NHS patients' rights

This information applies to Scotland.

NHS support services

NHS 24

You can get advice about NHS services and treatment, and personal health advice from the NHS 24 website or by phone on 111.

NHS inform

You can get health information, including details of local health services across Scotland, from NHS inform:

Healthcare Improvement Scotland

Healthcare Improvement Scotland (HIS) is part of NHS Scotland.  HIS:

• provides clinical standards and guidelines for NHS services

• inspects NHS Boards' hospitals and services

• publishes reports on its website

There is information about Health Improvement Scotland's work on its website.

The Patient Advice and Support Service

The Patient Advice and Support Service (PASS) is an independent service which provides free, accessible and confidential advice and support to patients, their carers and their families about NHS healthcare. The service is provided by Citizens Advice Scotland and you can access it from any Citizens Advice Bureau in Scotland.

PASS will:

• help you understand your rights and responsibilities as a patient

• provide information, advice and support for anyone who wants to give feedback or comments, or raise concerns or complaints, about healthcare delivered by NHS Scotland

• provide practical help with making a complaint, including writing letters, making phone calls and supporting you to prepare for and attend meetings

• work with the NHS by using feedback to improve your healthcare and NHS provision.

You can call PASS for advice and support on 0800 917 2127. Lines are open Monday to Friday, 9am to 5pm. You can find more information about PASS on its website.

GP services

If you normally live in the UK, even if you're originally from another country, you have the right to register with a general practitioner (GP) if you live in the GP's catchment area.

The GP doesn't have to accept you, but if they don't, they must have reasonable grounds and give you their reasons in writing.

You can download the NHS factsheet 'Health care in Scotland for holidaymakers from overseas' from NHS inform.

Choosing a GP

You can search for the nearest GP on NHS inform.

Registering with a GP

To register with a GP, you'll need to fill in an application form. This is available from the GP practice, or you can complete it online and email it to the practice.

You can find the form to register with a GP and guidance about how to register on NHS inform.

You don’t  need to hold a medical card to register with a GP or receive services from the NHS in Scotland.

You can only register permanently with a GP practice if you're going to be staying in the area for at least 3 months. If you're staying somewhere in the UK for less than 3 months, you can ask to be registered on a temporary basis. You can also register temporarily if you move around the country and have no permanent address. 

Children under 16 should be registered by a parent or guardian, but don't have to be registered with the same GP as the rest of their family.

GP treatment

You’re entitled to treatment from a GP at the surgery where you’re registered. When you contact your GP surgery, they must give you access to a GP, nurse or other health professional within 48 hours if that’s what you need. If they don’t, you can make a complaint.  But you don’t have an automatic right to see your own GP.

A GP must provide any necessary treatment in an emergency, even if you're not registered with them.

Treatment outside surgery hours

All GPs must make sure that a service is provided for their patients when the GPs are off duty. This is called an out-of-hours service. To access this service you must phone NHS 24 on 111. All calls to NHS 24 are free. If you're unhappy about how your call is handled, you can complain to NHS 24.

NHS boards must make sure that the standard of care provided by the out of hours service is satisfactory. If you are unhappy about the standard of treatment you have received, you can make a complaint.

GP charges

Basic GP treatment for NHS patients who live in the UK is free. There are charges for some services, for example check-ups for employees and vaccinations for people travelling abroad. For more information, read about help with health costs.

There are charges for some visitors from overseas, except in an emergency. For more information, read about NHS charges for people from abroad.

Changing GP

You might change GP if you move to a different area or you're unhappy with your healthcare. 

You can change your GP at any time without having to give a reason.

When you’ve registered with a new GP, you’ll no longer be registered with the old one. You can then make an appointment to see the new GP immediately.

Moving out of a GP’s area

If you’re changing address but aren’t moving too far, you might want to stay with your current GP. You should ask the GP if they’re willing to continue treating and visiting you at your new address.

Being removed from the register by a GP

A GP might remove you from the patient register, for example because you move out of the practice area or are abusive to people at the practice. In most cases, the GP must have given you a warning and their reason for removing you from the register.

