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Choice of provider for out-patient treatment is not working

  • David Veale (a1)
Summary

In 2012, the coalition government introduced the legal right for National Health Service (NHS) patients in England to choose their mental healthcare provider for out-patient treatment. This was a significant step towards parity of care between mental and physical ill health, and NHS Improvement and NHS England have provided sensible guidance on its implementation. However, several factors prevent the system from working as it was intended: lack of awareness of the principle of patient choice for out-patient treatment; complacency from some trusts and commissioners; mental health trusts operating outside the e-referrals system; misuse of care pathways; lack of direct access by many general practitioners for out-of-area referrals; and delays in authorisation for funding. I describe how I have come to this conclusion and suggest some solutions.

Declaration of interest

The author is employed by a trust that potentially benefits from ‘patient choice’.

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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Corresponding author
Correspondence to Professor David Veale (david.veale@kcl.ac.uk)
References
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1 Oliver, D. Choosing to be honest about patient choice. BMJ 2017; 357: j1829.
2 Department of Health. More Choice in Mental Health. Press release. Department of Health, 2012 (https://www.gov.uk/government/news/more-choice-in-mental-health).
3 NHS Improvement. Choice in Mental Health: Advice to Commissioners. NHS Improvement, 2016 (https://improvement.nhs.uk/documents/59/choice_in_mh_services_commissioners_2.pdf).
4 NHS England Patient Choice Team. Legal Rights to Choice in Mental Health: Clinical Scenarios. NHS England, 2014.
5 NHS England. Choice in Mental Health Care. NHS England, 2014 (https://www.england.nhs.uk/2014/12/mh-choice-guidance/).
6 NHS Improvement. Choice in Mental Health: How it Can Work for You. NHS Improvement, 2016 (https://improvement.nhs.uk/resources/choice-mental-health/).
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BJPsych Bulletin
  • ISSN: 2056-4694
  • EISSN: 2056-4708
  • URL: /core/journals/bjpsych-bulletin
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Choice of provider for out-patient treatment is not working

  • David Veale (a1)
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