How Specialist Access Works in Spain
Spain has a dual-track referral system — one for the public system and one for private care.
Public system specialist access requires a referral from a GP (médico de familia) contracted with the SNS. Without this referral, public system specialist appointments are not covered. Global Health cannot provide public system referrals — this requires a GP contracted with the Spanish public health system.
Private specialist access is available directly in most cases — you can book a private specialist appointment without a referral letter. However, arriving at a specialist appointment without clinical context significantly reduces the quality of that first consultation. A specialist who receives a clear referral letter — describing your symptoms, relevant history, current medications, and the specific clinical question — conducts a more focused and efficient assessment.
This service covers:
- Private referral letters — for private specialist consultations of your choice
- Blood test requests — for private laboratory testing at collection points across Spain
- Imaging requests — for private X-ray, ultrasound, MRI, or CT
- Clinical summary letters — documenting your assessment and findings for continuity of care
- Results review — blood test results, imaging reports, or specialist letters reviewed and explained clearly
This service does not cover:
- Public system SNS specialist referrals — these require a GP contracted with the SNS
- Emergency referrals — call 112 or go to the nearest emergency department immediately
Who This Service Is For
This consultation is appropriate for:
- Anyone who wants to see a private specialist in Spain and needs a clinical referral letter to accompany the appointment
- Patients who need blood tests or imaging ordered by a doctor before booking privately
- Patients who have received results — from blood tests, imaging, or specialist consultations — that they want reviewed and explained clearly
- Patients with a specific clinical concern they want formally assessed and documented before pursuing specialist care
- Patients who want a clinical summary letter — for insurance purposes, for a new doctor, or for continuity of care
- Patients who received clinical documentation in Spanish they want reviewed and contextualised
- Anyone in Spain without a registered GP who needs clinical documentation to access private specialist care
Why a Referral Letter Adds Value
Direct access to private specialists in Spain is available in most cases without a referral letter. But a specialist who sees you without context must start from scratch — and consultation time is spent gathering information that could have been communicated in writing in advance.
A referral letter issued after clinical assessment contains everything the specialist needs before you walk in — symptoms, duration, severity, current medications, investigations already completed, and the specific clinical question you are asking the specialist to address. The specialist can immediately focus on the clinical problem.
The difference in the quality of that first specialist appointment — between arriving with a comprehensive referral letter versus arriving without context — is significant.
Referral Letters — What They Include
A referral letter issued by a Global Health GP following clinical assessment includes:
- Patient details and relevant medical history
- Description of the presenting concern — symptoms, duration, severity, and relevant clinical findings from the video consultation
- Current medications and relevant investigations already completed
- Specific clinical question for the specialist — what you are asking them to assess or advise on
- Degree of urgency — routine, soon, or urgent — based on clinical assessment
The letter is issued in Spanish for Spanish-speaking specialists. If you need an English version for an English-speaking provider, discuss this with your doctor during the consultation.
Blood Tests — What Can Be Requested
Following clinical assessment, your GP can issue blood test requests for a wide range of investigations, including:
Metabolic and cardiovascular
- Full blood count (hemograma completo)
- Fasting glucose and HbA1c
- Lipid panel — total cholesterol, LDL, HDL, triglycerides
- Renal function — creatinine, eGFR, urea, electrolytes
- Liver function tests
- Thyroid function — TSH, free T4, free T3
- Uric acid
- Ferritin, iron studies, and B12/folate
Hormonal and reproductive
- Testosterone panel — total and free testosterone, LH, FSH, SHBG
- Female hormonal panel — oestradiol, FSH, LH, progesterone, AMH
- Thyroid antibodies — anti-TPO, anti-thyroglobulin
- Cortisol
- Prolactin
- DHEA-S
Inflammatory and autoimmune
- CRP and ESR (VSG)
- Rheumatoid factor and anti-CCP
- ANA and ANCA panels
- Complement levels
Infectious disease
- HIV, hepatitis B, hepatitis C serology
- STI panels
- Post-vaccination immunity checks
Other
- Vitamin D
- Coeliac screen — anti-tTG IgA
- PSA — prostate specific antigen
- HCG — pregnancy test
- Allergy panels — specific IgE
Blood test requests are issued following clinical assessment — your GP advises on which tests are clinically indicated for your specific presentation.
Accessing Private Blood Tests in Spain
Private blood test collection points are widely available across Spain — in Madrid, Barcelona, and in all major cities and provincial capitals. Private laboratory networks operate throughout the country with collection points in most towns.
After your consultation, your GP issues the investigation request and advises on where to go for collection based on your location. You book the collection appointment directly — no Spanish public health insurance is required for private blood tests. Results are typically available within 24 to 72 hours depending on the tests requested, though some specialist panels may take longer.
Imaging Requests
Where X-ray, ultrasound, MRI, or CT is clinically indicated following assessment, your GP issues a formal imaging request. Private radiology is widely accessible in Spain — major cities and most provincial centres have private radiology facilities that accept direct booking with a doctor's request.
Your GP advises on the most appropriate imaging modality for your specific clinical question and the urgency of the investigation.
Results Review
Received blood test results, imaging reports, or specialist letters that you want reviewed and explained clearly? Your GP reviews your results in full during a follow-up consultation — explaining the clinical findings, what they mean for your health, what the next steps are, and whether further investigation or specialist input is needed.
This is particularly useful for patients who have received results or clinical letters in Spanish and want them explained clearly — whether they are Spanish-speaking patients who want more time to discuss results than a standard clinic appointment allows, or international residents who need the clinical content explained in English or Portuguese.