If a GP removes you, they’ll tell the NHS board, which will then tell you. The removal takes effect 8 days after the NHS board receives the GP’s notice, or when you’re included on another register if this is sooner. You’re entitled to emergency treatment, or the continuation of treatment which happens more than once a week, until another GP accepts you.

If you’ve been violent, or have threatened to be violent, towards your GP or practice staff, and the police have been informed, the GP can remove you from their list immediately. The GP who has removed you will only accept you for emergency treatment if they think it’s clinically necessary. You’ll have to apply to the NHS board to be allocated to another GP.

If a GP has removed you from their register because of violence, you might have difficulty registering with another GP. You might want to make a complaint if you feel you’ve been treated unfairly, for example if you think you were discriminated against. You might be able to get help to do this from an adviser, find out how to contact the Patient Advice Support Service. 

Complaining about a GP

If you have a problem with your GP, you can try to speak to them or ask to speak to the practice manager. If you’re not comfortable doing this, you can contact the feedback and complaints team at your local NHS board - they will direct your complaint to the right place.  

You can read more about NHS complaints. You can also contact the Patient Advice and Support Service for more help.

Home visits

You can’t insist that a GP visits you at home. A GP will only visit you at home if they think your medical condition requires it. A GP can also decide how urgently a visit is needed.

If you become seriously ill after a GP refused a home visit, the GP could be found to be negligent or in breach of their contract with the NHS. You might want to make a complaint. 

A community nurse can visit you at home if your GP or a hospital consultant refers you. If you’re not an urgent patient, you can make an appointment and somebody should visit you on the day arranged.

A health visitor should visit you at home if:

• you’ve recently had a baby

• you’ve recently registered with a GP and have a child under five.

Second opinions

You can ask your GP to arrange a second opinion either from a specialist or from another GP. But the GP doesn't have to do this if they don't think it's necessary. You don't have a right to a second opinion.

You have the right to see a GP who is competent to deal with your case. If a GP refers you for a second opinion, you can't insist on seeing a particular GP. But a GP shouldn't refer you to someone you don't want to see.

If the GP refuses to arrange a second opinion, you may wish to change your GP.

If a GP is unsure about a diagnosis, they could be found negligent if they failed to refer you to a specialist and you suffered as a result. If your GP didn't refer you for a second opinion and you have suffered as a consequence, you might want to make a complaint. 

Medication

If a GP decides you need medication, they’ll usually give you a prescription. In some cases, the GP might provide the medication themselves, for example if the surgery is in an isolated area.

A GP must supply any drugs needed for immediate treatment in an emergency.

Problems with medicines 

You can use the Yellow Card Scheme to report suspected problems or incidents with medicines, medical devices and healthcare products. These problems include serious side effects that your doctor didn’t tell you about. There’s more information, including how to report a serious side effect, on the Yellow Card Centre Scotland website.

Licensing of new medicines

When a new medicine is developed, it must be licensed before it can be made available for use in the UK. The Scottish Medicines Consortium approves some licensed medicines for general use by the NHS in Scotland.

Hospital treatment

In most cases, you can only get NHS hospital treatment if your GP refers you. You can also get hospital treatment if you’re attending a special clinic, for example for the treatment of a sexually transmitted disease, or you need emergency medical attention.

Emergencies

If you need urgent medical attention, you can go directly to the accident and emergency (A&E) department of a hospital without a referral from your GP. Not all hospitals have A&E departments. Some hospitals have minor injuries units instead, where you can go without a GP referral.

The hospital that provides the emergency treatment is responsible for paying for the treatment. If you need emergency admission as an in-patient, your local health authority will pay.

If you go into A&E, someone should assess you immediately. You shouldn’t wait more than four hours before being admitted to a ward, sent home or transferred to another hospital.

If you have to wait for longer, you can complain. Find out more about waiting time standards on the NHS inform website

Violent patients

If you’re violent or abusive to NHS staff, the hospital might refuse to treat you, or give you a verbal or written warning before withholding or withdrawing treatment. Violent or abusive behaviour can include verbal abuse, threats, violence, drug or alcohol abuse in hospital and destruction of property.

