National Health System - A general outline of getting treatment.
Any facts or detail regarding the National Health System (NHS) written in the following paragraphs may well vary in different parts of the country. The NHS has gone through a great deal of change and continues to do so, thus it is impossible to be accurate as systems will change from place to place.
In the very beginning when the NHS was set up all eligible people (British Citizens) were issued with an NHS medical card and were able to register with a General Practitioner (GP) of their choice. Today all children born of eligible parents are issued with a medical card in order that they may register with a GP of their parent's choice. This medical card is also the means by which people can change their doctor after say, moving house, or for any other reason, by taking this medical card to a GP and asking him/her if they can become attached to that GP's list. If a person is unable to gain acceptance to a particular GP's list the local Family Practitioner Committee will allocate them to a GP.
Treatment
During a person's lifetime they are eligible for treatment of any disorder by their GP. All initial treatment is carried out by the GP who may also provide certain specialist services such as Family Planning, Ante Natal and Children's Vaccinations, etc. The GP is remunerated for these services by the Local Family Practitioner Committee.
Hospital Consultants
The local Health Trust employ hospital consultants, who depending on the contract involved, supplement their income by private consultations. A patient may see a consultant by being referred in the first instance by their GP and by and large the patient will always belong to the GP's list.
A GP will write a letter of referral to a consultant and the patient will be sent an appointment. Following treatment by the consultant, when the patient's condition has improved, they will be discharged back into the care of the GP. Should the patient attend the GP at a future date suffering from another disorder the GP, if he/she feels it is appropriate, will refer the patient of a consultant physician or whatever is appropriate. At all times the patient remains under the overall responsibility of the GP.
In certain cases such as with Relapsing Polychondritis (RP), the GP may refer the patient to a consultant rheumatologist who because of the multi-factorial nature of the disorder may refer the patient to consultants in other disciplines, such as Ophthalmology, Cardiology, ENT, etc. In this situation the rheumatologist remains in control of the patient's therapy and coordinates the work of the other consultants who become involved. They will report their findings to the rheumatologist who will follow the advice provided. At all times, however, the GP will be informed of the activities taking place.
Generally speaking, a rheumatologist will retain responsibility for an RP patient whilst keeping the GP informed.
