If your GP has recently suggested a referral to a hospital, you likely have questions about what happens next. A referral is a formal request from your primary care doctor to a Consultant—a senior doctor who is an expert in a specific field of medicine, surgery, or psychiatry.
This guide explains the process, from the initial letter to your first specialist appointment and beyond.
The most common reason for a referral is that your GP requires a specialist opinion to diagnose or treat your condition. While GPs are experts in “generalist” medicine, a consultant has deep expertise in one specific area (e.g., Cardiology for the heart or Oncology for cancer).
A referral is typically triggered to:
Access Specialist Expertise: To determine the best course of clinical management.
Request Advanced Investigations: Some tests, such as MRI scans, CT scans, or Endoscopies, often cannot be ordered directly by a GP and must be managed by a hospital team.
Surgical Evaluation: To decide if a procedure or operation is necessary.
Once the decision is made, your GP writes a referral letter. This is a vital document that ensures the consultant has the full context of your health. It includes:
The Clinical Question: Exactly what the GP wants the specialist to investigate.
Medical History: A summary of your past illnesses and previous operations.
Current Medications: A full list of what you are currently taking to avoid drug interactions.
Different regions and hospitals use various booking systems. You will likely encounter one of the following:
The NHS e-Referral Service: Your GP may give you a reference number and password. This allows you to book your own appointment online or by phone, giving you a choice of hospital and date.
Direct Letter: You may simply receive a letter from the hospital confirming a date and time. Check this carefully—you often need to confirm you can attend within a few days, or the slot may be given to someone else.
Telephone Request: Some hospitals send a letter asking you to call their “Outpatient Booking Office” to arrange the time.
When you arrive at the Outpatient Department, you may not always see the named consultant on your letter. You are part of a specialized team’s care, which includes:
The Consultant: The most senior doctor in charge of your care.
The Registrar: A senior doctor in training who is highly experienced and acts as the consultant’s deputy.
The Specialist Nurse (CNS/ANP): Highly trained nurses who specialize in specific conditions (like Diabetes or Breast Cancer) and often lead their own clinics.
Note: If you see a Registrar or Specialist Nurse, they will always discuss the final plan with the Consultant before major decisions are finalized.
If the specialist decides you need further tests (e.g., a Colonoscopy or an Ultrasound), the hospital—not your GP—is responsible for:
Organising the test and telling you when and where it will happen.
Providing the results. The consultant’s team will usually discuss results with you in a follow-up appointment or via a formal letter.
Managing the Waiting List: If you need an operation, the hospital will add you to their surgical waiting list. You should ask the consultant’s secretary for the current average waiting time.
If the consultant recommends a new medicine, they are responsible for the initial supply:
The First Week: They should give you a prescription to be filled at the hospital pharmacy (providing at least 7 days of medication).
Transfer to GP: They will then send a letter to your GP asking them to add the drug to your “Repeat Prescriptions.”
Specialist-Only Drugs: Some very expensive or complex drugs can only be prescribed by the hospital. In this case, you will always have to collect them from the hospital pharmacy.
After your appointment, the consultant will decide if you need to be seen again or if you can be discharged back to your GP.
Follow-ups: These can be face-to-face, via video, or over the phone.
Questions: If you have questions about your hospital treatment or if a promised appointment hasn’t arrived, contact the Consultant’s Secretary at the hospital. Your GP surgery often does not have access to the hospital’s internal booking system and cannot “speed up” the process for you.
A GP referral is a bridge to specialist care. It ensures that the right expert is looking at your specific health concern with the right tools. By staying organised and knowing who to contact at the hospital, you can ensure your journey through the system is as smooth as possible.
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