Each NHS board decides what types of behaviour could lead to the hospital withholding or withdrawing treatment, and how this policy is implemented. The hospital shouldn’t withdraw treatment for more than a year. If you’re violent or abusive to NHS staff and have severe mental health problems or are suffering life-threatening conditions, you shouldn’t be denied treatment.

It’s an offence to assault, hinder or obstruct an emergency worker - for example, a paramedic, doctor or nurse - while they’re carrying out their duties. The penalty is a fine of up to £10,000 or up to a year in prison.

Seeing a consultant

You don’t have a right to see a consultant or a particular doctor, but you can ask for this. Your GP can’t insist that you see a particular consultant or doctor. You have the right to see a doctor who is competent to deal with your case.

If you have special reasons for seeing a particular consultant - for example, your child is the consultant’s patient - you could ask for an appointment. You should explain your reasons for wanting to see the consultant. If you still have difficulty in seeing the consultant, you could write to the hospital administrator asking for their help.

You might want to get a second opinion after seeing a consultant, as either an out-patient or an in-patient. You’ll need to request this from the consultant, who might arrange for you to see someone else. If the consultant doesn’t agree, you could ask your GP to help.

Waiting lists

You might not be able to get the hospital treatment you need immediately and might have to go on a waiting list. There are maximum waiting times for in-patient treatment on the NHS. If necessary, the hospital might arrange for you to be treated in another hospital to have you treated on time.

There are also waiting time standards for a first appointment as an out-patient.

Waiting lists don't operate on a ‘first come, first served’ basis. Your position on a waiting list depends on a range of circumstances and might change. If your condition gets worse, your GP might recommend that you are seen more urgently. How long you'll have to wait to see a specialist or have an operation will depend on how severe your condition is, how busy the specialist is and other demands on the hospital facilities.

If you've been waiting longer than the target wait time, you can complain.

Find out more about waiting time standards on the NHS inform website.

If you have a question about waiting times, you can phone the NHS inform helpline.

If you're waiting to be admitted to hospital, you should contact the hospital appointments department or the consultant on a regular basis, reminding the hospital staff that you're still waiting. If you're prepared to go into hospital at short notice, you should say so, in case there’s a cancellation. You should also keep your GP informed of your condition, particularly if it gets worse.

If you're on a hospital waiting list and don’t turn up for an appointment or admission, the hospital might put you back to the bottom of the waiting list. If you’re not available for a period of time for a good reason, for example work commitments, illness or a pre-arranged holiday, you should tell the hospital. Your position on the waiting list will be paused until you’re available again.

Children going in to hospital

There are several issues you might want to consider if your child is going into hospital, for example:

• whether you can stay with your child

• how much help you can give with feeding and looking after your child

• what will happen to your child’s education

Children's Health Scotland might be able to advise on these issues. There’s also a leaflet for parents whose child is going into hospital for the first time on the Children’s Health Scotland website.

A child should usually be admitted to a children’s ward under the supervision of a consultant paediatrician (a children’s doctor). If your child is in an adult ward, you might want to make a complaint. 

The Scottish government has strongly recommended that hospitals allow unrestricted visiting on children’s wards. Hospitals should also let parents be with their children as much as possible. This could include allowing you to stay overnight at the hospital. You should make enquiries about these arrangements before your child goes into hospital.

If you’re finding it difficult to visit a child in hospital, for example if you have other children at home, you might want to discuss this with the medical social worker at the hospital.

If a patient dies in hospital 

If a patient dies in hospital, NHS staff should tell their relatives and GP as soon as possible. Staff should tell the relatives about the arrangements that need to be made.

An NHS Board might be responsible for arranging the funeral if there are no relatives or if the relatives can't afford the cost and don't qualify for a funeral support payment from Social Security Scotland.

Find out more funeral support payments.  

Hospital charges

Most hospital treatment for NHS patients who live in the UK is free. But there can be charges in an emergency for examining and treating people involved in road accidents. There are also charges for some services, for example beds with more privacy and alternative menus.

