A second opinion is when you choose to request the expertise of another healthcare professional after you've been given a diagnosis or treatment plan. What are the new rules about second opinions and and how can you request one? Do you have a right to a second opinion?   The General Medical Council, which regulates doctors, says doctors ‘must recognise a patient’s right to choose whether to accept your advice, and respect their right – to seek a second opinion’. However, receiving a second opinion on the NHS is not a legal right. More than 140 NHS trusts are also piloting a new initiative called Martha’s Rule , which would give patients the power to formally request an urgent review of hospital patients if their condition deteriorates from a team within the same hospital. Do you need a second opinion?  Before asking for a second opinion, it is worth asking your healthcare professional to go over your diagnosis and explain anything you don’t understand.  If you’re unhappy with your diagnosis or would like to try a different course of treatment, tell them. Your family or carer can also ask for a second opinion on your behalf, but only with your consent.  If they request a second opinion on your behalf, they should have all the information about your illness or condition, and check they understand it well.  Sometimes a consultant may ask a colleague to provide a second opinion.  For example, doctors may ask a colleague about a complicated case, or they may need to refer a patient to a consultant with a sub-specialty interest.   Things to consider  You may need to travel further to attend appointments at a different hospital.   If you have a serious medical condition requiring urgent treatment, you should discuss this with your current healthcare professional and ask whether any delay in starting treatment could affect your wellbeing. Requesting a second opinion should not negatively impact your care or relationship with your GP or any other healthcare professional taking care of you.  You may be able to find a specialist who has particular expertise in your medical condition, especially if it's rare, to give you a second opinion.  How do you get a second opinion?  You need to proactively seek a second opinion, which may involve, for example, asking to see a different GP at your practice, or going back to your GP to be re-referred to a different hospital specialist. If your GP agrees to refer you to a new consultant, they will be told that this is for a second opinion. They will also send your medical records to the new specialist. You will be treated as a new patient referral, and this will mean you need to wait longer for treatment. Considering the pros and cons of seeking a second opinion will help you make well-informed decisions about your treatment and your health.   What is Martha’s Rule?   NHS England is piloting Martha’s Rule , named after Martha Mills, a teenager who died in 2021 after developing sepsis in hospital. She had been admitted with a pancreatic injury after falling off her bike, but her treatment team did not address her family’s concerns about her deteriorating condition. In 2023, a coroner ruled that Martha would probably have survived had she been moved to intensive care earlier, and the government agreed to introduce a nationwide scheme based on initiatives already in place at some hospitals. NHSE said last year that 87 trusts had already implemented an escalation process to help patients or families get a second opinion, and 92 had partly or fully introduced a similar process for staff. In September and October, patients, relatives, carers, and staff made at least 573 calls about deteriorating conditions. Around half of these incidents led to a clinical review, and 14 resulted in patients being urgently transferred to intensive care. The pilots aim to develop a standardised approach to Martha’s Rule, ahead of scaling it up to the remaining trusts in England in the following years. What does Martha's Rule involve?  The three proposed components of Martha’s Rule are: All staff in NHS trusts must have 24/7 access to a rapid review from a critical care outreach team, who they can contact should they have concerns about a patient.  All patients, their families, carers, and advocates must also have access to the same 24/7 rapid review from a critical care outreach team, which they can contact directly, via mechanisms advertised around the hospital, and more widely if they are worried about the patient’s condition. This means that they don’t have to make the request via the medical team currently treating the patient.   The NHS must implement a structured approach to obtain information relating to a patient’s condition directly from patients and their families at least daily. In the first instance, this will cover all inpatients in acute and specialist trusts.  Looking for more information? Further information is available via the NHS website.

