In line with routine clinical practice patients wishing to seek a second opinion will be supported to do so. In the first instance clinicians should refer patients for a second opinion using their established protocols. If it is not possible to obtain a second or further opinion using established protocols then National Health Service trusts are instructed to contact their NHS England Regional Medical Director who will be able to offer further advice around a referral route. The NHS England Regional Medical Directors will support NHS trusts in identifying a suitable NHS specialist for a second opinion. Processes may differ in Scotland, Wales and Northern Ireland.