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Terry57 said on 24 September 2011

I am residing outside UK but I am receiving UK State Pension. I would like to know whether I am eligible for
medical treatment should I return to reside in the UK.
Please advise me of the procedure what I should do.

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alkazar1957 said on 18 September 2011

Anyone noticed that no-one gives a damn what comments you leave here?

Anyone been contacted about the comments you have left here?

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welsh person said on 07 August 2011

Shame this constitution is not available to those living in Wales. I have asked for this to happen and was told that the NHS in Wales does not need this! Having the constitution gives a patient certain rights which are not available to us in Wales, although we pay the same. All the "procedures" in place are not followed (11 months to receive some of my medical records) and there are no repercussions for the NHS staff. Shame, shame, shame...

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Klm2010 said on 22 June 2011

The NHS treatment of hypothyroid patients is an absolute disgrace. People are being under diagnosed and under treated on a daily basis. The cheapest treatment (thyroxine) is the treatment of choice in the NHS- funny that! People are left to suffer as a result and don't question anything, thinking that Dr known best. It's wrong and an absolute scandal. Patients need to do there own research and look at other avenues if you are suffering. There are other alternative treatments and specialists willing to use them but you need to take the initiative and look for them.

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Manu_london said on 04 April 2011

I like the words "Respect & Dignity" but I'm not sure that they mean the same to everyone! I am going through a process of regsitering myself with my local GP and find that the attitude of the administrators (yes, the receptionists and administrators!) is that they are doing me a great favour by registering me. And here I am paying close to £6k a year just for my national insurance contributions (maximum that can be made) and avoiding seeing a Doctor because I feel that they are overwhelmed by the system ! I probably see one around once a year for some antibiotics. I'm all for helping each other but not for being treated badly by anyone. Perhaps NHS staff should go on a course of customer service of some sort as the private sector organisation doAs its a public service, there is unfortunately not much I can do but just bear it.

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Autonomy said on 01 April 2011

Errrrrrr. Does the part about being allowed to make informed decisions and being involved in your treatment/care fall under the NHS constitution?
How about the Data Protection Act? Does that fit in somewhere???


I have been wronged in more ways that can be mentioned on here.

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Autonomy said on 31 March 2011

I am a big believer and follower of policies and promises from the Secretary of State for Health. The NHS Constitution would be fantastic if it were followed. My own experience of treatment/surgery was awful. I complained and the complaint got completely out of hand. I truly cannot believe that this situation was allowed to occur.
I agreed to a second elective surgery which went wrong, when I agreed to have it repeated a week later and was discharged, I tried to contact the surgeon and booking coordinator etc. I even attended the hospital in question the day before my third surgery was due to take place to try to gain information as I had not received a admissions letter for what is classed as fairly major surgery. I was only told that surgery was still taking place and that I should show up the next morning and that I could still take pain relief. This information was all relayed to myself and a friend by a receptionist/clerk. I was so stressed out I contacted PALS during the night via email. After my surgery which was very painful, I phoned PALS from the ward to see if they had received the email and they stated they had not. It was not good to hear the surgeon ask another healthcare professional "What can we do to prevent this from happening again" the morning after the third surgery while I was still in the room. The question was not answered by the other person, I think they realised their mistake.
I complained, this was not treated seriously, I asked PALS to transfer/enquire about moving my treatment to another trust which one of the consultants said was possible and he would be happy to forward my case load on to another consultant. Yet they did not do this. I am truly shocked and disgusted at this lack of communication and think that the NHS should be ashamed of themselves. I really feel violated. Rights, what rights????

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glynisrose said on 05 March 2011

Choices would be nice, also not being blackmailed / bullied into having whatever treatment the consultant says would be nice too.
I questioned my endocrinologists suggestions and they have discharged me! I now can't get prescriptions for my medication. I wonder how long it takes you to die of hypothyroid? I can imagine with no medication it will seem like forever!!

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Annh8456 said on 25 February 2011

A choice of being able to register with a dentist would be nice. All the practices in my area are even closed to waiting lists. No wonder people's teeth are rotting!

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Terry Cunningham said on 25 December 2010

I have been trying for a decade to establish NHS funding for Heliotherapy (natural phototherapy) for "severe psoriasis" despite this treatment being accepted and funded by the health systems of most EAA coutries, the NHS Dermatology profession seem to be strongly opposed to Heliotherapy. I wonder if there is any correlation between this fact and the fact that leading members of the UK dermatology profession are employed by the parmacetuical industry manufacturing systemic drugs approved by NICE on the strength of "industry sponsored trials and expert opinion" by dermatology professors presented to NICE appraisal and consultation commitees

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Page last reviewed: 28/05/2015

Next review due: 28/05/2017

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