Choosing the place of non-urgent care

Changing place of care within Soite

A client may change his/her place of care within Soite even for just one visit without a separate written notification. Changing the place of care applies to doctor’s and nurses’ receptions, oral and dental care, maternity and child health clinics, advisory services for senior citizens, rehabilitation, screenings and other health checks. In reception services, the assessment of the need of care is carried out at the client’s own place of care, and on basis of that, the client may contact the place of care that they wish to provide the care. A single visit must be agreed on in advance by contacting the place of care where the client wishes to use services. Within Soite, all changes of place of care or service are implemented as far as the provision of services and resources allow.

If you wish to change your place of longer-term care or the place for a service period within Soite, you must submit a written notification, i.e. a “Ilmoitus terveysaseman valinnasta” (Notification on the selection of health care station), which can be found (in Finnish) on the page for Forms for health care service:

Submit the application to the archive of Kokkola health care centre, where the notification will be registered and forwarded to the health care station of your choice. The notification on the selection of place of care must be submitted three weeks before the first visit. The responsibility for care is transferred to the new place of care no later than three weeks after the notification has been received.

This choice does not apply to school health care, student health care, long-term institutional care, occupational health care or home nursing outside one’s own region.

Changing the health care station in Finland

The Finns’ right to choose their place of care in public health care was extended in the beginning of 2014, so that patients’ freedom to choose the place of their non-urgent care applies to health care centres throughout the country and to all specialised medical care units in the country. In other words, a person may choose the health care centre/health care station responsible for their primary health care from anywhere in mainland Finland (Health Care Act, section 48).

Both the client’s new health care station and their previous health care station must be notified in writing about the choice of health care centre. The notification on the selection of health care station must be submitted three weeks before the first visit. The responsibility for care is transferred entirely to the new health care station no later than three weeks after the notification has been received. A new choice may be made no earlier than one year later. The form is available on the page for forms (in Finnish).

This choice does not apply to school health care, student health care, long-term institutional care, occupational health care or home nursing outside one’s own region.

The main principles concerning the change

• A written notification of the choice must be submitted to both the health care centre of the municipality responsible for care and the health care centre of the chosen municipality.
• A separate transfer notification must be submitted for each person transferring; children do not transfer automatically with their parents.
• The Health Care Act does not take a stand on a minor’s right to choose a health care station. In the case of minors, the Act on the Status and Rights of Patients applies. If a minor is able, on the basis of their age and level of development, to decide on their care, care must be provided in consultation with them. If a minor is unable to decide on their care, they must be cared for in consultation with their guardian or other legal representative. A health care professional assesses whether the minor is capable of deciding themselves which health care station will provide their care.
• The responsibility for care transfers to the health care centre of the chosen municipality no later than three weeks after the notification has been received.
• A person’s choice may apply to only one health care centre/health care station at a time.
• Changing health care stations binds the client for one year, meaning that the client may change health care stations again once at least one year has passed since the previous change.

The choice covers the health care station’s services in their entirety, including the following services:

• Health care guidance and health examinations (including, for example, birth control clinic services)
• Screenings (in accordance with the national screening programme)
• Maternity and child health clinic services (including, for example, monitoring of oral and dental health)
• Advisory services for senior citizens 
• Certificates
• Medical care (including, for example, examinations, treatment and medical supplies in accordance with the care plan) 
• Oral and dental care
• Mental health work (including, for example, psychosocial support in traumatic situations)
• Substance abuse services (including, for example, rehabilitation services) 
• Medical rehabilitation (including, for example, guidance, rehabilitation assessment, therapies, assistive equipment services and rehabilitation periods)

The form “Ilmoitus terveysaseman valinnasta” (Notification on the selection of health care station) can be found on the page Forms for health care service (in Finnish).

Non-urgent care for people from other municipalities, i.e. care in accordance with a care plan

• If a person lives or stays regularly or for a longer periods outside their municipality of residence because of work, studies, leisure activities, because a close relative or other close person lives there, or for some other similar reason, they may use other primary health care services than those of their own municipality to receive care in accordance with their care plan without changing the health care centre responsible for their care. 
• For persons from other municipalities, the notification procedure is the same as described above, but in addition to the notification, the client must submit the care plan prepared in their municipality of residence to the new place of care.
• The care plan is entered/scanned onto the care plan page, and the paper version is kept in the client’s paper medical records.
• For persons from other municipalities, no time limit has been set for changing the place of care, meaning that a person from another municipality may use the services of another municipality’s health care station for as long as their temporary stay in the municipality lasts.
• The municipality of residence is responsible for making changes in the care plan.

A client’s right to choose the health care professional treating them

According to section 49 of the Health Care Act, clients have the right to choose their attending licensed health care professional in the health care unit with which they are registered subject to restrictions arising from the expediency of service provision. As regards further treatment, clients shall be referred to the same physician or dentist who previously attended to them insofar as this is possible.

Reimbursement of costs arising from care

• The municipality or wellbeing services county that would have the responsibility for the patient’s/client’s health care if the right to choose was not exercised, may be invoiced for the health care that is provided. The costs are settled retrospectively through municipal invoicing.
• The reimbursement must be based on productisation or the product price, which the health care unit uses to monitor its own services.
• The client fee paid by the patient, and any other operating revenue related to the care, received by the service provider are deducted from the costs.
• The client fee is based on the Act on Client Charges in Healthcare and Social Welfare (734/1992) and on the decision of the municipality providing the service concerning the charging of client fees.
• The extension of the patients’ freedom to choose does not change the principle concerning reimbursement of travel costs. Kela will, however, continue to reimburse the cost of trips to the nearest place of care.

Choosing the place of specialised medical care

Under the Health Care Act, clients have the right to choose their place of examination and treatment in specialised medical care between all the public hospital in Finland. The freedom to choose applies to non-urgent care.