You've told us that you've experienced problems registering with a GP. This article explains more about your rights and what to do if you're refused the right to register. GP access is an ongoing issue you tell us about. We want to help you understand your rights when registering with your GP, using  NHS guidelines . Do I need proof of address to register with my GP? NHS guidelines state that you don't need proof of address, immigration status, ID or an NHS number to register with a GP. However, some GP surgeries ask for supporting documentation. They might have a few reasons to do this: It can help the surgery find your medical records or transfer them from another practice. It confirms that you live in the surgery's practice area if they do not accept patients from outside this area. If you don't have a permanent address, you can still register using a temporary address or the address of the GP surgery. Do I need identification to register with my GP? You do not have to provide an ID when registering with a GP, but it does help. Below is a list of documents that you can use as ID:  Passport Birth certificate Biometric residence permit Travel document HC2 certificate ARC card Utility bill What could stop me from being able to register at my GP? A GP must explain why they refuse your request to register in writing. The GP has the right to refuse if:  The practice isn't currently accepting new patients.  The practice only accepts patients living within its practice area.  You have been removed from that surgery before. What to do if you're refused the right to register There could be several reasons a GP may refuse your registration. But they must explain why in writing within 14 days. If you have problems registering with a GP surgery:  Call the NHS England Customer Contact Centre on 0300 311 22 33 Contact Healthwatch Somerset  Here are some ways that you can make a complaint: By  email  (for the attention of the complaints manager in subject line)  By post: NHS England, P.O. Box 16738, Redditch, B97 9PT By phone: 0300 311 2233 (Telephone Interpreter Service available) Further information can be found from your local  Citizens Advice  or  contact Healthwatch Somerset . This information can be made available in alternative formats, such as easy read or large print and may be available in alternative languages upon request. To receive this, contact 0300 311 2233 or send an  email to NHS England . I want to change my GP practice. Do I have to give a reason? No, you don't have to tell your practice why you want to change or your new one why you made that decision.  You'll need to fill in a registration form. A request will then be made to your current GP to transfer your medical records to the new GP surgery.  Read more information  on registering with a practice further away from your residence. Registering as a temporary patient You can register with a GP practice as a temporary patient. You can register as a temporary resident with a GP surgery for up to three months. To register, you must fill out a temporary services form (GMS3) from GP surgeries. After three months, you must reapply to register as a temporary resident or become a permanent patient. Accessing GP care as a student If you become unwell or need other medical treatment when you're at home or not staying near your university GP, you can  contact your nearest practice  to ask for treatment. You can receive emergency treatment for 14 days. After that, you will have to register as a temporary resident or permanent patient. You can also visit an  NHS urgent treatment centre . You don't need an appointment, and you don't need to be registered. They can treat minor injuries or illnesses such as cuts, bruises and rashes. They aren't designed for treating long-term conditions or life-threatening problems. More information Are you an asylum seeker, refugee, homeless or an overseas visitor, whether lawfully in the UK or not?  Find out how to register with a GP surgery .

GP practices very rarely remove patients from their list. If you are removed from a GP practice, you may need to register with a new one. GP practices may apply to remove patients from their list if the relationship between patient and GP has broken down. Your GP will normally explain the problem to you and try to resolve it. They may contact you or they may want to see you. If the problem can’t be resolved, the GP will normally advise you in writing that you may be removed from their list. Patients cannot be removed from a GP’s list because they’ve made a complaint. However, the basis of the complaint may mean that the relationship between patient and GP has already broken down. If a patient has been violent or abusive, or has behaved in a threatening way towards their GP or a member of staff and the police have been involved, they may be removed from their GP’s list immediately without warning. Your GP’s practice leaflet may explain their policy for removing patients from their list. Moving out of your GP’s catchment area You may also be removed from your GP’s list if you move out of the area covered by their practice. If you’re removed from your GP practice’s list, you may need to register with another GP practice. You will be given 30 days in which to make alternative arrangements. Getting a new GP You may choose to register with a different GP practice, but the practice does not have to accept you. This is the same for anyone registering with a GP– it’s not related to your removal from your former practice’s list. It may be because you live outside the practice’s catchment area or because the practice is not accepting new patients at that time. A practice cannot refuse you unless it has reasonable grounds for doing so. These must not relate to race, gender, social class, age, religion, sexual orientation, appearance, disability or a medical condition. It must also give you reasons for its decision in writing. If you’ve been removed from your GP’s list and you haven’t yet registered elsewhere, your local Integrated Care Board, known as ICB, can find you another GP. For more information, see: How do I register with a GP? You can register with a GP surgery using the NHS App. What if I need treatment? If you need emergency treatment or have treatment more than once a week, you can get treatment from your current GP until your condition improves or until a new GP practice accepts you. Patients who have been removed from their GP’s list because of violence are only entitled to emergency treatment if their GP thinks it’s clinically necessary. You can register with a GP surgery using the NHS App. Other family members If you’re removed from your GP’s list, it won’t necessarily affect other members of your family. However, this may depend on why you’ve been removed from the list. For example, if you’ve moved out of your GP’s area, other family members will also need to register with a new GP.

