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NHS general practitioners (GPs) services

Specialist referrals and services your GP may recommend

You are entitled to ask for a referral for specialist treatment on the NHS. However, whether you will get the referral depends on what your GP feels is clinically necessary in your case.

If you wish to be referred to a specialist in a particular field, such as a surgeon, or a gynaecologist (a specialist in the female reproductive system), you should see the GP you are registered with. This is because all your medical records are held by that practice. Your GP also generally understands your health history and treatments better than anyone and will base any decision for a specialist referral on this knowledge. 

To learn more, see: Can I demand a specific treatment?

If you ask your GP to refer you to a specialist, they will probably suggest that you first try various tests, or treatment options, to see whether your condition improves. Generally, you cannot self-refer to a specialist within the NHS, except when accessing sexual health clinics or accident and emergency (A&E) treatment.

A specialist will only see you with a letter of referral from your GP. The letter will give the specialist essential background information, such as your medical history, and it will also contain details that the specialist needs to pay particular attention to.

For more information, read this leaflet about what happens when you are referred (PDF, 596kb). The leaflet is also available as a black-and-white version.

If you want to see a private specialist, you are still advised to get a letter of referral from your GP. However, whether you see a private specialist, with or without a GP referral, or are referred to an NHS specialist, your GP is not obliged to accept the specialist's recommendations. For more information, read: Do I need a referral for private treatment?

Choosing a hospital or consultant

If you are referred to a specialist by your GP or other health professional, such as dentist or ophthalmologist, you may have the right to choose which hospital in England to go to for your first outpatient appointment.

You can also choose which consultant-led team will be in charge of your treatment. This means that if you choose a particular consultant for a procedure, you can choose to have your first outpatient appointment at the hospital where the consultant works and be treated by that consultant's team. Learn more about consultant choice.

Once you have decided on a hospital, you could book your first outpatient appointment through the NHS e-Referral Service. This can happen in the following ways:

  • Your GP can book it while you’re at the surgery
  • You can book it online using the Appointment Request letter your GP gives you
  • You can phone the NHS e-Referral Service line on 0345 6088888 (open Monday-Friday, 8am to 8pm and on weekends and bank holidays 8am to 4pm)

Learn more about patient choice of hospitals.

Under the NHS Constitution, if your GP refers you for a condition that isn’t urgent, you have the right to start treatment led by a consultant within 18 weeks from when you are referred, unless you want to wait longer or waiting longer is clinically right for you. For more information, read our guide to waiting times.

Other services you may access through your GP

As well as specialist referrals, your GP can help you find the right stop smoking services, weight loss service or other self-management programmes that help to prevent or manage a condition. Self-management programmes are not simply about educating you about your condition. They also let you take control of your health by learning new skills to manage your condition on a daily basis. These services may, however, not be available on the NHS and you may have to pay for them yourself.

Some areas may offer local schemes that allow patients to have subsidised access to gyms or weight loss services such as WeightWatchers, Slimming World or Rosemary Conley. It is worth asking your GP if there are any schemes available in your area.

You can also look for services in your area via the NHS service directories.


Your GP may also help you to find:

Mental health services

Mental health services are free on the NHS. You will usually need a referral from your GP to access them, although, there are some mental health services that allow patients to refer themselves for help. These commonly include services for drug and alcohol problems, as well as some psychological therapy services.

Your GP will assess your circumstances and offer appropriate advice or treatment and if necessary refer you to a psychological therapy service or another specialist mental health service for further advice or treatment.

These services may be provided by your GP practice, a large local health centre, a specialist mental health clinic, or hospital. The treatment may be provided on a one-to-one basis or in a group with others with similar difficulties, and therapy sometimes also involves partners and families.


You have the legal right to choose which provider and team you're referred to by your GP for your first outpatient appointment. Clinical commissioning groups (CCGs) provide mental health services for their communities. You have the right to choose any mental health service provider in England as long as they provide a clinically appropriate similar service to the one your local CCG provides. Find out more about your choices in mental health.

For more detailed information see our section mental health services explained, which includes a glossary of mental health services, teams and care pathways.

An NHS stop smoking service

The NHS Stop Smoking Service offers a range of free treatments, advice and support for people who want to quit smoking and it has a good track record of success. Alternatively visit the Smokefree website or call the Smokefree National Helpline to speak to a trained adviser on 0300 123 1044.

Find more tips on how to quit smoking on this site.

Exercise referral schemes

These are designed to help people who would benefit from regular exercise. They are aimed at people with medical conditions that put their health at risk and people who are at risk through a non-active lifestyle.

This may include the GP prescribing a number of hours at your local gym as part of a rehabilitation programme, or helping people with disabilities to become more active.

The Expert Patients Programme

The Expert Patients Programme (EPP) is a self-management programme for people who are living with a chronic (long-term) condition. The aim is to support people who have a chronic condition by:

  • increasing their confidence
  • improving their quality of life
  • helping them manage their condition more effectively

The basis of the programme is a training course that teaches people how to manage their conditions by using five core skills. These are:

  • problem solving
  • decision making
  • making the best use of resources
  • developing effective partnerships with healthcare providers
  • taking appropriate action



DESMOND stands for Diabetes Education and Self Management for Ongoing and Newly Diagnosed. This is a structured education programme for those newly diagnosed with type 2 diabetes, those who already have diabetes, and those who are at risk of diabetes.

There are currently six DESMOND education programmes available, although which programmes are offered may differ geographically.

For more information and advice visit the DESMOND website.


Page last reviewed: 13/01/2016

Next review due: 13/01/2019

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