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Frequently asked questions

Q: I think I need some physiotherapy - can I refer myself?

A: Currently self referral is not available in our area, you can ask your GP to refer you directly if it is appropriate for you.

Q: I need some advice on contraception - do I have to go to my GP?

A: No you don't have to go to your GP. We have a number of Contraception and Sexual Health clinics across Surrey. All of the clinics are confidential no matter what your age, even if you are under the age of 16.

You don't need permission from your parents or guardian to go, and you don't need a referral from a GP. Click here to find a clinic near you.

Q: I am feeling really low- what can I do to help myself?

A: ​In Surrey the first port of call for information and advice on emotional well-being is First Steps or 0808 801 0325 or email them.

If you feel you may need a little more help, we would suggest that you make an appointment to see your GP who can refer you on to other services.

You may also wish to contact Surrey and Borders Partnership NHS Foundation Trust which is the main provider of health and social care services for people of all ages with mental health problems, drug and alcohol problems and learning disabilities in Surrey and North East Hampshire.

Need urgent help? There is a dedicated weekend and evening Mental Health Crisis Helpline for people with mental health problems in Surrey and North East Hampshire. In times of crisis or distress please call: 0300 456 83 42. Find out more.

Q: I don’t want to go to my local hospital for treatment can I choose where to go?

A:​ You are able to choose which consultant led hospital service provider you want to be referred to. This means that you can choose from any hospital in England offering a suitable treatment that meets NHS standards and costs. Patients can also choose to go to independent sector providers who have a contract with the NHS. This is available for most patients, most of the time, but exceptions  may need to be made the in case of emergency and urgent services e.g. cancer, chest pain or if you need to be referred on for very specialist treatment. If you need to be seen urgently by a specialist (for example, if you have severe chest pain), your GP will send you where you'll be seen most quickly.                                          

Q: How do I find an NHS Dentist? 


A: If you call 111 and give them your postcode or address they will be able to tell you your nearest NHS dentist accepting new patients.

Q:How much will I be charged for dental treatment?

A:NHS dentistry charges vary depending on the type of treatment.

Click here for more information. 

Q: Can you mix private treatment and NHS?

A: Yes. Dentistry is one of the few areas where NHS and private treatments can be combined. This can be confusing as NHS patients can sometimes be charged more than the maximum NHS charge because their treatment has included some elements of private work.

Your dentist should give you a personal dental plan which lists the costs and highlights which part of your treatment is to be carried out on the NHS and which are additional private work.

 Q: Is an appointment with a hygienist available on the NHS?

A​Dental hygienist appointments are not routinely available on the NHS.

However, NHS Band 1 Treatment includes Scale and Polish. If your clinical requirement is for a scale and polish then your dentist can provide this as part of a Band 1 course of treatment.

If, however, following a full examination, your dentist feels that you'd benefit from a higher level of treatment (periodontal treatment), the options and choices should be discussed. These could include a Band 2 NHS treatment, or treatment on a private basis (with a dental hygienist)​.​

Q: What should I do if I disagree with my bill?

A: If you are at all unsure about the amount you have been charged you should, in the first instance, discuss this with your dentist. Your dentist should give you a personal dental plan which lists the costs and highlights which part of your treatment is to be carried out on the NHS and which are additional private work.   

Q: My dentist says that they can only perform root canal treatment as a private patient, but it is listed as a procedure available on the NHS what should I do?

A: Your NHS dentist should provide all treatment that is clinically necessary and this includes root canal work. When there is an infection in the root canal system of a tooth the options are either extraction or attempting to remove the bacteria through root canal treatment. Your dentist will advise you on the best clinical option.​​

Q: My new dentures don’t fit well - will I have to pay again to have them adjusted?

A: If your dentures are new and don't fit comfortably, tell your dentist immediately.

Over time dentures can become loose fitting. If this happens arrange an appointment with your dentist to have them adjusted.

Your NHS dentist should carry out any work needed to adjust your dentures free of charge up to 12 months afterwards. However, if you lose or damage them or they need replacing due to wear and tear, you will have to pay the full cost of a replacement. You should return to the same NHS dental surgery that did the original work.

Q: Am I eligible for NHS services?


The NHS Choices ​website has information about NHS eligibility.​​

Q: I have come from abroad to stay with my son for 6 months – what am I entitled to whilst I am here?

If you are not ordinarily a resident or you don't come under the NHS Charges to Overseas Visitors Regulations 2011 charges will apply for any hospital treatment you receive and cannot be waived.​

If this is the case you are strongly advised to take out private healthcare insurance that would cover you for the length of time you are in the UK. There is no facility to purchase healthcare insurance from the NHS therefore any necessary insurance must be organised privately.