Hospital discharge processes are in place to help you leave hospital safely. Whether you're returning home or, moving onto another care provider here’s what you should expect when it’s time to leave hospital. The current guidance for hospital discharge is set out in the  Hospital discharge service policy and operating model  from the Department of Health and Social Care. What should happen when you arrive at hospital When you arrive at the hospital, you should be given  information explaining the process of leaving the hospital . Changes to hospital discharge policy since the start of the pandemic mean that while you and your loved ones will still receive high-quality care in the hospital, you must be discharged as soon as you no longer require hospital care. For most patients leaving hospital this will mean that, where it is needed, the assessment and organising of ongoing care will take place when they are in their own home. While you are in hospital. staff should discuss with you what kind of care and support you are likely to need after your discharge. Any family or carers who might be supporting you should be involved in these conversations.  What should happen before you leave hospital 1) Explaining the process On the day that you are ready to be discharged from hospital, your health team will discuss this process with you and take you to the discharge lounge. Most people should then expect to be discharged within two hours, although this may take longer if you have more complex requirements for post-discharge care.  2) Hospital lounge and patient transport While you are waiting in the hospital discharge lounge, the discharge co-ordinators should discuss with you your transport home, any medication you might need, and support with immediate practical measures such as shopping and the turning the heating on, if there is no one at home to help you do this. They should also discuss with you whether you are likely to need any longer-term recovery support. 3) Aftercare and ongoing support If you need immediate care or support on the day of your discharge from hospital, this should be arranged by a care coordinator before you leave hospital. If you may need longer-term recovery support, you should be informed that a health professional will visit you in your home or other place of discharge to assess your ongoing healthcare needs after your leave hospital. If you are able to manage your own recovery without significant additional support from the NHS, you should be given information about voluntary or community support services you can contact, and informed that you can request a formal assessment at a later date if your situation changes. If your condition means that you will be discharged to a care home or other place with additional support, you may not be given a choice about where you will go, but you should be supported to move to your preferred long-term care home later. 4) Contact information Before you are discharged, you should be given information about who to contact if you need further health advice or support after leaving hospital. What should happen after discharge – your continuing support needs If you need ongoing recovery support after discharge, you should be visited in your home by a health professional who will arrange this. This could include things like: Whether any changes are needed to make your home safe and comfortable  Ensuring there are people to support you and keep you company  Whether you might need support for daily tasks (e.g. washing, getting dressed, cooking)  Whether a short-term wheelchair loan would be helpful for you Whether you need support taking any medication  This should happen the day you leave hospital or the day after and this support should then be made quickly available. Will I face any costs? Currently, any care and support you receive in your own home will be free for up to six weeks after you leave hospital. During this time, the team caring for you should assess whether you might need longer-term support and if so, support you to determine your eligibility for further funding. Need more information?  Read more on hospital discharge here: NHS - Being discharged from hospital GOV.uk - Hospital discharge information for patients entering hospital Age UK - Leaving hospital

Our report following a visit to Highfield House, a Grade 2 listed house converted to a care home and situated on the High Street, in the centre of Castle Cary. Key findings    The Healthwatch team all reported great first impressions of the home There is a real sense that this is the residents’ home, and staff appear to be like family within that home. The manager and deputy appear very caring and committed to ensuring each resident is happy and healthy The environment felt homely and welcoming, calm and organised Interactions between residents and staff were very personalised; staff know residents well. This was the same for staff interactions with relatives  It was apparent the home sought to get the right staff to fit the ethos and culture of the home Recommendations We would like the home to consider the following recommendations based on our observations and findings from the visit.   We liked that the home had strong links within the local community, including the local coffee shop, primary school and church (who deliver Holy Communion) and would recommend this continues We suggested the home consider a photo board of staff who were on duty that day We like that a resident has been asked to be the Resident Ambassador We really liked the ‘wish board/what matters to me most’ as this reflects the personalised nature of care in the home. Healthwatch would like to use this as an example of good practice to share with other providers   Read our report

In our latest Annual Report, The Value of Listening, we highlight how we've worked throughout the year to understand people’s health and care needs, and to use public feedback to help NHS and social care services improve care in Somerset. The report also outlines our work planned for 2024-25. The year in numbers 2,621 people shared their experiences of health and social care services with us, helping to raise awareness of issues and improve care. 4,325 people came to us for clear advice and information about topics such as mental health and the cost of living crisis. 35 outstanding volunteers supported us last year, giving up 126 days of their time to make care better for their community. We published eight reports about the improvements people would like to see to health and social care services. Next steps Over the next year, we will keep reaching out to every part of society, especially people in the most deprived areas, so that those in power hear their views and experiences. We will also work together with partners and our local Integrated Care System to help develop an NHS culture where, at every level, staff strive to listen and learn from patients to make care better. Our top three priorities are: Care at home Unpaid carers Pharmacies Read the full Healthwatch Somerset Annual Report 2023-24 to find out more about our work during the past year, including findings and recommendations for changes to services. Read our report If you need this report in a different format, please email  info@healthwatchsomerset.co.uk   or call 0800 999 1286.

