Getting a second opinion about your care
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.