If you are not eligible for free NHS treatment, most treatment given by staff at a hospital may be subject to a charge.

But there are exceptions, which are free to all, as follows:

  • Treatment given in an accident and emergency department (excludes emergency treatment given elsewhere in the hospital
  • Treatment given in a walk in centre providing similar services to those of an accident and emergency department of a hospital
  • Treatment for certain communicable diseases (excluding HIV/AIDS where it is only the first diagnosis and connected counselling sessions)
  • Compulsory psychiatric treatment
  • Family planning services.​

Q: I am a UK citizen, I work in the Middle East but own property here in UK (currently rented out) – am I eligible for NHS treatment?

A: Nationality or past or present payments of UK taxes and National Insurance contributions are not taken into consideration when establishing residence. The only thing relevant is whether you ordinarily live in the UK.

Ordinarily resident means, broadly, living here on a lawful and properly settled basis and that your centre of interest is the UK

Q: I have just come back to live in the UK, I will need to have surgery soon – is this OK?

A: Under the current Regulations, anyone who is taking up or resuming permanent residence in the UK is entitled to free National Health Service (NHS) hospital treatment in England. If your intention is to live permanently in the UK you will be exempt from hospital charges from the date of your arrival in the country, but you should expect to be asked to prove your intention and that you are legally entitled to live here.​​

Q: I am studying in the UK for 2 years but am from outside the EU – can I access NHS services?

AAny person living here lawfully and on a settled basis is regarded as resident in the UK and therefore entitled to free primary medical services – this includes seeing an NHS GP or dentist and hospital treatment.

On taking up residence in the UK it is advisable to register at your local GP practice as a patient. The practice may choose to accept or decline your application. An application may be refused if the practice has reasonable grounds for doing so, such as if you are living outside their practice area. A practice would not be able to refuse your application on the grounds of race, gender, social class, age, religion, sexual orientation, appearance, disability or medical condition.

Under the current Regulations, anyone who comes to the UK to pursue a full-time course of which lasts longer than six months, or a course of study that is of any duration but is substantially funded by the UK Government, will be fully entitled to free NHS hospital treatment in England. This will also apply to your spouse, civil partner and children (under the age of 16, or 19 if in further education) if they are living permanently with you in the UK for the duration of your course.​

Q: I am a UK citizen currently living in Canada and my Canadian wife is 6 months pregnant. We are planning to move back to the UK will she be able to have our baby at an NHS hospital?

A: Anyone who is not ordinarily resident is subject to the National Health Service (Charges to Overseas Visitors) Regulations 2011. These regulations place a responsibility on NHS hospitals to establish whether a person is ordinarily resident, exempt from charges under one of a number of exemption categories or liable for charges.​​

Q: I live in the UK but my sick mother is alone in my home country. If she comes here to live will she be able to use the NHS?

A: UK Elderly Dependent Visa

This visa exists for individuals who are present and settled in the UK to bring their elderly dependent relative (parent or grandparent), in certain circumstances, to join them in the UK.

Elderly Dependent Requirements

  • The elderly dependent is a parent or grandparent
  • The elderly dependent is wholly financially or mainly dependent on the relative present and settled in the UK and has no other relatives; in their home country with the ability to provide adequate support
  • If widowed/made widower the elderly dependent is 65 years of age or older
  • If travelling as a couple one of the elderly dependents is 65 or older
  • The relative present and settled in the UK must be able to support and accommodate their elderly dependent without recourse to public funds.​

Q: Please could you explain why 70 year old patients and 79 year old patients are currently being vaccinated against shingles, but at 76 I am apparently not yet eligible

AA study has shown that the most cost effective age to offer the vaccine is to individuals aged 70 to 79 years. While the vaccine is authorised for use from age 50 years and is effective in this age group, the burden of shingles disease is generally not as severe compared with older ages. The vaccine is not currently recommended in the programme for adults aged 80 years and above as the efficacy of the vaccine is reduced in this age group.

Vaccine supply from the manufacturer is at present limited, and between 1 September 2013 and 31 August 2014, there will only be enough vaccine to fully vaccinate two birth cohorts – the routine cohort (70 year olds), and one catch-up cohort (those aged 79 on 1 September 2013).

It is recommended that everyone aged 70 to 79 should be offered shingles vaccine; therefore, under the NHS Constitution everyone aged 70 to 79 years has a right to receive the vaccine. Given the amount of vaccine available. The most equitable approach is to vaccinate 79-year-olds first, as 79- year-olds will be too old to be eligible for vaccination in 2014/15, when more vaccine becomes available.

