The Patient's Charter for England
Putting the Citizen’s Charter into practice in the National Health Service
Foreword
The NHS Patient’s Charter is often derided as a weak and inadequate document. However, while it is easy to spot the Chater’s many shortcomings, it would be a mistake to ignore it: it does offer substantive rights to patients, many of which will be of particular interest to trans people.
The Charter was originally introduced in 1991, under the then Conservative government, and revised in 1995. When the Labour government took office in 1997, it instigated a review of the Charter, and the report produced later that year “The new NHS Charter - a different approach” identifies many shortcomings.
At time of writing, there is no further indication as to whether or when a new Charter should be expected. But in the meantime, why not take a close look at the charter’s provisions: were you aware, for example, that you have a right “to be referred to a consultant acceptable to you”? Have you considered the implications of that if your Health Authority offers a referral only to one so-called “Gender Identity Clinic”, and it is not one you would choose?
Claire McNab, December 1999
Update
The Patient’s Charter was abolished as part of changes to the NHS implemented in the year 2000 under the 10-year “NHS plan”.
|
||
Contents |
|
|||
Rights and Standards throughout the NHSACCESS TO SERVICESYou have the right to:
You can expect the NHS to make it easy for everyone to use its services, including children, elderly people or people with physical or mental disabilities. If your child needs to be admitted to hospital, you can expect them to be cared for in a children’s ward under the supervision of a consultant paediatrician. Exceptionally, when a child has to be admitted to a ward other than a children’s ward, you can expect a named consultant paediatrician to be responsible for advising on his/her care. PERSONAL CONSIDERATION AND RESPECTYou have the right to choose whether or not you want to take part in medical research or medical student training. You can expect all the staff you meet face to face to wear name badges. You can expect the NHS to respect your privacy, dignity and religious and cultural beliefs at all times and in all places. For example, meals should suit your dietary and religious needs. Staff should ask you whether you want to be called by your first or last name and respect your preference. PROVIDING INFORMATIONYou have the right to:
The NHS now gives you more information than ever before.
|
|
|||
The Patient’s Charter and You - GP Services
REGISTERING WITH AND CHANGING DOCTORSYou have the right to be registered with a GP.
You have the right to change your GP easily and quickly.
If you have changed GP, you can expect your local HA to send your medical records to your new GP quickly. This means within two working days for urgent cases and six weeks for all other cases. The NHS now meets this standard in 8 out of 10 urgent cases and in over 7 out of 10 routine cases. You have the right to receive information about the services your GP provides and to see on request a copy of your GP’s practice leaflet, which sets out this information. HEALTH CHECKS BY YOUR GPYou have the right to
DRUGS AND MEDICINESYou have the right to be prescribed appropriate drugs and medicines. If you fall within certain categories including being a pensioner, a person aged 60 or over, a child under 16 or under 19 in full time education, a pregnant or nursing mother, suffering from one of a number of specified individual conditions, or on income support or family credit, you have a right to get your medicines free. YOUR GP’S PRACTICE CHARTERWe are working with GPs and their health care teams to encourage them to produce GP practice charters. They will tell you about the standards of service you can expect from your surgery or health centre and the ways in which you can help the practice. These charters may cover:
More and more GP practices are producing their own charters for their patients. In June 1993 only 14% of practices had or were developing charters. Now it is well over half. You can help the NHS by only calling out your GP at night if it cannot wait until the next day. |
|
|||
The Patient’s Charter and You - Hospital Services
REDUCING WAITING TIMESMost patients go into hospital quickly after a consultant has decided that treatment is needed. Nearly half of all NHS patients who have to wait are admitted within 5 weeks. The Government is determined to maintain this excellent performance. In March 1991 over 50,000 patients were waiting 2 years or more to go into hospital. Now nobody waits this long (except for a handful of patients waiting for specialist fertility treatment). For hip or knee replacements and cataract operations, a waiting time guarantee of 18 months has already been established. In 1992 nearly 2,000 patients were waiting more than 18 months for hip, knee and cataract operations. Such long waits for these operations are now a thing of the past. From April 1995, the NHS is broadening this 18-month guarantee to cover all admissions to hospital. In addition from April 1995, you can expect treatment within one year for coronary artery bypass grafts and some associated procedures. (If your consultant considers your need for treatment is urgent, you can expect to be seen much more quickly than this.) Your operation should not be cancelled on the day you are due to go into hospital or after you have gone in. If it is, (for example because the hospital is dealing with the victims of a major road accident), you can expect to be admitted again within one month of the cancellation. OUTPATIENT APPOINTMENT WAITING TIMESFor the first time, the Government is introducing a national waiting time standard for a first appointment as an outpatient - when you are referred by your GP or dentist to see a hospital consultant. From April 1995, when your GP or dentist refers you to the hospital, 9 out of 10 people can expect to be seen within 13 weeks. Everyone can expect to be seen within 26 weeks. The Government will be working over time to tighten this standard further.
