Your right to choose who treats your OCD or BDD

Further Guidance on Your Right to Choose a Consultant-led Outpatient Mental Health Service Anywhere in England

Since April 2014, if you live in England, you have had the right to choose the consultant-led outpatient mental health service your GP refers you to. This service can be anywhere in England and this right means that the same rules apply for mental health services as for physical health treatment.

We have been supporting people to exercise that right since the change in the law, but things have been far from straightforward. Last month NHS Improvement produced the following guidance which makes things much clearer and we hope easier for people to really choose the service they’re referred to:

https://improvement.nhs.uk/uploads/documents/choice_in_mh_services_service_users.pdf

The guidance covers outpatient services from Improving Access to Psychological Therapies Services (IAPT) to Community Mental Health Teams (CMHT). It only applies to adults in England who are not currently receiving treatment from a CMHT and it does not apply to crisis, acute/emergency or inpatient services. You can only choose 1 type of service at a time. With an IAPT service, the referral must be made from a GP and not be a self-referral.

In order to make a referral to an out-patient service, your GP has to be satisfied that it is clinically appropriate to refer you to that service. So, if you are at risk of suicide or self-neglect then it is unlikely that an outpatient service alone will be able to meet your needs and your GP is unlikely to refer you. In a situation like this one your GP should clearly explain their reasons for not referring you and suggest alternatives.

They guidance states that "In some areas an assessment service will help to decide what type of treatment is best. If this is the case, you can choose a provider once the assessment has recommended a type of treatment.” i.e. if an assessment recommends out-patient CBT then you should be able to choose where to be referred and so not have to exhaust treatment locally or seek funding from your local Clinical Commissioning Group (CCG).  

The guidance also states that you "can choose providers known for specialist care or tertiary care if they offer the type of service required.” This means that you could choose to be referred to an out-patient service that is also a centre of excellence such as the Centre for Anxiety Disorders and Trauma (CADAT) at South London and Maudsley NHS Foundation Trust.

If you are seeking treatment for your OCD or BDD you should talk to your GP about the choices available to you. If your GP is refusing to refer you or your CCG is unwilling to fund your choice please contact our Advocacy Service. 

OCD Action are currently producing a directory of services, to help you make an informed choice on your treatment provider. If you would like to share your experiences of a particular service, please get in touch; email collette@ocdaction.org.uk or call us on 020 7253 5272. We are also going to be holding a Twitter chat on patient choice, to give you the chance to ask us any questions you may have (date TBC).