Individuals and organisations have the right to express their views about the performance of Healthwatch Somerset and the way in which it conducts its business. The policy below details how we will deal with complaints raised with us.

Our December newsletter includes updates about our work, information about health and care services, and helpful advice. To read our December newsletter - click on the pdf below If you need this newsletter in a different format, please email: info@healthwatchsomerset.co.uk  or call 0800 999 1286.

Our November newsletter includes updates about our work, information about health and care services, and helpful advice. To read our November newsletter - click on the pdf below If you need this newsletter in a different format, please email:   info@healthwatchsomerset.co.uk  or call 0800 999 1286.

Do you know about your rights to language support in NHS settings? High-quality translation and interpretation are vital to ensuring that people access the health and care services they are entitled to and understand their treatment. But did you know that healthcare providers must provide patients with translation and interpretation services?   Do you have a right to an interpreter?   It is your right to have a professional interpreter help you at every stage of your healthcare journey. It is the responsibility of your healthcare provider to arrange an interpreter for you.   The NHS has a  legal responsibility  to make sure that the services they provide are equally accessible to all sections of the community.  Guidance  to services also makes clear that a professional interpreter should always be offered where language is an issue in discussing health matters.  What should I expect?   You have a right to expect that the NHS provides timely interpretation support. Additional time should be provided at appointments when an interpreter is required.   Your healthcare worker should also record in your healthcare record:   your preferred spoken language (including dialect)   your preferred written language    whether you require an interpreter   This information should be passed on when you get a referral to other health or social care services.   You should never have to pay for language interpretation services.   Can I provide my own interpreter?   You might think that it’s easier to ask a friend or family member to help translate or interpret important information. Sometimes this may seem like the simplest, most straightforward solution.   But this brings up a range of risks and issues, and it is safer to use interpreters provided by NHS services. Even a person with excellent English skills may not be able to understand health-related information very well. This can create gaps in the information shared and increase the likelihood of something going wrong along the patient's healthcare journey.   Children should not be used to interpret or translate health and care information.    NHS guidance states that professional interpreting services should always be provided.  Using professional interpreters also benefits the NHS  There are many benefits of using professional interpreters, including:    ensuring accuracy and impartiality of interpreting   minimising legal risk of misinterpretation of crucial clinical information (for example, informed consent to undergo clinical treatments and procedures)   minimising safeguarding risk (for example, for victims of human trafficking)   allowing family members and friends to attend appointments and support the patient (emotionally and with decision-making) without the added pressure of needing to interpret   fostering trust with the patient Should health information be translated for me?  Healthcare providers should provide you with written information about health and care services (such as leaflets) in a language and format that you understand. When translated information isn’t available in your preferred language, it should be provided free.   High-quality translations provided by a trained translator should be available. Online tools, such as Google Translate, should not be relied on for translation in healthcare settings, as they may result in inaccurate or misleading communications between staff and service users.   Further support   Sources of existing translated health-related information include:  NHS.UK and NHS Inform  provide a series of health information translated into other languages  Doctors of the World  has produced translated health related information  While using visual aids should not replace the need for professional interpreting and translation, various tools have been developed to facilitate communication with people whose first language is not English:  The British Red Cross and NHS  Emergency Multilingual Phrasebook  is available in many languages. Picture Communication Tool

We visited the Community Diagnostic Centre in January and February 2024 as part of a Healthwatch England project about Diagnostic Centers across the country (see below). We made three separate visits, on different days and times. We carried out 32 interviews with people who agreed to speak to us. We also completed an accessibility audit of the site, which included information about travel routes. Our report covered three main areas: Overall patient experience. Accessibility. Travel The overall report was very positive. You can read our report at the bottom of the page. The Director of Patient Experience and Engagement from Somerset NHS Foundation Trust said: "We all felt that this was a very helpful report which provided a good, independent overview of the facility whilst recognising that public transport issues are a continued challenge. It is great to see such positive feedback and that the facility is making a real difference to our patients." Healthwatch England On 25th October 24 Healthcare Leader published a blog by Louise Ansari , CEO of Healthwatch England on what lessons the Community Diagnostic Centre experience holds for any expansion of community-based care. This article, which highlights several examples of good practice (and areas for improvement!) observed by local Healthwatch teams, follows on from the Healthwatch England report published in August on people’s experiences of using CDCs . You can read our Healthwatch Somerset report below:

Cervical screening, previously known as a smear test, saves over 4,000 lives every year in the UK. However, some women find it uncomfortable, so it's important to know what support is available and what adjustments you can request. Nearly a third of eligible women in England did not come forward for screening in 2023.   Cervical screening, which some people refer to as  ’going for a smear test’, checks the health of the cervix and help prevent cervical cancer.  Our new research shows many women put off going for cervical screening due to physical discomfort, embarrassment to undress and a belief they don’t need to attend as they aren’t currently sexually active.  In this blog we answer some of the key questions about cervical screening and the adjustments you can ask for to improve the experience of your screening appointment.   Do I have to attend cervical screening?  Attending a cervical screening appointment is your choice. However, the NHS highly recommends everyone with a cervix attend screenings, as they are vital to prevent cervical cancer.  Knowing what support is available and adjustments you can ask for may make it a more pleasant experience if you are worried about attending.  How is cervical screening done?  According to information on the NHS website, a nurse or doctor will use a soft brush to collect a small sample of cells from your cervix. The sample is checked for human papillomavirus (HPV), which can cause changes to the cells of your cervix. The process is quick; it usually takes about five minutes. Check out this  NHS video showing someone having a cervical screening .  Your cervical screening results are usually sent to you in a letter. Your nurse or doctor will tell you when you can expect your results.  What should I consider before booking my cervical screening appointment?  You do not need to do anything special to prepare, but there are things that may help, the NHS website says:  Book your screening for when you're not having a period – this includes the two days before or after you bleed.  Wait until after any treatment for unusual vaginal discharge or a pelvic infection.  Avoid vaginal medicines, lubricants and creams for two days before your appointment.  What cervical screening support is available?  You may feel anxious or worried about attending for several reasons. If you feel concerned about your appointment, you can discuss this with a health professional who can help when booking the appointment. Some  adjustments you can ask for  include:  Book the first appointment of the day to avoid waiting in waiting rooms for a long time.  Ask to be seen by a trusted doctor or female health professional.  Ask for a chaperone. This is usually another health professional, although you can also bring a friend, relative or carer.  Ask for a longer appointment if you feel you may need more time during the appointment.  Ask for an appointment, just to talk about what happens during the screening first.  Ask for a vaginal oestrogen cream or pessary to be prescribed ahead of your appointment, if you think screening may be more difficult after menopause.  What adjustments can be made during the appointment to make it more comfortable?  There are a number of adjustments you can ask for during your cervical screening. These include:   If you feel uncomfortable during your screening or are worried about removing your clothes, you can wear a skirt, dress or long top. This may help you to feel more covered, as you can keep these clothes on during your test and will only be asked to take off your underwear. Health professionals will always give you a modesty sheet to cover you.  You may feel more comfortable in different positions, like lying on your side. Your doctor or nurse will work with you to make sure you’re in the best position for yourself.  You can also a ask for a smaller speculum. Health professionals will use a speculum to see your cervix. They come in a range of sizes. You can talk to your health professional about which size suits you best.   It may help to agree on a word or hand signal during the test, so the health professional knows to stop if you need a break or feel uncomfortable.  Where can I learn more?   Follow the links below for more information on cervical screenings, cervical cancer, and support available.  Cervical screening - NHS ( www.nhs.uk )     Cervical cancer - stages, symptoms, diagnosis, treatment | Macmillan Cancer Support   Should trans men have cervical screening tests? - NHS ( www.nhs.uk )   Cervical screening: support for people who feel anxious about attending - GOV.UK ( www.gov.uk )   An Easy Read leaflet about cervical screening (www.gov.uk) Cervical screening myth busting: Question and Answer video - Leicestershire Partnership NHS Trust (www.youtube.com) About our campaign   Healthwatch England have launched a campaign to support NHE England’s ambition to eliminate cervical cancer by 2040.   Their report “ Cervical screening my way ” highlights the importance of professionals who carry out screening, being sensitive to the concerns and past experiences of women, and taking time to answer their questions, allay fears and make practical adjustments during appointments.