There might be charges for some visitors from overseas, except in most emergencies. You can read more about NHS charges for people from abroad. 

Financial help for hospital patients

If you're getting certain benefits, your entitlement might be affected if you go into hospital.

If you’re concerned about the effect of going into hospital on benefits, you should consult an experienced adviser, for example at a Citizens Advice Bureau. Find out where to get advice.

If you’re on a low income, you might be able to get help with travel costs to hospital and the costs of prescriptions, wigs and fabric supports.

You can read more about help with health costs.

Transport for patients

If you have medical needs that mean you need help with transport, the Patient Transport Service might be able to help:

• with getting to and from a hospital appointment

• when you’re being admitted to or discharged from hospital

There’s more about the Patient Transport Service on the Scottish Ambulance Service website.

If you don’t qualify for help from the Patient Transport Service, you might be able to apply to a local scheme. Your GP or NHS board should be able to give you more information about this.

Discharge from hospital

You shouldn’t be discharged from hospital until your care needs have been assessed and arrangements have been made for any services you need after you’re discharged. These are called community care services.

Any assessment should consider your wishes and the wishes of your family and any carer. The hospital should keep you fully informed and involved, give you enough time to make decisions and tell you how to seek a review of any decisions made. You can ask the hospital to assess your needs again if your circumstances change.

Hospital visits

Most hospitals have visiting hours, when people can visit patients. A visitor doesn’t have an automatic right to visit a patient, and the doctor might decide that visits would be bad for the patient’s health. There’s usually a limit to the number of people who can visit at any one time. The rules on visits from children are the same as for other visitors.

If someone wants to visit you in hospital outside visiting hours, they should discuss this with the ward sister. If they can’t get permission from the ward sister, they should contact the hospital administrator if they want to take the matter further.

Help with travel costs for visits 

If you're getting Income Support, income-based Jobseeker’s Allowance, income-related Employment and Support Allowance, Pension Credit or Universal Credit, you might be able to get help with travel costs to visit a relative in hospital.

You might be able to apply for a payment from the Scottish Welfare Fund, check how to apply to your local authority. 

Or you might want to apply for a budgeting loan to help with travel costs to visit a close relative. There's more information about budgeting loans on GOV.UK. If you're getting Universal Credit you'll need to apply for a budgeting advance instead of a budgeting loan. 

Maternity services

Ready Steady Baby! is NHS Scotland's guide to pregnancy, labour, birth and parenthood until your child is eight weeks old. The guide includes information on your baby's development, the care you’ll receive and mental health support during or after pregnancy. You can find the Ready Steady Baby! guide on the NHS inform website.

If you’re not getting the care you want, or you need more information on how maternity services are organised in your area, you should contact the supervisor of midwives at your local maternity hospital or the NHS board.

Treatment not available on the NHS

Access to some treatment, for example in-vitro fertilisation (IVF), might depend on the priorities of your NHS board. Some treatment might not be provided in your area. Access to some treatment might depend on your needs.

You can get details of services that aren’t provided, and any criteria for prioritising these services, from your NHS board.

Medicines not available on the NHS

A patient might want to ask to be treated with a licensed medicine that isn’t approved for use by the NHS in Scotland, for example for an end-of-life or rare condition. The Scottish government recommends that a patient discusses treatment options with their clinician.

The Scottish Medicines Consortium uses Patient and Clinician Engagement groups to gather detailed information on the benefits of a medicine, including how it can affect the quality of a patient’s life. There’s information about Patient and Clinician Engagement on the Scottish Medicines Consortium website.

Paying for treatment not available on the NHS

Some treatments used for certain illnesses that are very expensive and aren’t available on the NHS. You can choose to pay for these treatments yourself and this won’t affect your other NHS care. This means that the NHS should not withdraw its care if you buy additional care privately.

Any private care should be provided separately from the NHS care.

Complaining that treatment isn't available on the NHS

If you’re unhappy because a treatment isn’t available on the NHS, you can make a complaint. For information on making a complaint see NHS complaints.

