When can you ask for your referral to be re-assessed?
There are a number of reasons why you might wish to request re-assessment:
- You have received a rejection to your referral informing you that you are not entitled to healthcare from the specialist health service.
- You disagree with the deadline you have been given for the latest start of your healthcare.
- You disagree with the diagnosis or the severity of your condition.
- You disagree with the proposed treatment programme.
You do not need to justify your request for a re-assessment. You can only request a re-assessment for the same condition on one occasion.
How do you request a re-assessment?
General practitioners can send your referral for re-assessment. This will normally be your GP. It will be the doctor who assesses whether or not there are grounds for requesting re-assessment. If your doctor believes that you should be granted a re-assessment, your doctor will send another referral to the specialist health service. You can choose which treatment centre your GP will send this referral to. The re-assessment must be sent to a treatment centre that is authorised to assess referrals.
If your GP believes you have no grounds for requesting a reassessment, you will not be entitled to request one. However, your GP must refer you for a re-assessment unless there is an objective reason for not doing so. You can appeal to the County Governor (Statsforvalteren) if you disagree with the GP's assessment.
What does the re-assessment involve?
The specialist health service must assess the new referral on an independent basis and according to the same criteria that they use when assessing all other referrals. However, the response deadline of 10 working days does not apply to referrals for re-assessment.
The doctor who carries out the re-assessment must decide:
- whether or not you need and are entitled to receive healthcare from the specialist health service
- if appropriate, set a deadline for the latest start of your healthcare
The doctor who carries out the re-assessment must also consider whether the referral and the documents in the case are sufficient to reach a decision, or whether you need to be called for further medical investigations or tests. You will not be entitled to further medical investigations unless they are necessary in order for you to receive appropriate healthcare.
Re-assessment is simply an appeal, and the re-assessment will not necessarily be any better than the original one. In consultation with the doctor who refers you, you can decide which of the assessments should apply. With regard to this, it is important to remember that the treatment process that is outlined by the treatment centre you choose will not be binding for any other treatment centre.
What rights do you have to appeal?
You can only request a re-assessment for the same condition on one occasion. If your referral is rejected again, you can appeal to the County Governor. The County Governor can review all aspects of the case.
You can also appeal if you believe that:
- your right to re-assessment has not been upheld
- the re-assessment was carried out in an unjustifiable manner
- you disagree with the deadline for the start of your healthcare, your diagnosis or the treatment programme you have been given
If the re-assessment is also rejected, you can appeal to the County Governor (statsforvalteren.no). The County Governor can review all aspects of the case.
Right to complain
You have the right to complain if you believe your rights as a patient have not been upheld, or if you believe you have not received the health or care services you are entitled to.
Illustration: Eugenio Marongiu / Johnér Bildbyrå AB