Information for patients considering Private Medical Consultations
When you are seeing a private specialist, you should be aware what may happen about medication you may need after the consultation.
Guidance for NHS patients
In March 2009, the Department of Health (DH) published guidance (78) for NHS patients who wish to pay for additional private care. The guidance includes the key points below:
- your NHS care will continue to be free of charge
- you can’t be asked to pay towards your NHS care, except where legislation allows charges, such
as prescription charges
- the NHS cannot pay for or subsidise your privately funded care
- your privately funded care must be given separately, at a different time and place from your NHS care
Waiting times for NHS services
We are aware that NHS waiting times for some services are unacceptably long. However, for reasons of safety and professional accountability we cannot consider that a reason for our GPs to take on prescribing for issues that are beyond our expertise to diagnose and manage without specialist input.
Independent Private Referral:
If you choose to refer yourself to a consultant independently of your GP for additional privately funded care (i.e., outside the NHS), whether in the UK or abroad, you are expected to pay the full cost of any treatment (including medication) you receive in relation to the package of care provided privately (including non-emergency complications). Whilst you are undertaking private treatment, all prescriptions and associated care, monitoring of bloods, etc will also have to be undertaken privately. We are unable to ‘mix and match’ NHS and private care.
Private referral through your GP:
After a private referral made by your GP, your private specialist may give you a prescription. You may only need one prescription. The prescription provided by your private specialist will be a private prescription and you must pay for the medication.
If you need continued treatment, you may initially be given just one private prescription (which you will need to pay for) and advised to return to your GP to see if further NHS prescriptions can be provided.
There is no obligation, however, for your GP to accept clinical responsibility to prescribe the treatment recommended by a private specialist. To judge your clinical need for the treatment including the reasons for the proposed medication, your GP must have received a full clinical report from the private specialist.
If your GP does not feel able to accept clinical responsibility, then the GP may consider:
- Offering a referral to an NHS consultant to consider whether the recommended medication should be prescribed as part of ongoing NHS funded treatment.
- Asking the specialist to remain responsible for the treatment because of its specialist nature, and to provide further prescriptions, for which you will need to pay.
This is used in prescribing for complex conditions or with specialist medications, that often require specific monitoring and certainly require the GP to be able to access guaranteed urgent specialist advice or referral in case of problems. We can’t rely on this support from private providers.
If we start prescribing medication, we are taking complete clinical responsibility for the safety and appropriateness of that medication for an individual patient. Even under the NHS a GP can decline to take on shared care for a patient’s medication if they feel it is inappropriate or outside their competence.
Unfortunately, we are not able to enter shared care agreements with private providers. Over the past few years, huge numbers of private clinics have appeared offering diagnostic services for many conditions, some based overseas. Some of these clinics of course will provide thorough expert assessment and advice, but unfortunately others will not. We are not able to quality check all these clinics, and it is important for us to have a consistent approach
GPs have agreed to prescribe in line with local policies.
Only if your GP considers there is a clinical need and that an NHS patient would be treated in the same way would an NHS prescription to continue your treatment be considered.
If the recommendation from your private specialist is for treatment that is not in line with local policies, then your GP may change the medication in line with that used for NHS patients.
Your decision to see private care either independently or via your GP does not in any way impact your rights to access future NHS treatment for any condition. Patients seeking private treatment also have the choice of switching from private to NHS care at any time during their treatment, but you would be referred for NHS care in the same way as any other patient.
For these reasons, you may not be able to have an NHS prescription immediately, if at all.