Consent

You shouldn’t be examined, treated or operated on without your consent, unless:

• you have a notifiable disease that must, by law, be reported to the public health authority, or are a carrier of a notifiable disease

• you’ve been detained under the mental health act and might be unable to give your consent

• you can’t give your consent because of an impairment caused by dementia, brain damage or intoxication through drink or drugs

• your life is in danger, you’re unconscious and you can’t indicate your wishes

• a court or someone with parental responsibility authorises treatment. A person whose treatment is authorised by a court must be given an opportunity to defend their case against treatment in court

In some cases, it’s good practice to ask the patient to sign a consent form, but in other cases you can give verbal consent. For example, it’s good practice to get written consent for any procedure or treatment if there’s substantial risk or possible side effects. If you can give written consent, it’s good practice for the medical staff to get this from you for general anaesthesia, surgery and certain forms of drug therapy.

A health professional should record your written or verbal consent in your notes, with their explanations. If you’re concerned about a specific treatment, the doctor must describe other forms of treatment that are available.

If there’s doubt about your capacity to provide consent, a health professional must make an assessment.

The health professional should give you enough information that you can give consent. This is called informed consent. A consent form that you’ve signed is only valid if you’ve given informed consent. Consent for one procedure doesn’t imply consent for another procedure or form of treatment.

Before you give consent, the doctor must tell you about the treatment or operation, and any risks. The doctor will decide how much to tell you, the patient.

There is more about consent on the NHS inform website.

Children

A child under 16 can consent to, or refuse, any treatment if the doctor believes they understand the nature and possible consequences of the treatment. The doctor should get the consent of a parent or guardian if a child under 16 doesn’t have enough understanding, except in an emergency where there isn’t time to get it. If the local authority has parental responsibility for a child under 16, the doctor doesn’t need to get the consent of a parent or guardian.

There’s information for children and young people under 16 about consent on the NHS inform website.

Right to refuse treatment

You can refuse any treatment if you want. Even if you’re in the middle of a course of treatment that you gave your consent for, you can ask for the treatment to be stopped.

When you visit a doctor, this usually means consent to examination and treatment. The doctor can’t act against specific instructions. You should tell the doctor about any treatment you don’t want.

If alternative treatments can be used to treat your condition, the doctor should give you information on these. But you can’t insist on a treatment if the doctor or consultant thinks it’s not appropriate.

Forcing treatment on you against your will is assault. If you’re assaulted, you should contact your NHS board to make a complaint. Find out how to make a complaint to the NHS board. You might also want to involve the police.

Refusing treatment for your child

If you’re a parent or guardian of a child and you refuse to give consent for treatment which a doctor thinks is necessary, the action the doctor takes will depend on how urgent the treatment is.

When a child’s life is in danger, the doctor has the right to do whatever is needed to save the child’s life. But the doctor might need to get a court order if you refuse to give consent for your child to be treated.

If you don’t provide medical help for a child, or if you unreasonably refuse to allow treatment, you can be prosecuted for neglect.

End-of-life care

Palliative care is care given when a condition can’t be cured. Palliative care aims to control pain and other symptoms, and help patients and carers facing progressive illness and bereavement. These needs can be practical, social, emotional or spiritual.

Palliative care can be delivered in any setting. It can be provided at any stage after a life-limiting illness or condition is diagnosed, and not only in the last days, weeks or months of life. You can read more about palliative care, including specific conditions and sources of help, on the NHS inform website.

Right to die

The law about whether a person has the right to die is unclear. You have a right to refuse or stop treatment at any time, even if this means that you might die. But it’s illegal for a doctor to skip or carry out treatment with the specific aim of causing or speeding up death.

If you think you might become so ill that you could no longer decide about treatment, you should tell the doctor beforehand at what stage you would want treatment to stop.

You might want to write what you’d want to happen if you became too ill to give consent to medical treatment. Requests for specific treatment are called living wills, and refusals of treatment are called advance directives, but these terms are often used to mean the same thing. An advance directive refusing treatment is legally binding on health professionals.

If you’re thinking of making a living will or an advance directive, you should consult an experienced adviser, for example a solicitor or an adviser at a Citizens Advice Bureau. Find out how to contact an adviser.

