The thorny question of just how far the well-established principle of freedom of choice of NHS consultant actually extends to patients with ME/CFS – if at all – has been the subject of further correspondence in Parliament.
The Countess of Mar, who chairs the Forward ME Group of ME charities and patient groups, first took up the matter with the Government in a written question to which Lord Howe, Department of Health spokesman in the Lords, replied on 24 June 2014.
The Countess wasn't happy with the reply and told Lord Howe so by email. Lord Howe has now elaborated on his written answer with this letter.
If you have any comments on this issue, please post them below.
DEPARTMENT OF HEALTH
From the Rt Hon the Earl Howe P.C.
Parliamentary Under Secretary of State for Quality (Lords)
To the Countess of Mar
House of Lords
23 July 2014
Dear Margaret
Thank you for your email following up on my letter to you regarding patient choice. I am sorry that the previous answer did not provide you with sufficient clarity about choice of health service provider and consultant-led teams.
To clarify, the choice provisions for first outpatient appointment apply to only the first GP to consultant referral for physical health or named-health professional-led team in team in mental health. The rights to choose a health service provider and consultant-led team cannot simply be fulfilled by referring a patient to ‘any consultant', but to one that is clinically appropriate for the patient in respect of the condition for which they have been referred. Therefore, depending on the nature of the condition, as presented to the GP, a referral would be made to someone specialising in that clinical area. That specialist could be employed by any Trust that has a contract with any clinical commissioning group (CCG) in England, allowing for extensive choice across many clinical areas, even in speciality areas like Chronic Fatigue Syndrome (CFS)/Myalgic Encephalopathy (ME).
It should also be noted that any referral process should involve a discussion between the patient and referring health professional. When good practice is followed, choice and information about the options available are publicised and promoted to enable patients to make an informed choice of a health service provider and consultant-led team. NHS Choice (www.nhs.uk) is a key resource for patients, as it allows them to locate hospitals with specialist consultants and to use the feedback service to rate providers.
I understand from your email that the diagnosis of CFS/ME is far from straightforward. I am also aware that the choice right pertaining to the first outpatient appointment is limiting to patient like [name redacted] who have had a complex process of getting appropriate treatment. I would like to sure you that alongside partners in the health system, the Department is exploring areas in which to extend the choices available to patients, and embedding the offer of choice in everyday practice.
To progress the case of [name redacted], I recommend that he contacts his CCG again to request choice of provider and consultant-led team. If having done this [name redacted] is not satisfied, then I recommend that he contacts the Health Ombusdman to take up his concerns about a lack of appropriate treatment for his condition.
I hope that this reply is helpful to you and [name redacted].
Yours ever
Freddie
EARL HOWE