Parliamentary Question | are ME/CFS patients being denied their own choice of consultant? | 24 June 2014

June 25, 2014

The Countess of Mar (Crossbench, and chairman of the Forward ME Group of charities) tabled a corker of a written question about patient choice in the NHS.

She asked Her Majesty’s Government whether patients have the legal right to be referred to any hospital provider of their choice, no matter where the consultant is located in England, subject to the provisos listed on the NHS website under Choosing your Hospital; whether patients diagnosed with chronic fatigue syndrome/myalgic encephalopathy in Sussex and elsewhere have been denied the opportunity to do so by local clinical commissioning groups when their general practitioners request a referral; and, if so, why.

Earl Howe (Conservative), Parliamentary Under Secretary of State for Quality at the Department of Health, provided this written answer on 24 June 2014:

The 2014-15 Choice Framework and the NHS Constitution, both available on, set out when patients have legal rights to choice.

The NHS Constitution states that patients have the right to make choices about the services commissioned by National Health Service bodies and to information to support these choices.

The 2014-15 NHS Choice Framework establishes that if a patient needs to see a consultant or specialist as an outpatient for a physical or mental health condition, they can choose the organisation that provides their NHS care and treatment anywhere in England for their first outpatient appointment. They can also choose which consultant-led team or which mental health team led by a named health care professional will be in charge of their NHS care and treatment for their first outpatient appointment.

The organisation can be any clinically-appropriate health service provider with whom any clinical commissioning group or NHS England has a commissioning contract for the service required as a result of the referral, but the team must be clinically appropriate and led by a named consultant or health professional who is employed or engaged by that health service provider.

There are also times that patients are not able to make a choice, and these are outlined in the Choice Framework and the Handbook to the NHS Constitution. For example, patients can only choose a hospital or clinic that offers the right treatment and care for their condition. Furthermore, if patients need urgent or emergency treatment, they cannot choose who they see.

If a patient, who is not covered by the exemptions, has not been offered choice, or denied the opportunity to exercise choice by a clinical commissioning group, the 2014-15 Choice Framework sets out a clear complaints procedure.

In the same week, the Countess also asked HMG who is responsible for signing off Department for Work and Pensions training guidelines and manuals used by Atos and Capita (the latest one – downloadable HERE – went online earlier this year).

In a written reply, the Minister for Welfare Reform Lord Freud (Conservative) said:

In the contract with Atos to deliver the Work Capability Assessment, Health and Wellbeing Directorate (HWD) within DWP sign off all training and guidance material. For Personal Independence Payment (PIP), Atos and Capita deliver training and guidance based on policy documentation provided by DWP. The Pip contract requires Atos and Capita to involve DWP in the quality assurance process for their training and guidance but DWP does not sign off this material.

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