You must have a referral
In most cases, people start by seeing their local GP for a medical condition. If you have a physical or mental condition that requires more specialised healthcare than local healthcare or mental health services can offer, your GP will refer you to the specialist health service.
You do not need a referral in acute situations where you need urgent care.
The referral must be sent to a treatment centre that is authorised to assess whether you need to be investigated and/or treated by the specialist health service. Which treatment centres are authorised for this can be found in the online service Choose a treatment centre (Velg behandlingssted).
As a patient within the specialist health service, you have the right to choose where you will be treated. You can choose from all public-sector treatment centres and several private-sector treatment centres in Norway. You can also choose to see a contract specialist (avtalespesialist) .
Situations when you cannot choose where to be treated
You cannot change treatment centre to receive a more specialised treatment than you have been offered.
Your current state of health may also influence which treatment centre you are able to choose. For example, some treatment centres are unable to accept patients who are being treated for more than one medical condition.
You are also not able to choose where to be treated if you are under compulsory observation or compulsory mental healthcare, have been involuntarily admitted to an institution because of substance use, or are undergoing medication-assisted therapy (MAT).
How is your right to healthcare assessed?
Whether you are entitled to healthcare from the specialist health service or not is subject to clinical medical assessment. It is the treatment centre that receives the referral from your GP that makes the assessment. The final decision is made by a healthcare professional, usually a medical specialist.
The decision is made based on
- an individual clinical assessment of your state of health, based on the information in the referral
- national guidelines and recommendations issued by the Norwegian Directorate of Health
The assessment can have one of two outcomes:
You are entitled to healthcare from the specialist health service
You will be offered investigation and/or treatment at a hospital or by a specialist. At the same time, you must be given a binding time limit for when the healthcare should start by.
You are not entitled to healthcare from the specialist health service
The assessment concludes that you do not need to be investigated or treated by the specialist health service. In some cases, investigation and/or treatment may be offered by your local health service (kommunehelsetjenesten). You can find out about local healthcare options by consulting your GP or your municipality's website.
The treatment centre receiving your referral has 10 working days to decide whether you are entitled to investigation and/or treatment by a specialist. If serious illness is suspected, the decision must be made sooner.
In the reply you receive to your referral, you must be informed of:
- whether or not you are entitled to healthcare from the specialist health service
- the guaranteed time to treatment, i.e. the maximum amount of time you must wait for investigation or treatment to start
- the time and place of your first appointment
If your first appointment has not been booked for you when the reply is sent out, you must be informed of when the treatment centre plans to call you in. The reply will also be sent to the person who referred you.
What to do if you receive no reply within the time limit?
If you do not receive a reply within the guaranteed time limit, you can:
- contact the treatment centre that received your referral
- contact your GP or the person who referred you
If you still receive no reply, you can contact the Health and Social Services Ombudsman for advice, or submit a complaint.
What to do if your referral is turned down?
If your referral is rejected, you can ask your GP whether there are grounds for requesting a reassessment at another treatment centre. Read more about getting a new assessment of your health status.
Conditions for being entitled to healthcare
There are several conditions that must be met for you to be entitled to necessary healthcare from the specialist health service:
- You must have a need for healthcare in the specialist health service.
- You are expected to benefit from the healthcare.
- The cost of the healthcare is in reasonable proportion to the expected benefit of the healthcare.
- The healthcare is within the scope of the services that the specialist health service is responsible for providing and financing.
Appealing a denied referral
If you do not agree that your referral should have been turned down you can appeal against the decision. You also have access to file an appeal if you are a relative. Read more about which decisions you can appeal, and the steps involved.
You may be entitled to have various types of treatments abroad covered. Your coverage depends, among other things, on where you are to be treated and what kind of healthcare you receive.
What is meant by “the specialist health service”?
The specialist health service exists to diagnose, treat and follow up patients with acute, serious and chronic diseases and disorders and is a collective term for:
- district psychiatric centres
- habilitation and rehabilitation centres
- centres for interdisciplinary treatment of substance use disorders
- prehospital services
- specialists in private practice
- laboratory and diagnostic imaging services
Services offered within the specialist health service may change over time due to both medical advances and changes in the organisation of Norwegian healthcare.