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Advice for patients on what to expect if you have been referred to the hospital specialist.  

All Brent GP practices are recommended to use BROS (Brent referral optimisation service) to arrange booking for your appointment, for more information in regards to BROS please select the BROS tab within services section of this website.

Please read this information carefully; it may save you an unnecessary trip to the surgery by talking this process through with your specialist. 



  • Looking after all your tests, including appointments and managing the results 
  • Providing prescriptions when needed 
  • Issuing a sick note if required 
  • Providing you with a follow up appointment if necessary. 

Tests & Investigations 

All tests and investigations required by the specialists must be ordered by them and the appointments sent to you from the clinic. If the specialist requires blood tests he/she should arrange for this to be done at the clinic at the same time as your appointment. For follow-up tests, he/she should provide you with a completed request form for you to take to your practice. You may need to make an appointment for this. 

The specialist is responsible for acting upon the results of any test he/she requests and for informing you of the results. If you haven’t heard from the specialist about a test result, please ring his or her secretary at the hospital. Unfortunately, your surgery may not know the result and will not know what the specialist intended to do with the information. 


If the specialist prescribes a new medication or changes one that you are on, they should include details of this in the letter they write to your GP. They may also give you a hand-written note to take to your GP practice so that they can issue you with a prescription. 

If you are uncertain what changes the specialist is making, please ask them to explain it to you at the appointment. It saves you having to see your GP to discuss something he or she may only know of from a short letter of explanation. 

 Sick or Fit Note (Med3) 

If you need to be certified as unfit for work as a result of your condition, or the treatment provided by your specialist (or therapist) he or she should issue a sick note when you are discharged from hospital or seen in the clinic. Please ask your specialist for a sick line if you need one. 

 Follow Up Appointments 

If you need to be seen again the hospital will provide you with another appointment. Please contact the specialists’ secretary if it does not arrive in a timely way. 

Brent Referral Optimisation Service

Brent CCG has commissioned Brent Referral Optimisation Service (BROS) as the referral process for its patients.

The referral process has been introduced throughout GP Practices in Brent. This will involve all 1st Outpatient and Urgent GP Referrals and means that if you have an appointment and your GP decides that you need to have a referral they now follow a referral management process. This involves sending the referral to a triaging service to ensure that the referral is correct and following the preferred clinical pathways. Once it has been decided that the referral is appropriate and that it has all the necessary attachments e.g. most recent blood test results etc the BROS team will contact the patient by telephone for an appointment at a suitable hospital or clinic and at a date and time that is convenient for the patient to attend.

The Brent Referral Optimisation Service is expected to provide a data source for audit in terms of quality and improvement, to shape future service redesign and provide feedback mechanisms which would inform practice based referral performance.

When a GP refers a patient during the consultation, they will hand a letter to the patient explaining the Brent Referral Optimisation Service, they will check contact details with the patient to ensure that the practice has the most up to date mobile/telephone number and address so that the BROS team can contact the patient easily. They will also include whether the patient has any communication needs i.e. Requires an interpreter, uses text phone, needs large print. The GP will also make sure that any strong preferences and instructions are clearly identified on the referral.

You would normally receive a telephone call within two days of BROS receiving the referral letter from the GP. If the BROS team have tried to call you and have had difficulty in contacting you then they will write to you.

If you do not receive a telephone call from the Brent Referral Optimisation Service then you are advised to call BROS Freephone number 0800 027 9289 and their email address for you to follow up any query. between 8.00am – 6.00pm Monday to Friday, 9.00am – 12 .00 noon on Saturday to ensure that they have received your referral and that they are dealing with it.

This referral management service excludes referrals for: -

  • 2 week waits
  • Mental Health
  • GP Direct Access – Imaging or Tests
  • Domicillary Visits – District Nurses
  • Maternity and Obstetrics

These referrals will be dealt with in the usual way. Brent Optimisation Referral Service welcomes your feedback on your experience of the referral process

Please visit 

BROS patient letter


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