Frequently asked questions
In partnership with the
- Referral-related questions
- Phio (self-referral)
- Triage process
- Appointment wait time questions
- Diagnostic results questions
- General process & communication questions
- Follow-up & ongoing care questions
- External physiotherapy
- Secondary care
- Appointment attendance
- Etiquette & support
- Cauda Equina Syndrome information
- Location & directions questions
Referral-related questions
When your GP sends a referral to us, it is automatically downloaded and we process it as quickly as possible, often on the same day.
Once we’ve triaged and accepted a referral, we automatically send you a text message to let you know. Please note that, unfortunately, we can’t send this acknowledgement to landline numbers.
If we haven’t sent you a text message, it usually means that:
- We’ve not been able to accept your referral – we might need more information from the GP first, or it may not be something the MSK service can manage; or
- Your GP hasn’t sent it yet.
There can sometimes be a short delay if additional checks or information are needed, but if it’s been more than 7 working days since you were referred and you haven't received a text message, please contact us. Please be aware though that if we don’t have a record of you or your referral, you will then need to contact your GP.
In this case you would need to contact your GP to let them know your situation, and they will get in touch with us if they feel you need to be seen sooner.
In many cases, yes: you have the right to choose where you receive your care. Depending on your condition, and the services you require, you may have a number of options to choose from; or there may only be one option available - not all hospitals or clinics provide every type of treatment, and some have specific clinical criteria which need to be met to accept referrals, but we will support you to make the best choice for you. If you have a specific preference, let your GP know during your appointment so they can include it in your referral.
Once your referral is accepted, it will be reviewed by a senior clinician, and then:
- You may be added to an in-house Circle waiting list to be seen by the right team.
- You might be referred to a physiotherapist if you need help with movement or physical recovery.
- You could be sent for tests or scans (called diagnostics) to help understand your condition better.
- You may be referred to a specialist or hospital clinic (known as secondary care) for more expert treatment.
Phio (self-referral)
You can refer yourself to your local Circle MSK service* without needing to attend an appointment at your GP practice.
Self-referral works best if you have a problem with just one body area – 2 or more can make the process more complicated, so you are better seeing someone at your GP practice.
*Please note that self-referral is not available to patients in South and West Hertfordshire. Additional First Contact Physiotherapists (FCPs) – specialist MSK clinicians working in GP practices – are working in your area, who will be able to assess and help you quickly with your MSK problem. Please contact your GP practice to make an appointment.
You can complete a self-referral online through our Phio Self-Referral form. The system will guide you through a series of questions about your symptoms and medical history so we can direct you to the right care.
A Phio self-referral typically takes around 25-35 minutes to complete – but is available 24/7 so you can complete it when it’s convenient for you, and as you can complete this without having to make an appointment, it can be quicker than going through your GP. However, urgent cases should always be discussed with your GP or NHS 111 first.
You will receive a confirmation SMS (text message) once your referral has been reviewed and accepted.
If your referral is not accepted, we will let you know and explain the reason. You may be advised to contact your GP, seek another service, or arrange further tests before a new referral can be made.
If you don’t want to use Phio, there are other options available to you to access help for your MSK condition. Traditional methods such as the following can be considered:
- Booking an appointment at your GP surgery, with an FCP or GP
- Seeking advice from your local pharmacy
- Using the self-management advice on our website [link]
- Seeking private treatment
- Submitting a paper self-referral (Bedfordshire and Greenwich patients only)
Triage process
A qualified clinician reviews the details in your referral, along with any supporting test results or medical history, to decide the most appropriate next step for your care. This may include booking you into a clinic, directing you to another service, or requesting further information from your GP. If your condition isn’t something we can look after in the MSK service, we may return the referral to your GP and ask them to contact you to discuss alternative options.
Triage ensures your referral is directed to the right service, at the right time, by the right clinician. It helps prioritise urgent cases and makes sure all the information needed for your care is in place before your appointment.
Most referrals are triaged within a few working days, but this can vary depending on the type of referral and urgency. Urgent cases are reviewed as quickly as possible, often on the same day.
Your referral is triaged by experienced clinicians who specialise in the relevant area of care. They use clinical guidelines and their expertise to make safe and timely decisions.
The vast majority of referrals we receive are, indeed, for conditions we can look after in the MSK service, in which case we will accept your referral, and you will receive an SMS (text message) to confirm this. After that:
- You may be added to an in-house Circle waiting list to be seen by the right team.
- You might be referred to a physiotherapist if you need help with movement or physical recovery.
- You could be sent for tests or scans (called diagnostics) to help understand your condition better.
- You may be referred to a specialist or hospital clinic (known as secondary care) for more expert treatment.
If a referral is not accepted, your GP (or the person who referred you) will be informed of the reason. They can discuss alternative options with you, such as referring you to another service or arranging further investigations.
If you are concerned about the decision, speak to your GP or referring clinician. They can review the triage outcome with you and, if appropriate, provide additional information or submit a new referral.
Sometimes more details are needed to make sure you are referred to the correct service. This may include recent test results, scans, or medical history. Your GP will be asked to provide this information, and you can help by booking any outstanding tests or appointments they recommend.