Because of the limited supply of vaccine, vaccinating patients earlier than indicated could result in those aged 79 being unable to receive vaccine while eligible. Vaccine stock will however be carefully monitored, and if any age cohort can be vaccinated earlier than set out in the public health information they will be informed.

Q: My GP has said that there isn’t any funding for my treatment – why?

A: Recently there has been a substantial rise in referrals for non urgent or low priority procedures. In addition, there is increasing evidence that for some procedures significant numbers of patients report no clinical benefit. By stopping doing things which aren’t clinically necessary, we can safeguard and continue to do what’s clinically essential or urgent, such as cancer referrals and life-threatening trauma cases in A&E.

Medical needs are always at the heart of decisions about our priorities.  Going forward it is clear that the NHS cannot continue to offer treatments where there is no or very limited clinical evidence or which are predominately cosmetic, rather than on health grounds. 

East Surrey Clinical Commissioning Group has been talking to the people of East Surrey and have been told that the public want commissioners to make decisions that are;

  • Clinically necessary
  • Proven to be effective
  • Safe
  • Equitable and
  • Cost effective​

Q: Are there any exceptions?

A: Individual Funding Requests (IFR) are considered for treatments that are not normally funded by the NHS. The IFR is made by a Dr (either GP or specialist) and heard by a panel. The panel comprises of an independent GP, representatives from Public Health and commissioning and a lay representative. The panel will particularly look for “exceptionality” i.e. why one case should attract funding where others would not. The panel approach does seem to be the fairest way of allocating resources.

Individual Funding Requests Policy and Operating Procedures

Treatments not routinely funded

Procedures with restrictions or thresholds​

Q: Does East Surrey Clinical Commissioning Group fund IVF and if so how many cycles?

A: If you are eligible, you are entitled to two cycles of IVF. In order to be eligible for NHS funding of IVF you and your partner will have to meet all of the criteria listed within the policy. 

Click here to view our Assisted Conception Policy

Q: Why can’t I have my Varicose Veins operated on?

A
:  Varicose veins are graded 1-6 according to their clinical presentation, and currently we only fund specialist assessment for cases graded, by a GP, as 3 or above. This decision was made after careful consideration and with the agreement of the South East Coast Policy Recommendation Committee.


For those patients referred to a specialist, and for whom surgery is recommended, there are still considerations. One of these considerations is that non- surgical interventions should have been tried and failed.

We do have a limited budget with which we have to fund medical treatments for East Surrey residents, but financial constraints are not the only reason for restricting the numbers of varicose vein referrals. By ensuring that only the most severe cases are seen by our specialists, we can ensure that these patients receive their appointments (and possibly their operations) much more quickly.​​

Q: What is NICE and do East Surrey Clinical Commissioning Group have to follow their guidelines?

A: The National Institute for Clinical Evidence (NICE) provides guidance to all NHS organisations around the safety, cost and clinical effectiveness of treatments. However, the duty to maintain financial balance and preserve essential services lies with Clinical Commissioning Groups.​

Q: I have been waiting more than 18 weeks for my operation – can I go privately and send you the bill?

A: You have the right to start your consultant-led treatment within a maximum of 18 weeks from referral, unless you choose to wait longer, or it is clinically appropriate that you wait longer. This includes treatments where a consultant retains overall clinical responsibility for the service or team, or for your treatment (this means the consultant will not necessarily be present for each appointment or treatment, but will take overall responsibility for your care).

If it is not possible to be seen within the maximum waiting time, ESCCG will investigate a range of suitable alternative hospitals or community clinics that could be able to see or treat you more quickly.

However, you will need to contact the original hospital or clinic first before alternatives can be investigated for you. All treatments must be agreed in advance, and retrospective claims will not be considered.

The right to be seen within maximum waiting times does not apply:

  • If you choose to wait longer
  • If delaying the start of your treatment is in your best clinical interests, for example where stopping smoking or losing weight is likely to improve the outcome of the treatment
  • If it is clinically appropriate for your condition to be actively monitored in secondary care without clinical intervention or diagnostic procedures at that stage 
  • If you fail to attend appointments that you had chosen from a set of reasonable options, or 
  • If the treatment is no longer necessary.

Q: Please could you confirm which Gluten-free products you allow on prescription and how many units per month?

A: The previous system (before 2010) of supply of gluten free foods on prescription was established around 40 years ago when gluten-free foods were not readily available in supermarkets and shops.

