Legal documents are used to determine a patient’s healthcare plan if they don’t have the capacity to make their own voluntary and informed decisions.
Advanced directives – patients themselves provide authority when they have the capacity to specifically state their consent on certain procedures in times they may not have capacity.
If a patient has no advanced directives or if the advanced directive cannot be used to determine consent for a certain procedure, a health and well-being Lasting Power of Attorney is used (LPA).
The Patient nominates someone else to make their healthcare decisions for them in the future when they may lack capacity.
If this person is doubted to be acting in the best interest of the patient, or if there is no Advanced Directive or LPA, an Independent Mental Capacity Advocate (IMCA) can be consulted. The role of an IMCA is to be a legal safeguard for people who lack capacity and make decisions based on their best interests.
Doctors will act in the best interest of the patient. They will consider what the patient may have wanted. Doctors have a duty to speak to family members and find out the patient’s background, taking into account cultural and religious beliefs to make their decisions. There is a Whole team of doctors and healthcare professionals to decide this.
The NHS Constitution sets out your rights and responsibilities as a patient. These include:
If a GP refers a patient on an urgent referral for suspected cancer, they must be seen by a specialist within a maximum of 2 weeks. After this, a patient should wait a maximum of 62 days from referral to first treatment, if they are positive for cancer, and more specifically a maximum of 31 days to be given treatment, from their decision to have treatment.
More About Urgent Referrals
You have the right to be involved in planning and making decisions about your health and care with your healthcare team.
You can speak to your healthcare team about being involved in any decisions about your health. This is often referred to as ‘shared decision making’. You should have a conversation about all your concerns and needs, and what matters to you. This can help you to think about what’s important to you when making decisions about your treatment.
Holistic Needs Assessment or a Concerns Checklist may be used.You can ask your healthcare team for information and support about the tests and treatments that are available to you, including what they involve and their risks and benefits to you and any side effects on your health. When making these decisions remember you can involve your family and carers.
You can also request to access your medical records to help you better understand your condition, treatments and cancer care. Doctors write to each other about your care, they should aim to send you a copy of their letters or emails. If you do not get a copy, you can ask for one as this can help you make decisions about your care. Please note that you should only request this if absolutely necessary, as accessing records can take a long time.
Your doctors will not be able to give you any treatment until you have given your consent. We have further information about talking to your healthcare team and making decisions about treatment.
An HNA is an assessment and discussion you may have with someone from your healthcare team. Everyone diagnosed with cancer in England should be offered an HNA. Together, you will talk through any physical, emotional, practical, financial and spiritual concerns you may have about your cancer diagnosis. A plan can then be tailored to your care and support needs, which should lead to referrals to support and services to help meet your needs. Any needs or concerns can be discussed from any area of your life. If you are not offered one and would like one, you should speak to your healthcare team about one.
You have the right to receive care and treatment that is appropriate to you, meets your needs and reflects your preferences.
Speak to your healthcare team about the treatment you want, and you can make decisions about your care together. They will be able to give you more information about your care and they should support you in fully understanding any decisions and choices you make.
You might feel disappointed if you can’t have the treatment you would like. You may find it helpful to talk to your healthcare team. Ask them whether there are other treatments you can have or if you can take part in a clinical trial. You can read more about clinical trials.
It is worth remembering that treatment decisions are complex and are based on the evidence as to what is best for you at your stage of cancer. They also take into account other issues such as separate medical problems you may have. This may limit your treatment options.
You might be able to talk with other people who have tried to get the same treatment. It can be helpful to share experiences. Ask your specialist whether they can arrange this for you.
When making a complaint, a patient should complain to the healthcare provider or the commissioner. This can be in writing, by email or by speaking to someone in the organisation. A complaint should be made within 12 months of the incident, or 12 months of the matter coming to a patients attention. This time limit can be extended in some cases where it is still possible to investigate a complaint.
Anyone can complain on someone’s behalf with their permission, a family member, carer, friend or local MP. A patient can also reach out to an NHS complaints advocate to help make a complaint. They are independent of the NHS and can help write a complaint, attend a meeting, or explain available options. This service is free to anyone making a complaint about their NHS treatment or care.