Getting a GP referral

A referral in health and social care occurs when a professional directs a person to a service or specialist for additional support. It typically happens when someone requires care or intervention beyond what their initial care provider can offer. Referrals ensure people access the right help at the right time.

You're entitled to ask your GP for a referral for specialist treatment on the NHS.

However, whether you'll get the referral depends on what your GP feels is clinically necessary in your case.

If you wish to be referred to an immunology specialist or another speciality, you should see the GP you're registered with.

This is because all your medical records are held by that surgery.

Your GP also generally understands your health history and treatments better than anyone else and will base any decision for a specialist referral on this knowledge.

If you ask your GP to refer you to a specialist, they'll probably suggest that you first try various tests or treatment options to see whether your condition improves.

You cannot self-refer to a specialist at a hospital within the NHS.

A specialist will not see you unless they have a referral letter from your GP.

The letter will give the specialist essential background information, such as your medical history, and it'll also contain details that the specialist needs to pay particular attention to.

Initial GP consultation

Schedule an appointment with your registered GP to discuss your symptoms.

Presenting symptoms of a primary immunodeficiency (PID): Severe, Persistent, Unusual, Recurrent infections, with a history of PID Running in the family (SPURR). Take a look at our webpage for Symptoms & diagnosis – Immunodeficiency UK. You could ask your doctor and nurses involved in your care to look at the IPOPI booklet Diagnosis of PID. This booklet has been specially designed to help non-specialist investigation of a potential PID.

Presenting symptoms of a secondary immunodeficiency (SID) also include frequent, prolonged or unusual infections.

Causes may include blood or bone marrow disorders, drugs (medicines) and treatment for cancer. Some cancers can be responsible for SID, too. The main medicines that cause problems are those that target the immune system, including immunosuppressant drugs, 'biologics' and chemotherapy. These medicines may have been used in the treatment of conditions such as rheumatoid arthritis, multiple sclerosis, inflammatory bowel disease and psoriasis, and of blood and lymph node cancers in particular. See our booklet ImmunodeficiencyUKSecondaryImmuno.pdf.

Preliminary Tests: Your GP will often run basic tests first. These can include a full blood count (FBC) and immunoglobulin levels.

The Referral Process

If the GP agrees a referral is needed, they will submit it through the NHS e-Referral Service (e-RS).

Information Required: The referral must include your full medical and medication history, as certain drugs (like ACE inhibitors) can mimic immune issues.

Urgency: The GP will categorise the referral as 'urgent' or 'routine' based on your clinical needs.

Triage: Once received, an immunology consultant will review (triage) the referral. They may accept it for an appointment or write back to your GP with management advice if a specialist visit isn't immediately required.

Booking Your Appointment

Online/App: You can often book or manage your appointment via the NHS App or the Manage Your Referral website using a booking reference and access code provided by your GP.

Right to Choose: In England, you generally have the right to choose which hospital or consultant-led team you are referred to for your first outpatient appointment.