If you’re concerned about being treated against your wishes, you should ensure you make this clear when the treatment is offered.

Organ donation

Adults and children over 16 are usually assumed to have agreed to their organs being used for transplant after they die if they haven't made their wishes clear while they were alive. This is even if they haven't registered their wishes on the NHS organ donor register. Find out more and register on the Organ Donation Scotland website.

Access to medical records

You have the right to see most health records held about you, subject to certain safeguards. You’re entitled to be told about:

• how the information is used

• who has access to the information

• how you can arrange to see your records.

Subject to certain safeguards, you have a right to see any medical report written for an employer, prospective employer or insurer by a doctor who is responsible for your ongoing care. This can be your GP or consultant or any doctor who has treated you in the past.

You can read more about accessing your health records, including what to do if you think information is wrong, on the NHS inform website.

Asking for information about health services

You have a right to ask for, and get, information from NHS boards, hospitals, GPs, dentists, opticians, pharmacists and other health professionals.

You might want to access information about:

• services and service standards

• decision-making processes

• the use of public funds

In most cases, the health authority must give you the information in 20 working days. The exception is if there’s a valid reason, for example the health authority doesn’t hold the information you asked for, or giving out the information wouldn’t be in the public interest.

Healthcare providers such as doctors and nurses must try to make sure that things are explained to you in a way you understand. If they don't, you might not have given proper consent to treatment. If it's difficult for you to communicate, for example because you don't speak English well or you have an impairment which affects your communication, providers should present the information in a way you understand. This could mean offering an interpreter or a sign language interpreter.

In some circumstances, if a provider doesn't communicate with you properly, you can complain that they have discriminated against you. This might be race discrimination if you can't understand what the provider is telling you because English isn't your first language. Or it might be disability discrimination if you can't understand what they’re telling you because you’re disabled, for example if you're deaf.

If you need to talk about a personal medical issue which affects only women or men and you need an interpreter, you can complain about sex discrimination if the interpreter isn’t the same sex as you.

Discrimination

Organisations and people providing health services mustn’t discriminate against you because of your race, sex, disability, religion or belief, or sexuality. Your NHS board might also have an equality policy which says it won’t discriminate against you for other reasons, for example if you have HIV.

If you're disabled, a healthcare provider must make 'reasonable adjustments' to allow you to use their services. If they don't, they must be able to show that this is justified, otherwise they’ll be discriminating against you. Examples of making reasonable adjustments include providing information on audiotape as well as in writing or installing a ramp to allow wheelchair access.

Example

I have hearing difficulties and it’s embarrassing when I go to the dentist – I can never hear the receptionist call my name.

You could ask your dental surgery to keep a record of all their patients with hearing difficulties. Receptionists can then come over and tell you when the dentist is ready to see you, rather than calling your name. The surgery should agree to this. If they don't, and they don't have a good reason, they’re probably discriminating against you and you should make a complaint.

Example

An NHS clinic has refused to offer fertility services to us because we're a lesbian couple. Is it allowed to do this?

No, if the clinic is refusing to treat you just because you’re a lesbian couple, and the treatment would be offered to an opposite-sex couple, this is sexuality discrimination and it's against the law. You’ll need to get expert advice about how to take this further.

But if the clinic doesn't offer fertility treatment to any couples, regardless of their sexuality, you won't be able to complain about sexuality discrimination.

If you think that a doctor, dentist, nurse or other healthcare professional is discriminating against you, you can complain about this. You should ask to see a copy of the equality policy of the organisation they work for and point out where they’re failing to keep to it. Check how to make NHS complaints.

Find out more about Discrimination in health and care services.

Veterans and serving armed forces personnel

The Scottish government has set out the healthcare services that serving and former armed forces personnel and their families are entitled to as part of the armed forces covenant.

Veterans with service-related injuries or ill health should get priority based on clinical need, even if the symptoms don’t appear for some time after they leave service. This means that if there's a more urgent medical emergency, that will take priority.

Find out more about the health rights of veterans on NHS inform. 

You can get information and support for people in the armed forces community across Scotland on the Armed Services Advice Project website.