Appointment wait time questions
Wait times for MSK appointments can vary depending on your location, the specific treatment pathway, and current levels of demand.
We’re not able to manage a cancellation list due to the high volume of patients referred to our service. To keep things fair, any cancelled appointments are offered to patients who have been waiting the longest, based on both the referral date and the clinical urgency of their referral.
We often have large numbers of patients who need to be seen, and waiting times can be longer than we’d like, but we see everyone as soon as we can – we’re grateful for everyone’s patience. If your condition is getting worse, please contact your GP to arrange a review and if they feel you need to be seen sooner, they will get in touch with us.
Depending on what service or treatment you need, the location can sometimes be changed. Please contact us via phone or email to change the location or time of your appointment. If you’re unable to make your appointment, please give us as much notice as possible so that we can offer your appointment to another patient.
Diagnostic results questions
For helpful information about being sent for scans or tests, please click here.
Hospitals typically take up to 4 weeks to complete and release scan reports. If it has been more than 4 weeks since your scan, please contact us so we can follow up with the provider on your behalf to find out when the report is expected.
The time it takes to receive your test results depends on the type of scan or test and the provider. As a general guide:
- X-rays and blood tests (especially from walk-in services) are usually quicker and can take up to 4 weeks to be reported
- MRI scans typically take 4–6 weeks for the report to be completed and sent to us
- Ultrasound scans (USS) may have longer waiting times, with some providers taking up to 9 months to complete and return the report.
Once we receive your results your clinician will review them, and then the results will be shared/sent out to you and/or we may make a follow-up appointment if needed.
Please note: Circle does not have any control over test or scan appointments carried out in other sites/hospitals, so we are not notified when you’ve had your appointment. If you’ve had your test/scan, we encourage you to contact us with the date so we can monitor for the report and follow up if needed.
Once we receive your results your clinician will review them. They may write to you with the results (if this is appropriate from the discussion you had during your appointment) or we may make a follow-up appointment – either by telephone or face-to-face – if needed, to plan next steps for you.
Yes, we can send your results to you and your GP once they have been reviewed by the clinician.
General process & communication questions
We send confirmation that we’ve received your referral by text, appointment details are sent by text and letter, but we will soon be moving over to email instead of post for anyone for whom we have an up-to-date email address – anyone without an email address will be sent a letter, as before. If you have a telephone appointment, you will be contacted by telephone.
If you have updated your details with your GP surgery, these should automatically update on our system too, but if you want to inform us directly of an update of contact details, please feel free to call or email our contact centre.
Please call our contact centre, who will be able to assist you. However, we will need to arrange another appointment if you miss your original appointment slot.
Our clinicians have clinical commitments throughout the day, so we will not be able to put you directly through to them if you call our contact centre, unless you have a scheduled appointment with them at that time. However, our contact centre team can pass on any queries you have to the clinician, who may subsequently ask the contact centre team to give you the appropriate information, or they may arrange a time to speak with you.
Absolutely, yes! Once we receive your referral, we will send you a link to some self-help resources.
We aim to respond to patient emails within 2 working days, though you may receive a reply sooner. If your matter needs a faster response, please call us so we can help you more quickly.
You can share a compliment or make a complaint by contacting our Patient Advice and Liaison Service (PALS).
Please click here for more information on the process, including how to contact us.
You can request your medical records by emailing [email protected]. In your email, please include:
- The dates of the records you require
- A copy of photo ID (driving licence or passport) to confirm your identity
- If you do not have photo ID, we can accept a recent bank statement, utility bill, or council tax bill dated within the last three months
We cannot process your request without valid ID. Once we receive your request and ID, we have 30 calendar days to provide your records.
Follow-up & ongoing care questions
Your next steps will be discussed by you and the clinician you see at your appointment, but the usual outcomes from an appointment with us would be one of the following:
a) you may be given advice and discharged from our service
b) you may need a follow-up appointment, which we will arrange
c) you may need to have a test (e.g. a scan or a blood test) and whether or not you need a follow-up will be communicated to you
d) you may be referred to another team within the MSK service for treatment and/or an exercise programme
e) you may be referred out to a specialist in a hospital – where there’s more than one option available, you can choose where you’d like us to send you on to.
Please contact us via phone or email. If you are due to have a follow-up appointment, our contact centre will be able to help you to arrange this.
Yes, Circle Integrated Care supports your right to request a second opinion or be re-referred.
If you experience the same problems again within 6 months of being discharged from the Circle service, you can simply contact us again and we will reinstate your referral (this is called “Patient initiated follow up” or PIFU) – without needing to go back to your GP. If it has been longer than this, you will need to go back to your GP surgery, for an assessment and referral back to us if appropriate.
External physiotherapy
Referrals are made based on your individual clinical needs. In some cases, Circle may refer you to another service, specialist, or location to ensure you receive the most appropriate care for your condition. This decision is made to help you access the best possible treatment and support, in the most timely way possible.
Once your referral has been processed, you will receive confirmation by letter, text message, or email. This will include details of the provider or service you’ve been referred to, along with any next steps you need to take such as booking an appointment or attending an assessment.