YOUR CARE IN HOSPITALIf you go to an accident and emergency department you can expect to be seen immediately and have your need for treatment assessed. In Accident and Emergency Departments, 9 out of 10 patients are now seen and assessed for treatment as soon as they arrive. You can help the NHS by using your accident and emergency department properly. Consider whether your need for treatment is urgent or whether you could be better cared for by your GP. When you go to an outpatient clinic you can expect to be given a specific appointment time and be seen within 30 minutes of that time. In outpatient departments, more than 8 out of 10 patients are now seen within 30 minutes of their appointment time. From April 1996, if you are admitted to hospital through an Accident and Emergency Department you can expect to be given a bed as soon as possible, and certainly within two hours. You can help the NHS - and all other patients - by keeping to your appointment time or giving the hospital early warning if this is not possible, so that others can be seen sooner. You can expect a qualified nurse, midwife, or health visitor to be responsible for your nursing or midwifery care. You will be told her name. If you agree, you can expect your relatives and friends to be kept up to date with the progress of your treatment. SINGLE SEX WARDSExcept in emergencies, you have the right to be told before you go into hospital whether it is planned to care for you in a ward for men and women. In all cases, you can expect single sex washing and toilet facilities. If you would prefer to be cared for in single sex accommodation (either a single sex ward or "bay" area within a larger ward which offers equal privacy) your wishes will be respected wherever possible. There may be some cases, particularly emergencies, where a hospital cannot provide single sex accommodation. This is most likely to arise if you need to be looked after by a specialist nurse in an intensive care ward or in an observation unit. It is also possible that single sex accommodation may not be available at the time proposed for your admission. If this is the case, you have the choice of accepting the immediate admission or of waiting for single sex accommodation to become available. CATERING SERVICESFrom April 1995, if you have to stay in hospital, you can expect to be given a written explanation of the hospital’s patient food, nutrition and health policy and the catering services and standards you can expect during your stay. The standards will mean that:
THE HOSPITAL ENVIRONMENTYou can expect enquiry points and clear signposting in all hospitals to help you and your visitors to find your way around. You can expect to be cared for in an environment which is clean and safe. During the time you spend in hospital you can expect reasonable measures to be taken for your personal protection and safety. You can also expect to have facilities to keep personal money and belongings safe. You can help the NHS by reporting any suspicious incidents or behaviour to members of staff. LEAVING HOSPITALBefore you are discharged from hospital, you can expect a decision to be made about how to meet any needs you may continue to have. Your hospital will agree arrangements with agencies such as community nursing services and local authority social services departments. You and, if you agree, your carers will be involved in making these decisions and kept up to date with information at all stages. YOUR HOSPITAL’S OWN STANDARDSYou can also expect your health authority to set local standards on
You can expect your hospital to display information on the Patient’s Charter including these local standards and whether they are meeting them. You can expect your hospital to make it clear to you how you can complain or make comments and suggestions whilst you are in hospital. You can expect your hospital to publish regularly details of the number of complaints they have received and the time they took to deal with them. |
|
|||
The Patient’s Charter and You - Community ServicesAPPOINTMENT TIMESThere are nurses, health visitors and midwives working in your community. From April 1995, if you need a home visit from one of these professionals, you can expect to be consulted about a convenient time. You can then expect a visit within a two-hour time band. Exceptionally, your community nurse, health visitor or midwife may be unable to make this appointment or be delayed. In these cases, your community nurse, health visitor or midwife should let you know and make another appointment with you. SEEING COMMUNITY NURSES AND MIDWIVESYou can expect to receive a visit from someone in the district nurse team or the mental health nurse
