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Patients declining appointments

Guidance for GPs – Patients declining appointments

Since the beginning of the COVID-19 pandemic, there has been an increase in the number of patients declining referrals to secondary care. Information has been provided to the CCGs about how GPs should consider approaching patients who have declined treatment. This information and is applicable in all such situations, irrespective of the reason that patient is declining treatment. This key points below are drawn from the GMC guidance.

  • You must respect a competent patient’s decision to refuse an investigation or treatment, even if you think their decision is wrong or irrational.  You may advise the patient of your clinical opinion, but you must not put pressure on them to accept your advice.  You must be careful that your words and actions do not imply judgment of the patient or their beliefs and values.
  • If the patient is a child who lacks capacity to make a decision, and both parents refuse treatment on the grounds of their religious or moral beliefs, you must discuss their concerns and look for treatment options that will accommodate their beliefs. You should involve the child in a way appropriate to their age and maturity. If following a discussion of all the options you cannot reach an agreement, and treatment is essential to preserve life or prevent serious deterioration in health, you should seek advice on approaching the court.
  • In an emergency, you can provide treatment that is immediately necessary to save life or prevent deterioration in health without consent or, in exceptional circumstances, against the wishes of a person with parental responsibility. 

In providing this information, the CCG notes that clinical practice is a matter for GPs and the CCG cannot advise them as to how they discharge clinical duties.  As such, GPs may wish to carefully consider the GMC guidance above and satisfy themselves that they are acting in accordance with their duties.


Download: Guidance for GPs – Patients Declining Appointments

© 2022 NHS Havering Clinical Commissioning Group.