A wide range of gluten free foods can now be purchased from all major supermarkets, including Asda, Budgens, Marks and Spencer, Morrisons, Sainsbury’s, Tesco, and Waitrose. Gluten free foods are however, currently more expensive than gluten based equivalent foods. The fact that gluten free foods were freely available on prescription may have stifled competition in this sector in the past and may have contributed to keeping prices artificially high.

The recommendation to restrict the type of gluten free products available on prescription was made by the South East Coast Primary Care Trust Alliance Regional Commission Board on 17th December 2010.

The two main reasons for adopting the recommendation were; 1) achieving the most cost effective use of NHS resources and 2) ensuring equity in the supply of dietary products across the South East Coast region.

Regional discussions were clinically-led and with some involvement of Coeliac UK, the national support group for people with coeliac disease. In April 2011, NHS Surrey wrote to all Surrey GPs informing them of the decision to implement South East Coast PCT Alliance recommendations about the prescribing of gluten free foods. GPS were asked to write to coeliac patients to inform them of the changes.

This means that the prescribing of gluten free products on FP10 (i.e. prescribed by a GP) is limited to eight items per month per patient. These eight items can be either long-life bread or flour.

The rationale for not including fresh bread is that it counts as a “special order” item and subsequently attracts an additional delivery fee of between £10 - £40. NHS Surrey (the previous commissioning organisation) felt there was insufficient justification for the additional spend which requires diverting money from treatments to be spent on delivery charges.

The supply of gluten free products on prescription had been under discussion for some time at both local and regional levels. We need to maximise the best and most equitable use of finite NHS resources, ensuring both coeliac and non-coeliac patients are treated fairly (given that no other food allergy products are available to adults free of charge, for instance to people with diabetes or who are lactose intolerant).​​

Q: I would like to change GPs what should I do?

AMost GP practices take patients from a set geographical area around their practice. The postcode where you live will denote which GP practice or practices you could join. In most areas patients will have a choice of at least two practices.

Each practice has its own registration procedure. Be prepared to fill in a registration form, produce any proof of address that might be requested and possibly attend a welcome consultation with the Practice Nurse. 

You do not need to tell your previous surgery why you are leaving.

If you are having difficulty in registering with a GP, contact the Primary Care Support Service.

Primary Care Support Service - Surbiton
187 Ewell Road
Surbiton
Surrey
KT6 6RF
Switchboard: 0208 335 1400 Fax: 020 8335 1401​

Q: My practice will only register me as a temporary patient – why?

A: It is the discretion of the GP as to who he or she registers as an NHS patient, but the GP must have reasonable non-discriminatory grounds to refuse someone.
A GP practice can register patients as a temporary patient - when they are in the area for more than 24 hours or less than three months, or as a permanent patient - when they are here for more than three months.​ 

Q: I have just moved into the area and do not have any utility bills or bank statements that show my new address – what other documentation can I use?

A: ​Contact the GP practice and ask what information/proof of identify they would consider to be appropriate.​

Q: I want to complain about my practice, who do I contact?

AIf you disagree with the way your GP wants to treat your health problem, or you're unhappy about the service provided by your GP surgery, tell them openly. However, if you feel unable to do so or you're unhappy with the response you receive, as a first step, speak to the practice manager. You may then wish to make a complaint.

All GP surgeries have a complaints procedure. You will find this at the reception or on the practice website. You can contact the practice in writing or by email.

You have the right to:

  • have your complaint dealt with efficiently, and properly investigated
  • know the outcome of any investigation into your complaint
  • take your complaint to the independent Parliamentary and Health Service Ombudsman if you're not satisfied with the way the NHS has dealt with your complaint
  • make a claim for judicial review if you think you've been directly affected by an unlawful act or decision of an NHS body
  • receive compensation if you've been harmed.  ​​

Q: My GP won’t give me a repeat prescription for a 6 monthly supply any more - why?

A: Commissioning organisations have recommended to GPs that they prescribe in quantities of a maximum of 28 day supply, wherever appropriate, due to the amount of money wasted yearly on prescriptions that go unused.

GPs may, at their discretion, choose to prescribe a longer period of medication. When doing this, consideration should be given to the likelihood of any adverse events which may go unnoticed, or alterations in therapy which could result in wastage.

You may find (according to the medication that you take) a pre-payment certificate is a cost effective option. Someone regularly receiving 4 or more prescription items in 3 months or 14 items in 12 months could save money by purchasing their prescriptions in this way.

Click here to find out more​​

Q: Do I really have to pay for an insurance report or sick certificate?

