In theory you can choose which hospital you attend. For me it's a blend of support that I feel is medically helpful and positive in competition with geographic convenience.
A major reorganisation of NHS care that started in 2019, got sidetracked by Covid and was bulldozed into a go live date in July 2022 before the various components were ready. This has had a major effect on the new processes. Previously we had relatively small, local Cost (also Care) Centre Groups (CCGs) that provided overview, financial regulation and local (specific) technical regulation to local Hospital Trusts and GP Surgeries. My local Surgery was in a CCG of 18 (I think) GP Surgeries and 3 hospitals all 3 part of one Hospital Trust. Since 1 July 2022 the CCGs have been replaced by massive Integrated Care Centres (ICSs) with their governance from Integrated Care Boards (ICBs), centred in substantial geographic Regions. So my former Bucks South is now part of Bucks South, Oxford and Berkshire West; this comprises several Hospital Trusts and somewhere in excess of 140 GP Surgeries. So now Bucks, Oxford and Reading hospitals are available to me (in theory).
But in practice the drawback is that Trusts don't trust, won't share medical records and the bureaucracy defeats the goal of Integrated Care. I still can't get my Bucks GP to carry out a blood test that is needed by the Oxford Oncology team - it seems to be a financial matter! - and when there is a test such as my HbA1c done by my Bucks GP they adamantly won't share that with my Oxford Endocrinology team. I have to manually get the results and email it across. Of course if the Oxford Hospital were to organise the blood test then they'd have those results; I just have to make a specific 40 mile journey for the blood test and my Bucks GP would get to know the result - but only from the Oxford Consultant's after report. That might sound fine - except the report is logged with my GP but the content is not visible to me through Patient Access, just the existence of the report!
So in practice this is a fair old mess and reflects the worst bits of the creaking NHS. Once you have decided where you would prefer to get your T1 or any other specialist care as well as considering geographic convenience and best medical care on the day, at least ask about how mechanisms can be set up to make sure that your records are suitably kept up to date and shared with any likely nearest A&E Department. After 3 years Oxford have become quite adept at finding workarounds with my GP; but when I was admitted to Stoke Mandeville for emergency surgery for a life threatening colon blockage there was a blatant disconnect within Stoke Mandeville. I was fortunately very 'compos mentis' and able to show the SM Surgical team my surgical reports from my total pancreatectomy at Oxford, a couple of years previously and generally keep them informed about my relatively unusual T3c events.
