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Private referrals and treatment

Are you considering, or have you had Private Treatment (in the UK or Abroad)?

What is the NHS guidance regarding private treatment?

When you consult a private (i.e. non-NHS) healthcare provider you should be aware of what may happen regarding any medication and monitoring recommended by the specialist. 

There is guidance available for NHS patients who wish to pay for additional private care (https://www.nhs.uk/common-health-questions/nhs-services-and-treatments/if-i-pay-for-private-treatment-how-will-my-nhs-care-be-affected/).  The guidance says:

  • 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 can’t pay for or subsidise your private hospital treatment
  • There must be as clear a separation as possible between your private treatment and your NHS treatment
  • Your position on an NHS waiting list shouldn’t be affected if you choose to have a private consultation.

Do I need a GP referral for private treatment?

No. You can get private treatment from a consultant or specialist without being referred by your GP.  However, the British Medical Association (BMA) believes it is best practice for patients to be referred for specialist treatment by their GP because they know your medical history and can advise you if a referral is necessary.  If you have private medical insurance, a referral is also needed from a GP in most cases.

It’s best to see your GP first if you’re unwell or have symptoms. Talk to them about whether you might need a specialist assessment or treatment.

If your GP thinks you need to see a specialist and you want to pay for it privately, they can write a letter of referral to a private consultant or specialist explaining your condition and your medical history.  You will need to provide information to your GP on where you would like to be referred to and your GP will only refer you to a specialist if they believe that specialist assessment or treatment is necessary. If they do not think it is, they do not have to refer you – either privately or on the NHS. 

If you disagree with your GP’s decision, you can ask them to refer you to another healthcare professional for a second opinion (an opinion about your health from a different doctor).  Although you do not have a legal right to a second opinion, a healthcare professional will rarely refuse to refer you for one.

You may also choose to refer yourself to a private healthcare practitioner independently of your GP for privately funded care (i.e. outside the NHS), whether in the UK or abroad.

Information about costs and treatment

If you choose to refer yourself to a private healthcare practitioner independently of your GP for 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 diagnosis, monitoring and medication) you receive in relation to the package of care provided privately (including non-emergency complications). Where your GP has referred you to a private practitioner you may be supplied with a private prescription. This can be dispensed by any community pharmacy and you will be required to pay for the medication dispensed.

If, following initial treatment (package of care), your private practitioner deems it necessary for ongoing medication and/or monitoring they will liaise with your NHS provider to deem if it would be appropriate to transfer care back to NHS provision. There is no obligation for your NHS provider to accept recommendations made to prescribe treatment by the private practitioner. An NHS prescription would only be considered by your GP if the following criteria are met:

  • There is a clinical need for your medicine
  • That an NHS patient would be treated in the same way
  • That the medicine is something they would routinely prescribe

To assess 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 practitioner.  Please note that your GP does not have the facility to translate documents into English – please ensure that any documents from an overseas provider are translated into English before you pass these on to your GP.

If your NHS practitioner does not feel that it is appropriate for them to prescribe the medicine/treatment recommended by the private practitioner, then they may consider:

  • Prescribing you an equivalent locally recommended medication, which should deliver a similar/identical benefit
  • Offering a referral to an NHS consultant to consider whether the recommended medication/treatment should be prescribed as part of ongoing NHS treatment
  • Asking the private practitioner to remain responsible for the treatment because of its specialist nature, and to provide further private prescriptions, for which you will need to pay
  • If your private practitioner has asked you to have ongoing monitoring/treatment which is not available on the NHS, your GP may advise that you will have to arrange this privately 

Some private hospitals have pharmacy departments that can dispense your private prescription or your community pharmacy may be able to order it for you from a private prescription.  Where medication prescribed is not available to order via community pharmacy, your private healthcare provider can advise on suitable supply routes.

The cost of a private prescription is calculated depending on the cost of the medication. There is considerable variation in the cost of medicines so it is suggested that patients discuss the possible cost of medications with their private practitioner as part of their treatment plan. The pharmacy will charge you for the full cost of your medication as well as a professional fee for the process of obtaining, dispensing and checking your medicine. Costs can vary between pharmacies so you are entitled to ‘shop around’ before deciding where you would like your medicine supplied from.

What happens if I need to transfer my care back to the NHS?

If, after seeing the specialist privately, you want to transfer back under NHS care, regulations allow for this to be facilitated.  This transfer and arrangement of care must be done by the private provider and should not be passed back to the GP for this to be done.  The private specialist should write a referral to the appropriate NHS clinic as a handover of care.  NHS specialist teams may not always agree with a diagnosis or treatment plan made elsewhere by private providers.

What if I need a Sick Note?

If you need to be certified as unfit for work following assessment and treatment by a private provider, your private clinician is responsible for issuing you this certificate.  Your sick note should cover the period that they expect you to be unfit for work or until your next contact with the Specialist.  You should not need to see or contact your GP to get a Fit Note following hospital treatment unless your inability to work is unexpectedly prolonged.

Private treatment overseas

If you are considering, or have had, privately funded treatment overseas which would not have been offered by or had any involvement with your local NHS Board, Scottish Government has provided guidance to GP Practices to clarify the position of NHS Scotland as follows:

  • While the NHS in Scotland will always provide emergency care where necessary, all routine pre and post-operative care should be part of the package of care purchased by the patient
  • Choosing to pay to travel abroad for surgery is not recommended by NHS Scotland, or by the surgical specialist associations in the UK

If you still wish to do this, be aware that NHS Scotland is under no obligation to provide pre and post-operative care other than emergency care – see also information on NHS Inform – https://www.nhsinform.scot/tests-and-treatments/surgical-procedures/surgery-abroad-without-nhs-referral