A: If you are off sick for up to 6 days you don’t need to produce a sick certificate but you can fill out a self- certificate. However, some employers will not accept self certification and insist on a doctor’s note.

Certificating someone who has been sick for less than 6 days is not part of the essential core GP work and can therefore be issued at a cost. Similarly filling in insurance reports and validating passports is not essential NHS / GP services and may attract a cost. How much is charged is entirely up to the practice to decide.​

Q: Why is my practice allowed to use an 0844 telephone number?

AFollowing a public consultation on the future use of 0844 numbers in the NHS, the Department announced that it would be prohibiting the use of telephone numbers which charged the patient more than the equivalent cost of calling a geographical number to contact the NHS. 

As a result of the consultation, directions were issued which instruct organisations not to use contact telephone numbers which have the effect of the patient paying a premium above the cost of a call to a geographical number.

The difficulty for practices is that they could not have anticipated the specific packages that individual patients may have agreed with their telephone provider (many make little or no charge at all for local calls).

Many practices who adopted the 0844 number did so believing that this would provide a better service for their patients. To change back to a local number again, may mean incurring an additional cost (for cancelling a contract) and would definitely mean investing time and money to advertise new numbers when resources are already scarce.

If your practice has an 0844 number you should let them know how you feel about it by writing either to your Practice Manager or by contacting your practice’s Patient​.

Q: Why won’t my practice give me some of my travel vaccinations free of charge? 

A: Not all travel vaccinations are available free on the NHS, even if they're recommended for travel to a certain area. As a general rule, the following travel jabs are usually free:

  • tetanus, diphtheria and polio booster
  • typhoid
  • hepatitis A and some combined vaccines, such as combined hepatitis A and B
  • cholera.

Your practice may be able to give you travel vaccinations, but it is not part of their core NHS business and it is not a service that they have to provide.

Some vaccinations take time to become effective, so consult your doctor at least two months before you plan to travel for advice and to arrange any vaccinations that you may need.

If your practice do not offer travel vaccines, or are temporarily unable to provide this service, you may be advised to attend a specialist travel clinics.

Click her​e for information on travel vaccinations​

Q: I have been told by my practice that I have been “de- registered”- why would they do that? I haven’t needed to bother them for years 

A: This could be for any number of reasons but should never happen without good cause. To find out why you have been removed from your GPs register call the Primary Care Support Service on 0208 335 1400.

Under the terms of their contracts GPs may be required to de-register someone if they are out of the country for more than three months.​

Q: I am 52 and haven’t been called for breast screening yet – what should I do?


A: Screening is organised according to your GP practice. Once every three years your GP practice will be contacted and all women eligible for screening will be invited. Not every woman will receive an appointment as soon as she is 50. However you should receive your first appointment by your 53rd birthday and therefore there is no need to contact them for an appointment.

To find out when women from your GP practice are due to be screened, please telephone the Jarvis Breast Screening and Diagnostic Centre on 0333 200 2062 (9am - 5pm Monday – Friday).​

Q: Why can’t I continue with my breast screening now that I am 72? I thought that the risk of getting breast cancer increased as you get older.

A: Women over the age of 70 are encouraged to continue with breast screening but must contact Jarvis Breast Screening and Diagnostic Centre on 0333 200 2062 (9am - 5pm Monday – Friday) for an appointment.

Please ensure that if at any time you notice any changes in your breasts or have any breast symptoms of any kind then please contact your GP practice immediately.

Q: I have recently moved house but am still registered with the same GP – will I get missed?

AIf you have notified your GP practice of your new address or if you have changed your GP practice you will be invited for screening when your GP practice is invited. If this is likely to be over three years since your last invitation you will be invited separately from your practice to ensure you are screened on time.

If you have moved house and fear you may have missed a screening appointment please contact Jarvis Breast Screening and Diagnostic Centre on 0333 200 2062 (9am - 5pm Monday – Friday).

Q: Can I ask my GP for an health MOT?

A: Services can vary between practices. Contact your surgery or talk to your GP to find out which health screening services are available and appropriate for you.​​

Q: Do we have screening for bowel cancer in Surrey?

A: Yes, The Surrey Bowel Cancer Centre is part of the National Screening programme. Click here for more information

The NHS Bowel Cancer Screening Programme offers screening every two years to all men and women aged 60 to 69. People in this age group will automatically be sent an invitation, then their screening kit, so they can do the test at home. After your first screening test, you will be sent another invitation and screening kit every two years until you reach 69. If you are aged 70 or over, you can ask for a screening kit by calling the Freephone number: 0800 7076060​