Primary, Secondary and Tertiary Care

Primary care

Primary care is the first point of contact for someone when they contract an illness, suffer an injury or experience symptoms that are new to them. It is generally regarded as the ‘gateway’ to receiving more specialist care.

This contact will be with a GP, Dentist or Optician.

 Secondary care

A patient who has been provided with primary care may be referred to a secondary care professional – a specialist with expertise on the patient’s issue.  These are consultant-led services which include psychology, psychiatry and orthopaedics.

Secondary care is usually (but not always) delivered in a hospital/clinic with the initial referral being made by the primary care professional.

Tertiary care

Once a patient is hospitalized, they may require highly specialised treatment and care within the hospital. Tertiary care requires professionals, usually surgeons, with specific expertise in a given field, to carry out investigation and treatment for the patient.  Examples include neurosurgery, cardiac surgery and cancer management.


How an Advocate can support a client accessing health care

A client can request that an Advocate support them at health appointments.  Such appointments could be GP appointments, or appointments relating to mental health.

An Advocate will meet with the client prior to attending the appointment in order to ascertain what the role of the advocate will be. This can vary depending on the client’s needs.

In a general sense, an advocate will…

  • Make sure that you understand what is being said to you
  • Support you to ask any questions you may have
  • Ask questions on your behalf if you do not feel able to

Medical Records

If a client wishes to access their medical records, an Advocate can request this on their behalf from the Patient Administration Department at DGRI. The client is required to us give signed permission before we can do this.

Please note that the NHS may incur a charge to receive records.


Dumfries and Galloway Advocacy Service carry out weekly ward rounds at Dumfries and Galloway Royal Infirmary. This gives patients an opportunity to speak to an independent person about any issues that they may have encountered during their stay in hospital.

NHS Complaints

Following the introduction of the Patient Rights (Scotland) Act 2011, patients have a legal right to complain, give feedback or comments, or raise concerns about the care they have received from the NHS.

We can either refer you to the Patients Advice and Support Service (PASS) whose remit is to work with clients in relation to these issues. Or we can support you to complain.

PASS is part of the Citizens Advice Bureau and the link to their website can be found below.

Useful links

NHS Dumfries and Galloway

“The service I received was excellent; I was made to feel comfortable and positive about my situation, many thanks.”