Airlines may ask patients to provide letters or medical certificates confirming that a person’s medical condition is currently stable and a patient is ‘fit to fly’, this often affects pregnant women. GPs are not specially trained in aviation medicine and not insured to certify whether patients are fit to fly. In the case of our pregnant patients, we also do not have direct access to the ante natal records. Unfortunately we are therefore unable to provide any such certification.

We understand that this decision may cause inconvenience to some of our patients however, our primary responsibility is to ensure the safety and well-being of all our patients and we believe this decision aligns with that responsibility. If your midwife is also unable to provide this service, you may wish to request certification via a private provider.

Introduction

This document outlines the policy for managing requests for follow-up care and prescribing for patients who have undergone bariatric surgery (e.g., Sleeve Gastrectomy, Gastric Bypass, Gastric Band) privately or overseas. It aims to provide clear guidance for both practice staff and patients, ensuring safe and consistent care while protecting NHS resources.

The policy is based on guidance from BOMSS and NICE and adheres to the principle that private and NHS care must be kept separate to prevent the NHS from subsidising private treatment.

This structured process ensures patient safety, clinical responsibility, and minimal administrative burden while clarifying responsibilities for both patients and practice staff.

Practice Implementation: Post-Bariatric Surgery Care

Overview

Follow-up care within the first two years after private or overseas bariatric surgery is considered specialist care. The responsibility for this care remains with the operating private provider. This process is designed to ensure consistent handling of related requests while maintaining clear boundaries between private and NHS responsibilities.

Key Practice Considerations

• The first two years of post-operative follow-up is specialist care and is the responsibility of the private provider.
• We do not enter shared care agreements with private providers.
• We do not accept workload transfers(e.g., requests to arrange tests or prescribe specialist supplements) from private providers.
• Patients can request a transfer to NHS care, but acceptance is subject to NHS service criteria and capacity.

Patient Information: Follow-up Care After Private or Overseas Bariatric Surgery

What is the policy on follow-up care?

If you choose to have bariatric surgery privately (in the UK or abroad), you are responsible for arranging and funding your post-operative follow-up care. The first two years after surgery require specialist monitoring, which is not a routine service provided by your GP.

Your private surgical provider is responsible for your care, including:

• Blood tests and monitoring.
• Nutritional supplementation plans and prescriptions.
• Management of any surgery-related complications.

Arranging Your Private Follow-up Care

Before undergoing surgery, you must ensure you have a full, funded follow-up package with your private provider for at least two years. You should clarify with them who is responsible for:

• All necessary blood tests and scans.
• Prescriptions for specialist supplements and medications.
• Managing any complications.
• The process and criteria for discharge from their care.

Transferring to NHS Care

You have the right to request a transfer to NHS care in line with the NHS Constitution. However, please be aware:

• If your follow-up needs are still specialist in nature(typically within the first two years), we will refer you to an NHS-commissioned bariatric service.
• Acceptance by an NHS service is not guaranteed and depends on their specific criteria and capacity.
• If a referral is rejected, you may need to escalate this formally to the local NHS commissioner.

Once you are formally accepted by an NHS specialist service, your GP will provide elements of care that normally fall within general practice, guided by the advice from the NHS specialists.

Prescriptions and Monitoring

• Specialist supplements/medications required after bariatric surgery are not routinely prescribed by GPs if you are under private care.
• Your private provider is responsible for all prescribing and monitoring until an NHS service accepts the transfer of your care.
• We cannot arrange tests or complete forms solely to support your private follow-up care.

Summary: Key Points to Consider Before Private or Overseas Bariatric Surgery

Topic	Key Information
Follow-up Responsibility	The private surgical provider is responsible for the first two years of specialist follow-up care, including monitoring and complication management.
Prescriptions & Tests	Your private provider must organise and fund all related prescriptions (e.g., vitamins, minerals) and blood tests. GPs cannot undertake this for private care.
Transfer to NHS	A transfer to NHS care is possible but requires referral to and acceptance by an NHS specialist service, which is not guaranteed.
GP Role	GPs will not provide routine specialist follow-up but will support care that normally falls within general practice only after a patient is accepted by an NHS specialist service.
Shared Care Agreements	We DO NOT enter into shared care agreements with private providers due to the need to keep private and NHS care separate.

