Improving Local Services
Changes to Hospital Referrals
The way patients are referred from their GP in Gwent to hospital services in the
Aneurin Bevan Health Board area will change from September 2012. This relates to
those patients resident in Gwent and registered with GP Practices in Blaenau
Gwent, Caerphilly, Monmouthshire, Newport, and Torfaen.
What does this mean for me?
When you attend an appointment with your GP, your doctor may feel that you need
to be referred to hospital for diagnosis or treatment. At the present time, your doctor
may refer you to a hospital in England or Wales.
From September 2012, GPs and other clinically qualified NHS staff in Gwent will
direct referrals to services within Gwent hospitals as much as possible. This is
provided that the expertise and space is available at one of our own hospitals to
carry out the treatment required. Where these services are not available locally, the
Health Board will look to provide the treatment in another NHS service in Wales
What kind of treatments does this change affect?
This is only for new referrals to a hospital for treatment that doctors consider as not
immediately life threatening e.g. cataracts, surgical problems, routine diagnostic
tests etc.
It therefore does not apply to patients who are in a middle of a course of hospital
treatment or package of care.
What kind of treatment is not included?
At present, the new referral arrangements will not include the following:
 Emergency treatment e.g. Accident and Emergency
 GP, Dental, Pharmacy or Optician’s services normally referred to as Primary
Care Services
 Community Services e.g. Health Visiting, District Nursing
 Mental Health and Learning Disabilities services
 Services identified as specialist which requires specialist treatment.
 Requests for funding exceptional treatment (treatment that is not routinely
provided because it is new, developing or only provided in very specific
clinical circumstances). A separate process exists for this referred to as the
Individual Patient Treatment Request process.
 Requests for treatment in countries of the European Economic Area
What if the treatment I need is not available within the Health Board?
The Health Board will then look to provide the treatment from another hospital within
Wales. Welsh hospitals work closely together to provide treatment plans and
pathways for a wide range of conditions without the need for patients to have to
travel outside Wales.
Are there any other exceptions where treatment would be provided outside
these new referral arrangements?
There may be occasions when, although the service is available locally, a patients’
treatment may be better served at a hospital outside Wales.
In these cases, your GP or referring clinician would need to send an ‘Out of Area
Referral Form’ to the Health Board demonstrating that that there are circumstances
which, if unaddressed, are likely to have a serious impact on the patient’s continuing
health and wellbeing.
The Health Board will then consider the request on a case by case basis in
conjunction with a senior clinician.
What will happen next?
If approved, your referral will be automatically forwarded to the hospital where your
GP has requested treatment take place. You and your GP will be informed of the
decision within two working days.
If the request is not approved, the referral will be sent to a service within the Aneurin
Bevan Health Board area and you and your GP will be informed of the decision. This
will not affect your waiting time for treatment.
What if I disagree with the outcome of the decision?
If you do not agree with the outcome of the decision, your GP can make a formal
request for a review of the decision by the Health Board’s Review Panel. The
Review Panel will meet within one month of the request being received and consider
the evidence presented to them. Once again you and your GP will be informed of
the decision.
Why have these changes been made?
The Health Board aims to establish simple uniform arrangements based around high
quality, sustainable, local services for patients registered and resident in Gwent.
This aim is to focus our resources in developing a wider range of services in Gwent
and in Wales generally in line with the Welsh Government plan for health called
‘Together for Health’.
There are many examples across the Health Board area of how services have been
developed and improved by investing in our services and staffing locally. It will also
mean that the Health Board can carry out much more treatment locally without the
need for patients to travel.
If the immediate health needs of a patient would be better served by having their
treatment outside the health board area then referral outside the Health Board area
can still be made. These changes only affect non-urgent routine treatment that we
can readily provide locally.
Where can I get further information:
For further information, please contact the Health Board Prior Approval Team on
01633 623461.
On request, Aneurin Bevan Health Board has access to interpreters who can speak
other languages. This leaflet can be made available in other languages, large print,
Braille or on audiotape