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If you need to see a specialist, you have the right to choose which service you're referred to by your GP. This legal right, which was introduced in April 2009, lets you choose from any service offering a treatment that meets NHS standards and costs.You can choose a service according to what matters most to you, whether it's location, waiting times, reputation, clinical performance, visiting policies, parking facilities or patients' comments.

A choice of service is available for most patients and in most circumstances. Exceptions include emergency and urgent services, cancer, maternity and mental health services.If you need to be seen urgently by a specialist (for example, if you have severe chest pain), your GP will send you where you’ll be seen most quickly. You can access more detailed information on the exceptions via the link below.


There are many reasons why you might prefer one service to another. Location, waiting times, clinical results and parking facilities are just some of the things that patients consider when choosing a service. Evidence shows that if you choose a service in which you feel comfortable and confident, you’re likely to improve both the result of your treatment and your experience while you’re in hospital.

You don’t have to make the decision yourself. If you prefer, your GP can choose for you.

If your GP wants to refer you to a specialist, you can take away information about hospitals and decide later. In most circumstances, this is the most sensible option.

The services you can choose from will depend on the type of specialist you need to see. The choice you make may be based on a wide range of factors, such as location, waiting times, reputation, clinical performance, cleanliness, travel, parking facilities and visiting policies. You can choose your service according to what’s most important to you.

For detailed advice on researching services and how to choose the best service for you, go to:

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It’s your choice

If you’ve been diagnosed with wet age-related macular degeneration (‘wet AMD’), the NHS can offer a range of treatments for your condition. Following a recent case at the high court in London, the NHS in our region can now offer a wider range of drugs for wet AMD. 

What is age-related macular degeneration?

Age-related macular degeneration (AMD) is caused by changes to the macula, which is the central area of the retina, at the back of your eye. It usually occurs in people over 55 years old, and in later stages of the disease it causes vision impairment.  ‘Wet’ AMD is caused by abnormal growth of blood vessels under the retina. These vessels can leak, causing damage to the macula. The macula is important for your central vision, and damage to this area leads to difficulty with things like reading and writing. 

Treating wet AMD

Wet AMD is treated by injections into the eye, with medicines called anti-vascular endothelial growth factors, or anti-VEGFs. These prevent the growth of new blood vessels and therefore any damage to the macula.  With this treatment, most people maintain vision at their current level, and up to a third see an improvement. Unfortunately, about one in ten patients do not respond to treatment. The NHS can now offer you a choice of three drugs for these injections. In the past, we have offered drugs called Eylea® and Lucentis®, and these are still an option for you. Your local NHS can now offer you a drug called Avastin® (bevacizumab), following a judgement by the high court. Avastin® is already widely used to treat wet AMD both in Europe and the United States, is commonly used in private medical practice in the UK and is much cheaper than the other two drugs.

It’s your choice

Studies have shown that all three drugs are as safe and effective as each other. The National Institute for Health and Care Excellence (NICE) and the Royal College of Ophthalmology agree that all three medicines are equally safe and effective for treating wet AMD. If you are treated with Avastin®, you may be able to start your treatment earlier than the other two drugs. Earlier treatment may mean a better outcome for you as a patient. Avastin® is up to 20 times cheaper for the NHS to buy – and every penny that we save can be invested in more treatments for NHS patients. Using Avastin® could save our region’s NHS up to £13.5 million a year to spend on healthcare. But this is your choice as a patient, and all three drugs are available to you, except when a clinician feels there is an advantage with one drug over another.

Making your choice

It’s your choice - and we want you to know all the facts. As a patient, you can discuss your options with your ophthalmologist before you decide which treatment is right for you. Whatever you decide, you will receive the same high quality care as other patients. If you have started treatment with one of the medicines and decide that you want to switch to a different drug, you are free to do so at any time. To find out more, please speak with your ophthalmologist or visit

Treatment for wet AMD following a recent High Court Case - patient choice