College Road Surgery
Version 1, September 2025
MS

Introduction

This document outlines the Right to Choose (RTC) referral process for Attention Deficit Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD) assessments. It aims to provide clear guidance for both practice staff and patients, ensuring an efficient and safe referral process.

The document is divided into two sections:

1. Practice Implementation – Guidance for staff on processing RTC referrals.
2. Patient Information – A structured guide to help patients understand their choices, responsibilities, and next steps.

This structured process ensures efficient referrals, patient safety, and minimal administrative burden while clarifying responsibilities for both patients and practice staff. By implementing this, we aim to streamline RTC referrals, reduce unnecessary delays, and protect practice resources.

Practice Implementation: RTC Referral Process

Overview

RTC allows patients to choose their preferred NHS-contracted provider for ADHD/ASD assessments. This process is designed to ensure referrals are handled consistently while maintaining patient safety and minimising administrative burdens.

Key Practice Considerations

• Patients must choose their own provider—GPs cannot recommend one.
• RTC providers are responsible for arranging any transition to NHS services.
• GPs cannot routinely prescribe ADHD medications, and Shared Care Agreements are NOT accepted with any private providor.

 

Patient Information: Right to Choose Referrals and Prescriptions

What is the Right to Choose?

Patients have the right to choose their provider for an ADHD or ASD assessment under the NHS Right to Choose scheme. Our GPs will provide the referral to the patient or send it directly to their chosen provider upon request.

If the patient has any questions about their appointment, they must contact the provider directly. RTC providers are typically private companies with NHS contracts.

Choosing a Right to Choose Provider

Our GPs cannot select a provider on the patient’s behalf. Patients must:

• Research their options.
• Choose a provider that meets their needs.
• Inform the practice of their choice so that we can advise on the next steps.

A useful resource for finding RTC providers is ADHD UK: https://adhduk.co.uk

Diagnosis and Follow-up

• Most RTC providers operate remotely and conduct online assessments.
• NHS services may not accept these diagnoses, and additional assessments may be required before transitioning into NHS care.
• The RTC provider is responsible for arranging any transfer of care into the NHS. Some providers claim they cannot do this, but this is incorrect and leads to unnecessary delays and additional work for our team.

Prescriptions and Shared Care Agreements

If an RTC provider diagnoses a patient with ADHD, they may recommend medication. However:

• ADHD medications are specialist-prescribed drugs, meaning GPs cannot routinely prescribe them.
• The prescribing responsibility remains with the specialist service.
• RTC providers may request a Shared Care Agreement, but we DO NOTE enter into these due to:
  • Patient safety concerns – Each RTC provider has different prescribing protocols.
  • Service continuity risks – If an RTC provider ceases trading or loses its NHS contract, prescriptions may be suddenly discontinued.

Patients should consider this before choosing a provider and ensure their RTC provider will continue prescribing any recommended medications.

Summary: Key Points to Consider Before Choosing an RTC Provider

Topic	Key Information
Choosing a provider	Patients must research and select their own provider. A good starting point is ADHD UK.
Diagnosis acceptance	NHS services may not accept RTC diagnoses without reassessment.
NHS transfer responsibility	The RTC provider must arrange any transition into NHS care. Some may claim they cannot, but this is not true.
Prescriptions	Our GPs cannot routinely prescribe ADHD medication. Prescriptions remain the responsibility of the RTC provider.
Shared Care Agreements	We DO NOT to enter into a Shared Care Agreement due to patient safety concerns and service continuity risks.

If patients have further questions, they should speak with us before making a decision.

This guide tells you what to expect from your general practice (GP) and how you can help them, so you get the best from the National Health Service (NHS). More details can be found through the links below.

When and how can you contact your general practice?

Your general practice is open from 8.20am to 6.30pm, Monday to Friday.

Throughout these hours you, or your carer on your behalf, can:

• Visit the practice
• Call them
• Go online using the practice’s website or the NHS App.