You can expect to receive a visit from your midwife if you and your midwife agree this is necessary. Together you and your midwife will discuss and agree the care you need both before and after your baby is born. You can expect to receive a visit from your health visitor
COMMUNITY CARE CHARTERSIn addition to these new standards for Community Services, the NHS is working with local authorities to help produce local community care charters which will cover the standards of service you can expect from, for example, homecare services, aids and equipment for daily living and day care. |
|
|||
Ambulance ServicesIf you call an emergency ambulance (999 call), you can expect it to arrive within 14 minutes in an urban area*, or 19 minutes in a rural area*. In 1993/4 over three quarters of ambulance services achieved these targets. You can help the NHS by remembering that the emergency ambulance service is there for people in the most urgent need of hospital treatment. Irresponsible use of the 999 service can cost lives. Please call 999 only in emergencies. * An ’urban’ area is one where the population density is over 2.5 people per acre. If there are fewer people, it is a ’rural’ area: You can find out what type of area you live in from your local District Health Authority. |
|
|||
Dental, Optical and Pharmaceutical servicesYOUR DENTISTNHS dentists provide free treatment for some people, including children under 18, and subsidised treatment for others.
YOUR OPTOMETRISTAn optometrist (or ophthalmic optician) tests sight and prescribes glasses and contact lenses. Glasses and contact lenses are not supplied through the NHS but some people can get help with their costs.
If you are fitted with contact lenses, you can expect:
YOUR COMMUNITY PHARMACISTPharmacists are health professionals, who are readily available to give advice on treating common problems. While dispensing your prescription, your pharmacist will review and confirm that the medicine is appropriate and give you the information you need so that you can use your medicines properly. A certificate in the pharmacy will show your pharmacist’s name. You have the right to
Warning - don’t keep old medicines around the house. Please return them to your pharmacist for safe disposal. |
|
|||
The Patient’s Charter and Maternity ServicesThe Government has published a special charter for pregnant women and new mothers. This explains your rights and the standards of service you can expect to receive during pregnancy, the baby’s birth and post natal care. Among other things, it covers:
These rights and standards are part of the Government’s policy in "Changing Childbirth". You can get copies of the Maternity Charter from your GP’s surgery, ante-natal clinic, hospital, Health Authority, Community Health Council and the local library. Or you can ring the National Health Information Service on 0800 665544. |
|
|||
Learning from YouYou can help the NHS by telling us about your experiences of the NHS - good and bad - so that we can improve the service it offers. If you have a comment, suggestion, or complaint, the first step is to tell the people who provide the service - the doctor’s surgery or health centre, the community nurse, the hospital. Their addresses and telephone numbers are in the phone book. If you want to pursue a complaint about your GP, dentist, optician or pharmacist, contact your Health Authority. The HA aims to:-
If you want to pursue a complaint about hospital or community services, contact the general manager or chief executive of the hospital concerned. You have a right to have your complaint investigated and to receive a full and prompt written reply from the general manager or chief executive. Your local Community Health Council provides independent help and advice on making a complaint. Their number is in the phone book. If you are not satisfied after a complaint has been investigated by the NHS, you can ask the Health Service Commissioner for England, (sometimes known as the Ombudsman) who is completely independent of the NHS, to consider investigating your case. There are some matters which he cannot investigate, and there is a separate leaflet explaining his powers. The Ombudsman’s address is; 11th Floor
