Going Into Hospital

You can call for an ambulance in an emergency: telephone 999.

There are nationally agreed standards for ambulance arrival times. An ambulance should arrive within:

• 14 minutes if you live in an urban area
• 18 minutes if you live in a rural area
• 21 minutes if you live in a remote area

Ambulances can also be used for routine journeys which can be arranged through the Northern Ireland Ambulance Service, GPs or hospitals.

Most hospital appointments and admissions happen by GP referral. A hospital should, as far as possible, try to arrange an appointment that is convenient to you. You should be given at least 2 weeks’ notice of an appointment or admission and should be provided with information such as:

• When to attend (including date and time)
• Where to attend (including directions)
• What to bring (for example, current medication)
• The name of the consultant responsible for your care and treatment
• The treatment you may be given

If you are admitted to hospital, you may find that the benefits you receive are affected.

•     Personal Independence Payment (PIP), Disability Living Allowance (DLA) and Attendance Allowance (AA) will usually be withdrawn after four weeks in hospital.
•     Pension Credit and Income Support can be affected after 4 weeks in hospital if you receive additional amounts (for example, as a result of losing your AA/DLA)
•     Carer's Allowance can continue to be paid for 12 weeks if you receive it for looking after a person who is admitted to hospital or if the carer themselves goes into hospital. However, Carer's Allowance will stop if the patient’s PIP, DLA or AA cease.
•     Employment and Support Allowance may be affected after four weeks if you receive additional premiums on your award.

You have the right to see a doctor who is competent to deal with your case. You do not have the right to see a particular consultant or doctor, although this can be requested by you or your GP.

If you die in hospital, your relatives and GP should be informed as soon as possible. Advice should be given to relatives of arrangements that need to be made.

Go directly to an Accident and Emergency (A&E) department without a referral by a GP if you are in need of urgent medical attention. Accident and Emergency departments should not be used for minor or trivial ailments. Serious illness or life-threatening situations can include:

• Loss of consciousness or slipping in and out of consciousness
• A suspected heart attack e.g. persistent chest pain for 15 minutes or more
• A suspected stroke: loss of speech or inability to speak clearly, facial weakness or inability to raise both arms
• Breathing difficulties 
• Heavy blood loss or a deep wound such as a stab wound
• Suspected broken bone
• Medicine overdose or poisoning
• A severe allergic reaction

You may need to attend A&E if you have a fall or suspected stroke/heart attack. However, it is important to note that in some situations you should not be moved and, rather than going to A&E, an ambulance should be called. This includes situations where your injury may be made worse by moving you, you are in shock and need constant attention, you have hurt your back or neck or you have severe chest pain or difficulty breathing.

When you enter A&E, your need for treatment should be assessed immediately by a triage nurse. However, the most serious cases will be treated first. Targets have been set so that 95% of patients attending A&E should be discharged or admitted within 4 hours of their arrival. No patient should be waiting longer than 12 hours in A&E.

Dietary requirements should be assessed to record your allergies, ethical sensitivity or religious belief. You or your family should inform the hospital of special dietary needs or if you have difficulty eating. It is also important that staff are informed if you:

• Need help filling in the menu
• Find menu choices unsuitable
• Have difficulty reaching for your food or drink
• Have difficulty opening or cutting up food
• Have difficulty chewing or swallowing

You will be allocated a named qualified nurse for your nursing care.

When you have been given an admission date, your operation should not be cancelled on the day you are due to arrive in hospital if this is due to a non-medical reason such as emergencies or staff sickness. If an operation is cancelled, you should be offered an alternative date, which should be within 28 days of the original appointment or sooner for life-threatening conditions.

If you are referred to a hospital as an outpatient, you should receive a letter from the hospital with details of your appointment time and date within 2 weeks of the referral.

You should not have to wait more than 9 weeks for a first appointment. However, appointments are allocated based on clinical priority. When an individual appointment time has been allocated, you should be seen within 30 minutes of your appointment time or, if delayed, you should be informed of the reason for the delay. 

At your first appointment you should be seen by a consultant or senior doctor. Following your attendance at an outpatient clinic you should receive a report, through your family doctor, within one week of their attendance.

If your heart and breathing stops, it may be possible to restart the heart using cardiopulmonary resuscitation (CPR). CPR is not always successful, and some patients may not regain their previous level of physical or mental health. You can decide whether or not you want CPR should it be required. If you refuse it, your wishes must be followed.

A death certificate must be issued before organs can be removed from the body. Unless you have stated that you do not want your organs to be used for donation/research purposes, the decision will be left with the person legally responsible for the body.

You have the right to refuse or stop treatment/medication at any time even if this could lead to your death. However, it is illegal for a doctor to omit or carry out treatment with the intention of hastening/inducing death.

If you believe you will soon no longer be able to make decisions regarding your treatment, you should inform your doctor beforehand at what stage you want the treatment to stop.

You can write a living will which enables you to make an advanced decision in writing of what you want to happen if you become too ill to give/refuse consent to treatment. If you are forced into treatment that you do not want, this can be treated as an assault. Nevertheless, a doctor can examine or treat you without your consent in certain circumstances – for example, if you are unconscious.

You do not have the right to be cared for in a single sex ward but you should be informed before you go into hospital (unless it is into emergency or intensive care) if the ward will be mixed. Efforts should be made to offer beds in single sex wards where possible. Privacy and dignity should be protected by screens and/or private washing areas.

If you cannot receive treatment immediately, you may need to go on a waiting list. You should expect to wait not longer than:

• 9 weeks for your first outpatient appointment
• 13 weeks for inpatient or daycare treatment
• 2 weeks for an urgent GP referral for suspected breast cancer
• 62 days for an urgent referral for cancer treatment
• 31 days from diagnosis with cancer to treatment

How long you have to wait on a waiting list will depend on a number of factors including the severity of your condition. Therefore, if your condition severely deteriorates while you are waiting, your GP may recommend that you are seen as a matter of urgency. Therefore, you should keep your GP informed of your condition.