You can choose the way you contact your practice based on what is best for you. Some practices may have longer hours or may ask that you contact them via phone or in person for urgent queries.

What if the practice is closed?

If you need urgent help for your physical or mental health when the general practice is closed, and you cannot wait until they open, go online to 111.nhs.uk or call 111. They will tell you what to do next.

What if it’s an emergency?

If it’s a serious or life-threatening emergency, go straight to A&E (Accident and Emergency) or call 999.

What happens when you contact your practice to request an appointment?

Whether you make your request by phone, on-line or visiting your practice, you may be asked to give your practice some details so that they can assess what is best for you based on your clinical need. The practice team will consider your request for an appointment or medical advice and tell you within one working day what will happen next.

This could be:

• An appointment that day or a subsequent day
• A phone call that day or a subsequent day
• A text message responding to your query
• Advice to go to a pharmacy or another NHS service.

Your practice will decide what is best for you based on your clinical need.

Your practice cannot tell you to just call back the next day.

Who might help you?

You might be offered a face-to-face appointment or a phone call with a GP or other member of the practice staff, like a nurse or pharmacist.

If you have a carer, they can speak for you with your consent.

You can ask to see a preferred healthcare professional, and the practice will try to meet your request, although you might have to wait longer for that person to be available.

It can be helpful to see the same healthcare professional, particularly if you have a long-term health condition.

From what age can you see a GP on your own?

If you are 16 or older, you can make and go to appointments by yourself.

If you are under 16, you can still ask to see a GP without your parent or guardian. The GP will decide if that’s appropriate for you.

What if you need extra help?

If you do not speak English, you can ask for interpretation services in your preferred language when you make an appointment.

If you need extra help like longer appointments, a quiet space, wheelchair access, or information in a different format, tell your practice and they will try to help.

How do you choose a general practice?

You can:

• Call or visit a local practice
• Use Find a GP online.

If you want to change to a new general practice you can do so at any point. Most people have a few choices nearby.

Do you need ID or proof of address?

No, you do not need ID, an NHS number or proof of address. It can help the practice if you do, but it is not needed to register or see a GP.   You can also register with a practice if you are homeless.

Can a practice say no to registering you?

They must write to you within 14 days if they say no and explain why. A practice can only say no for a good reason, like if you live too far away or their patient list is closed. For example, they cannot say no for reasons such as immigration status, not having a permanent address, or for reasons connected with other characteristics protected under equalities legislation.

Can you choose which hospital or clinic you are referred to?

If your GP needs to refer you for a physical or mental health condition, in most cases you have the right to choose the hospital or service you’d like to go to. You can get further information on your right to choose on the nhs.uk website.

If you are new to the UK

You can still register with a GP. It’s free to use and your immigration status does not affect your right to register with a GP.

If you are away from home but still in the UK

If you are away from home for more than 24 hours (but less than 3 months), you can register as a temporary patient near where you’re staying.

You can also change your nominated pharmacy so you can get your medicine nearby. You can do this by contacting your practice or via the NHS App.

Do general practices charge for anything?

NHS GP services are free.  Sometimes, if you ask the GP to do private work (like writing a letter for insurance), they may charge a fee.

How should everyone be treated?

The practice should treat everyone fairly, kindly and respectfully.  Likewise, you should also treat staff with respect.  The practice can remove patients from their list if they are violent or abusive to staff.

To learn more about your rights, you can read the NHS Constitution.

How can you help your general practice?

1. Be prepared: Before an appointment, think about writing down your symptoms, what you are worried about and what you want to talk about.
2. Be on time: Being late for an appointment or being unavailable for a timed call-back can affect other patients.
3. Cancel if needed: If you can’t go to your appointment, tell the practice as soon as you can, so that they can offer it to someone else.
4. Use the NHS App or website: If you’re confident using smart phones or computers, you can book or cancel appointments, order repeat prescriptions, and see your test results online.
5. Turn on notifications: If you use the NHS App, turn on notifications so the practice can contact you more easily.  Please keep an eye out for messages.
6. Order repeat medicines on time: Make sure you ask for repeat prescriptions on time, so you don’t run out, and only order what you need.
7. Join the Patient Participation Group: You practice will have a group of patients who can offer feedback on the services it delivers. Your practice website should explain how you can join.

