Referral System
Also known as: GP gatekeeping, Specialist referral, Letter of referral, Verwijsbrief (Netherlands)
A referral system requires you to see a GP first before accessing a specialist or hospital department.
Last updated: 2 April 2026
Real-world example
You have a recurring knee problem and want to see an orthopaedic specialist in Amsterdam. You go directly to a specialist clinic but they won't see you without a verwijsbrief (referral letter) from a GP. You have to book a GP appointment first, explain your problem, get the referral, then rebook with the specialist. In Bangkok, by contrast, you walk directly into a specialist's office without any referral.
Why travellers need to know
Some countries require a GP referral before you can see a specialist; others let you self-refer directly. Knowing which system your destination uses avoids wasted appointments and delays. Countries with referral requirements (UK, Netherlands, Denmark) will simply turn you away at the specialist's door without one. Countries without (France, Japan, Thailand, most of Asia) let you book directly.
Country-specific notes
GP referral required for all NHS specialist access
The NHS requires a GP referral for virtually all specialist and hospital outpatient care. The only exceptions are A&E, sexual health clinics, and some mental health services. Private specialists in the UK also typically want a referral letter, though it's not legally required.
Frequently asked questions
How Nomedic helps
Your Nomedic record includes your diagnosis history, making a GP referral appointment faster when the doctor can see what they’re referring you for.
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