Second Opinion Request

This policy establishes clear guidance for services within NHS Lothian on the consistent and equitable management of patient requests for second opinions regarding diagnosis or treatment. Recognising the Scottish Government’s position that patients have the right to seek a second opinion, the policy balances patient autonomy with clinical judgment and ensures that requests are considered fairly and consistently.

In this policy ‘patients’ should be read as ‘patients, their families, carers, parents and advocates’.

Applicable to all patients receiving care from NHS Lothian. It outlines the roles of patients, healthcare professionals and third parties, while emphasising the importance of patient consent and clear communication.

The policy promotes a structured referral system to facilitate second opinions, ensuring timely access to alternative clinical opinions without compromising the primary clinician’s role. It also addresses the management of refused or repeated requests, emphasising transparency, appropriate documentation and escalation protocols when necessary.

Additionally, it provides guidance on resolving disagreements between clinicians and patients, encouraging the use of advocacy services and alternative appeal mechanisms where appropriate. Exceptional circumstances requiring external referrals or additional approvals are clearly defined.

Overall, this policy aims to enhance patient-centred care, promote trust and collaboration between patients and clinicians, and ensure safe, effective, and equitable health care.