Advance Directives and LPA

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.

What are my rights as an NHS patient?

The NHS Constitution sets out your rights and responsibilities as a patient. These include:

  • free access to health services, except in some situations such as if you’re not a UK resident
  • not being unlawfully discriminated against, and being treated with dignity and respect
  • being treated by appropriately qualified and experienced staff
  • being protected from abuse, neglect, and care and treatment that is degrading
  • choosing your GP practice and expressing a preference for a doctor within your GP practice
  • receiving care and treatment that is appropriate to you
  • accessing NHS services within the maximum waiting times
  • not having to share sleeping accommodations with patients of the opposite sex when you are admitted to the hospital
  • receiving suitable and nutritious food and hydration to sustain good health and wellbeing
  • receiving information about the test and treatment options available to you, what they involve and their risks and benefits
  • being given access to your own health records and having any factual inaccuracies corrected
  • being involved in planning and making decisions about your health and care, being able to accept or refuse treatment that is offered to you, having access to drugs and treatments that have been recommended by NICE (National Institute for Health and Care Excellence) if your doctor says they are clinically appropriate for you
  • receiving care and treatment that is appropriate to you, meets your needs and reflects your preferences being able to complain if you’re unhappy or if things go wrong.

How long should I wait to start cancer treatment?

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 

Can I choose which hospital I am referred to?

You have the right to make choices about your NHS care. This can include choosing the hospital that provides your care when you’re referred for your first appointment with a consultant. You can speak to your GP about where and when you would like to see a specialist. However, when you are being referred for cancer services you cannot choose which hospital you are referred to as you must be seen within the 2-week maximum waiting time. You can ask to be referred to a different hospital if you have to wait more than 2 weeks before seeing a specialist for suspected cancer. The waiting time starts from the day the hospital receives the referral letter, or when you book your first appointment through the NHS e-Referral Service.

How should I be involved in decisions about my health?

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.

Holistic Needs Assessment (HNA)

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.

Do I have the right to the treatment I want?

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.

What can I do if I can't access the treatment I want?

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.

Can I complain about NHS services or staff?

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.

  • have your complaint acknowledged and properly looked into
  • be kept informed of progress and told the outcome
  • be treated fairly, politely and with respect
  • be reassured that your care and treatment will not be affected as a result of making a complaint
  • be offered the opportunity to discuss the complaint with a complaints manager/li>
  • expect appropriate action to be taken following your complaint
  • Your local Healthwatch can help you find independent NHS complaints advocacy services in your area.
  • You can also contact social services at your local council and ask about advocacy services. Find your local social services
  • POhWER is a charity that helps people to be involved in decisions being made about their care. Call POhWER’s support centre on 0300 456 2370 for advice.
  • The Advocacy People gives advocacy support. Call 0330 440 9000 for advice or text PEOPLE to 80800 and someone will get back to you.
  • Age UK may have advocates in your area. Visit their website or call 0800 055 6112.
  • VoiceAbility gives advocacy support. Call 01223 555800 for advice or find the contact details for your local VoiceAbility service
Safeena - Muslim Cancer Support Network

Safeena - Muslim Cancer Support Network

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