Why Hospitals Tell Everyone to “Get an Expedite Letter”
Many patients are told by hospital booking teams or secretaries to “ask your GP for an expedite letter.” This often happens because:
- Call handlers and admin staff do not have clinical authority to change your appointment.
- It shifts the responsibility back to your GP, even though it doesn’t change how referrals are prioritised.
- It creates the appearance of action, without altering the underlying clinical triage process.
In short, it’s a standard script, not a meaningful solution
We understand it’s frustrating to wait for hospital appointments, especially when you’re in pain or your condition is worsening. However, asking your GP to send an “expedite letter” to the hospital rarely speeds things up—and here’s why.
Hospital Appointments Are Managed by Hospital Teams, Not GPs
Once your GP refers you to a hospital specialist, your care is managed entirely by the hospital. NHS hospital trusts are responsible for booking and prioritising appointments according to clinical need—not based on letters or requests from GPs, patients, or relatives.
Under the NHS Standard Contract (Service Conditions 6.1 and 6.3), it is clearly stated:
“The Provider must ensure that Referrals are clinically triaged and managed appropriately and in accordance with Clinical Triage and Referral Protocols…”
This means:
- Only hospital clinicians can decide if your case should be prioritised.
- GPs have no control over hospital waiting lists or appointment scheduling.
- Hospitals are contractually required to assess patients fairly based on urgency—not on requests from GPs or patients.
Repeated letters can overburden hospital admin systems, delaying care for patients who truly need urgent reassessment.
An expedite letter is only appropriate when there has been a significant change in your clinical condition—something that means your health situation is now more urgent than others already on the waiting list.
But if your symptoms are the same, or your situation hasn’t changed meaningfully, asking to be “expedited” means asking to be moved ahead of other patients with similar or worse problems who’ve been waiting longer. That’s not fair, and the hospital won’t do it—because it goes against NHS policy and clinical prioritisation standards.
What You Can Do
- Contact the hospital’s Patient Advice and Liaison Service (PALS) for non-clinical support or to raise concerns.
- In emergencies, always go to A&E or call 999.