Tel; 0171 276 2035. The Government intends to take further action to improve the NHS complaints procedures. The aim is to put matters right more quickly for the patient and to use their experience to improve the quality of service for everyone. IF YOU WANT MORE INFORMATIONRing the National Health Information Service. Call free on 0800 665544 for information on any NHS service - (UK only). |
|
|||
How you can Help the NHSThroughout this document, we have explained how you can help the NHS by using its services responsibly, letting us know about your experiences and being prepared to help others. So please remember to
|
|
|||
Charter MarkIf you think your local hospital, community trust or GP practice is doing a really good job and delivering excellent service, you may like to nominate them for one of this year’s Charter Mark awards. The Charter Mark award scheme tests and rewards excellence throughout the public services. Twenty two Charter Marks have been awarded to NHS services so far. The award scheme is run by the Prime Minister’s Citizen’s Charter Advisory Panel. Write to: The Charter Mark Awards or telephone: 0645 400444 |
|
|||
InformationGET MORE COPIES OF/INFORMATION ABOUT THIS LEAFLET AND ETHNIC MINORITY, AUDIO CASSETTE, BRAILLE, LARGE PRINT AND SIGN LANGUAGE VIDEO VERSIONS0800 555777SORRY - UK ONLYAuthorPatient’s Charter Unit, Department of Health CopyrightThis document is Crown copyright but may be reproduced without formal permission or charge for personal or in-house use. © Crown Copyright 1996. HistoryThe Patient’s Charter, first published October 1991, aims to improve the quality of health service delivery to patients. The Charter sets out patients’ rights in the NHS and the standards of service they can expect to receive in areas addressing, among others, waiting times; information about services and treatment; and privacy and dignity of the patient. A revised Charter, issued in 1995, draws together the rights and standards set out in the original Charter together with improvements made since 1991. Dental, optical and community pharmaceutical services were also covered for the first time in the revised Charter. This Charter applies in England. Separate charters have been drawn up for Northern Ireland, Scotland and Wales. Catalogue number:H51/006 0870 2RP 500K Nov 96 (23) EP If you want more informationRing the National Health Information Service. Call free on 0800 665544 for information about the Patient’s Charter or on any NHS service. If you think your Charter rights are being denied, you can write to Alan Langlands, Chief Executive of the NHS, who will arrange to have the matter investigated and if appropriate put right. You can write to him at the address below. FeedbackIf you want to comment about anything mentioned in this Charter, or wish to make a suggestion, including new ideas for Patient’s Charter standards, write to: Patient’s Charter Unit
Alternatively, use the standard feedback form for this web site. Your comments will be passed to the Patient’s Charter Unit. Related PublicationsThe Patient’s Charter and Maternity Services (published April 1994) - explains the rights and services women can expect to receive during pregnancy, the baby’s birth and postnatal care. The Blood Donor’s Charter (published 1995) - sets out donor’s rights and the standards of service they can expect to receive from the National Blood Service. The Patient’s Charter and Services for Young People (published March 1996) - explains how the rights and standards in the Patient’s Charter apply in particular to children’s care. The Patient’s Charter and Mental Health Services (published 16 January 1997) - explains the rights and services adult mental health patients can expect from the NHS. Annual NHS Comparative Performance (“League”) Tables show how local hospitals and ambulance services are doing against some of the national standards. Copies of these publications, and the Patient’s Charter, are available from the Health Literature line on 0800 555777 (UK only). Enquirers from abroad wishing to obtain copies of The Patient’s Charter and related publications should write to the Patient’s Charter Unit. Write to the Northern Ireland Office, Scottish Office or Welsh Office for copies of the Patient’s Charters for Northern Ireland, Scotland or Wales. Addresses for obtaining charters for Northern Ireland, Scotland and WalesThe Scottish Office N.Ireland: The Welsh Office |