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Second Opinions - Draft

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Overview

Requests for Second Opinions in non-acute settings

There is sometimes uncertainty about the rights patients have when requesting a second opinion within the NHS.

It is generally considered that doctors must respect the right of patients to request a second opinion although this is not a legal right. The guidelines from the organisations below may be helpful:

BMA

https://www.bma.org.uk/media/nalcxoal/the-doctor-patient-relationship2024.pdf

“Patients have the right to a second opinion? The GMC’s guidance Good medical practice at paragraph 18 states that doctors ‘must respect the patient’s right to seek a second opinion’. This is not the same as saying that NHS patients have a legal right to a second NHS opinion. It is generally considered to be good practice, however, to comply with patient requests for second opinions unless there are good reasons to justify a refusal. If a healthcare professional refers a patient for a second NHS opinion, the patient cannot insist on seeing a particular practitioner or provider. A patient who requests a second opinion within the private sector can continue to access other NHS services.”

https://www.gmc-uk.org/professional-standards/professional-standards-for-doctors/good-medical-practice/domain-2-patients-partnership-and-communication

“You must recognise a patient’s right to choose whether to accept your advice, and respect their right to seek a second opinion.”

The Patients Association

https://www.patients-association.org.uk/getting-a-second-opinion

“The NHS encourages patients to seek second opinions if they have any doubts or concerns about their diagnosis or treatment. It is seen as a right – but not a legal one – and it can lead to better outcomes and patient satisfaction”.

Request for second opinions in acute settings

Requests for second opinions in acute settings is covered separately by Martha's Rule which is not covered by the advice on this page. Please see NHSE website for further information:

NHS England » Martha’s Rule

How can patients request a second opinion

Second opinion from same provider

Patients may request a second opinion from another doctor within the same provider.

If they want to request a second opinion within the same provider they should approach their named consultant to request this either verbally or in writing. They can also contact the relevant hospital PALS team for support:

Second opinion from different provider

If an patient cannot resolve their concerns with their initial provider as above then they may wish to request a second opinion from an alternative provider via their GP.

This will require a new referral and should contain the reasons why a second opinion is being sought.

Patients should also be advised to read the advice from the patient association regarding the pros and cons of requesting a second opinion.

Requests for third or more opinions

If a patient makes repeated requests for further opinions following their second opinion then this would not be supported by BNSSG ICB. GPs are advised to decline these requests and ask patients to resolve any ongoing concerns with their current provider. In this event a full explanation should be given as to the reasons for the refusal.

Referrers may like to consider using existing advice and guidance services if further advice is required about patient care and the need for further opinions.

Efforts are made to ensure the accuracy and agreement of these guidelines, including any content uploaded, referred to or linked to from the system. However, BNSSG ICB cannot guarantee this. This guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer, in accordance with the mental capacity act, and informed by the summary of product characteristics of any drugs they are considering. Practitioners are required to perform their duties in accordance with the law and their regulators and nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.

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