How can you give feedback or raise concerns?

If you want to give feedback, raise a concern or wish to make a formal complaint, ask to speak to the practice manager. If you don’t feel comfortable doing this, contact your integrated care board (ICB) – the local NHS body that oversees GPs practices. You can find your local integrated care on the NHS England website.

You can also give feedback about your practice to your local Healthwatch. Their job is to make sure NHS leaders and other decision-makers hear your voice and use your feedback to improve care. Healthwatch is independent and impartial, and any information you share with them is confidential. To find your local Healthwatch visit the Healthwatch website.

_{Source: NHS England » You and your general practice – English
Publication reference: PRN01907}

Seeing the same GP over time can have a big impact on your health and wellbeing. Continuity of care helps your GP understand your medical history, spot changes early, and provide more personalised treatment.
When you consistently see the same GP, it’s easier to manage long term conditions, prevent complications, and make informed decisions about your care. It also builds trust, making it easier to discuss health concerns openly and feel confident in the advice you receive.
At our practice, we aim to support continuity wherever possible. From keeping your medical records up to date to helping you book appointments with a familiar GP, our goal is to make your care smoother, safer, and more personal. Continuity benefits everyone – patients, GPs, and the wider healthcare team.

 

Please click here for more information

The NHS Birmingham and Solihull Integrated Care Board (ICB) was established on 1 July 2022, in line with the Health and Care Act 2022. An ICB is a statutory NHS organisation responsible for planning to meet the health needs of the local population, managing the NHS budget and arranging for the provision of health services.

NHS Birmingham and Solihull Integrated Care Board (ICB) has oversight of the local health system, coordinating and planning in a way that improves population health and reduces inequalities.

While Birmingham and Solihull Integrated Care System brings together health and care partners to deliver joined up care, NHS Birmingham and Solihull ICB is the statutory organisation bringing the NHS together locally to improve population health and establish shared strategic priorities within the NHS, within the local area.

The ICB is responsible for delivery against all health elements of the system health and care strategy, which will be agreed by the Integrated Care Partnership for Birmingham and Solihull.

You can find more about the ICB at www.birminghamsolihull.icb.nhs.uk.

The NHS operate a zero tolerance policy with regard to violence and abuse and the practice has the right to remove violent patients from the list with immediate effect in order to safeguard practice staff, patients and other persons. Violence in this context includes actual or threatened physical violence or verbal abuse which leads to fear for a person’s safety.

In this situation we will notify the patient in writing of their removal from the list and record in the patient’s medical records the fact of the removal and the circumstances leading to it.

 

 

There is a Central NHS Computer System called the Summary Care Record (SCR). It is an electronic record which contains information about the medicines you take, allergies you suffer from and any bad reactions to medicines you have had.

Why do I need a Summary Care Record?

Storing information in one place makes it easier for healthcare staff to treat you in an emergency, or when your GP practice is closed.

This information could make a difference to how a doctor decides to care for you, for example which medicines they choose to prescribe for you.

Who can see it?

Only healthcare staff involved in your care can see your Summary Care Record.

How do I know if I have one?

Over half of the population of England now have a Summary Care Record. You can find out whether Summary Care Records have come to your area by looking at our interactive map or by asking your GP.

Do I have to have one?

No, it is not compulsory. If you choose to opt out of the scheme, then you will need to complete a form and bring it along to the surgery.

More information

For further information visit the NHS Care records website.

Do you have concerns about possible Safeguarding issues?

Members of the public can report a concern for an adult with care and support needs to Birmingham City Council in the following ways:

• Online
• Email: ACAP@birmingham.gov.uk
• Telephone: 0121 303 1234
• Text Relay: dial 18001 followed by the full national phone number

Read more about what we mean by care and support needs.

Members of the public can report a concern for a child and young adults to Birmingham City Council by visiting Birmingham Children and Young Adults Service.