FAQs - Changes to NHS referral Services


Why have I received this letter?

You have received this letter because our records show that you live in England but are registered with a GP practice that is based in Wales, or is a branch surgery of a Welsh GP practice. This means that, in the future, your GP practice may change the way they refer you for onward consultant-led treatment. If your GP practice adopts this new referral method, and if you are referred for a consultant-led service, then your referral will be sent to a Referral Assessment Service, and you will be contacted by a member of their team to book an appointment for you.


What is the reason for this?

In 2013, responsibility for the long-standing protocol for cross-border healthcare between England and Wales transferred from the Department of Health to NHS England.  A revised protocol for cross-border healthcare was agreed between NHS England and the Welsh Government, and took effect from April 2013. Arrangements under the terms of that protocol continued as previously, where responsibility for all healthcare services (primary and secondary care), for patients living in England but registered with a Welsh GP fall to the Welsh NHS. Changes to English NHS legislation which came into effect from 1 April 2013 means that consultant-led care for English residents is the responsibility of their Clinical Commissioning Group (CCG), even if those patients are registered with a GP practice in Wales. The protocol has remained in place whilst we have worked with the Welsh NHS to reach a solution for new referral arrangements for our English resident patients.


Why is this change happening now?

A number of NHS organisations in England and Wales have been collaborating to enable English resident patients to be able to access NHS England commissioned consultant-led care. This has involved a great deal of detailed technical work to ensure that patient care is not affected by the new arrangements, which has taken some time to do. A solution has been agreed that will redirect English resident patients who want to access consultant-led healthcare in England.  However, it is important to note that this service is being implemented by Welsh GP practices who have chosen to be a part of the new referral process, but Welsh GPs are under no contractual obligation to make this change and some may choose not to participate. If you have any questions you can always speak to your GP practice who will be able to tell you if your practice is taking part.


Do I need to change my GP practice?

No, you do not need to change GP practice if you don’t want to, you can continue to be registered at your Welsh GP practice. The letter and leaflet is intended to explain future changes to referrals for consultant-led treatment, it does not make any changes to the services you receive from your GP practice.


What if I have received a letter from the CCG but I actually live in Wales?

Please disregard the letter and leaflet. This change affects English resident patients only. There will be no change to the way you are referred for consultant-led care.