If you’re not comfortable with the provider you’ve been referred to, you may be able to request a change — depending on your clinical needs, the stage of your referral, and the availability of alternative services.
We recommend contacting us as soon as possible so we can review your referral and discuss your options. We’ll consider:
- Whether your referral has already been accepted or an appointment booked
- The availability of other suitable providers
- NHS referral guidelines and clinical considerations
- Any preferences you’ve shared
We always do our best to support your choice, but please note that changes may not always be possible due to service capacity or clinical requirements.
After your referral has been processed, the external provider will get in touch with you directly. The way appointments are arranged can vary between providers — some may book an appointment on your behalf and send you the details, while others may ask you to book it yourself.
You’ll usually be contacted by phone, letter, or email with instructions on how to confirm, reschedule, or manage your appointment.
If you're unhappy with the care or treatment you received from a secondary care provider, it's important to raise your concerns so they can be addressed appropriately.
Speak to the provider directly in the first instance: most hospitals and clinics have a Patient Advice and Liaison Service (PALS) or a dedicated complaints team who can help resolve issues informally or guide you through the formal complaints process. If you need further support, or are not getting the response you need, please contact Circle.
Secondary care
The decision about which hospital you are referred to is based on several factors, including:
- Your medical condition and clinical needs
- The services and specialties available at different hospitals
- Current NHS guidelines and referral pathways
- Capacity and availability at hospitals
Where possible, your preferences are also taken into account. If your preferred hospital has the clinical and logistical capacity for your condition, we will always try to refer you there.
Waiting times for secondary care (such as specialist appointments, diagnostic tests, or hospital treatment) can vary depending on the provider, the type of care needed, and current demand.
Once your referral has been processed, the provider should contact you directly with information about your appointment and expected wait time. If you haven’t heard from them within a reasonable timeframe, you can contact the provider for an update.
Sometimes - it depends on your individual circumstances and the stage of your referral or treatment.
If you would like to change your secondary care provider, please contact us directly. We’ll look into your request and advise you based on factors such as:
- Whether your referral has already been accepted or an appointment scheduled
- The availability of alternative providers offering the same service
- NHS guidelines and referral pathways
- Any clinical reasons that may affect your choice
Where possible, your preferences will be taken into account, but changes may not always be possible due to clinical or logistical constraints.
In some cases, referrals can be expedited but this depends on your clinical condition and whether it meets the criteria for urgent or fast-track referral under NHS guidelines.
If you believe your situation is urgent or has changed since the referral was made, please contact your GP or referring clinician. They can assess your condition and, if appropriate, update the referral to reflect the urgency.
Please note that referrals cannot be expedited for non-clinical reasons, such as personal preference or travel plans.
Appointment attendance
Yes, we do run some clinics on a Saturday. However, please note that our contact centre does not operate over the weekend, so any patient queries or support requests will need to be handled during weekday working hours.
If you arrive within 10 minutes of your scheduled appointment time, you’ll still be seen. However, if you arrive more than 10 minutes late, you may be marked as Did Not Attend (DNA) and your appointment may need to be rebooked.
If you think you’re going to be late, it’s best to contact us as soon as possible. Please allow plenty of time to travel and check in to avoid missing your appointment.
If you don’t tell us, you can’t make your appointment, you will be marked as “Did not attend” (DNA) – and if you DNA twice without letting us know we will have to discharge you back to your GP. Not attending appointments means wasted appointments, which leads to longer waiting times for everyone, so please try your best to come to your appointment or let us know with as much notice as possible if you can’t.
Etiquette & support
We recommend wearing comfortable, loose-fitting clothing to make assessment and treatment easier.
Yes. Your clinician will explain the procedure, aftercare, and any possible side effects before treatment.
Your appointment letter includes details about travel options and parking facilities.
Yes. Please let us know in advance if you need an interpreter so we can arrange this for you.
Yes. Chaperones are available on request - please speak to a member of staff before your appointment.
We will do our best to accommodate your preference. Please note that this may affect the timing of your appointment.
Cauda Equina Syndrome information
Cauda Equina Syndrome is a rare but serious condition caused by pressure on the nerves at the base of your spine. It needs urgent medical attention.
Seek emergency help immediately if you experience:
- Sudden problems with bladder or bowel control (difficulty starting or stopping urination, loss of control)
- Numbness or tingling in the groin or inner thighs (sometimes described as “saddle anaesthesia”)
- Weakness, numbness, or loss of sensation in one or both legs
If you notice any of these signs, call emergency services or go to the nearest emergency department without delay.
Please click here for more detailed information.
Location & directions questions
Your appointment location will be clearly stated in your appointment confirmation. These will include the name of the clinic or hospital and its full address.
This may depend on the service you need for you condition – some services are only offered at specific locations. If there is an alternative option which is closer to you, we would be happy to arrange that so please contact us and our contact centre can advise.
We provide the full address, including postcode, on your appointment confirmation.
Not necessarily – this will depend on your treatment pathway. The location of each of your appointments will be clearly stated in your appointment confirmation.