Dear Patient

A private provider is any consultant, hospital or other organisation that charges for healthcare. References to private provider on this page will refer to the person or body who is providing you with private healthcare.

 

PRIVATE REFERRALS

SELF-REFERRALS Contrary to popular belief about needing a GP referral letter, any patient can self-refer to any private provider without any input from a GP. You do not actually need a GP referral letter. You simply ring up the provider and ask to be seen. To facilitate your self-referral, if you need it, we can supply a summary printout of your record free of charge to take with you to your appointment.

Please note that you must yourself select which private provider you wish to attend as we cannot direct you to a particular private provider as such recommendations may be seen as being anti-competitive.

NHS REFERRAL BUT GOING PRIVATE INSTEAD If the GP was going to refer you to an NHS hospital, but you wish to go private instead, we can supply the referral letter that we would have sent to the NHS hospital. This is free of charge.

FEES FOR REFERRAL LETTERS OR INSURANCE FORMS However, if you have decided yourself to see a private provider, but that provider requires a referral letter or insurance form completing before they can see you, we can compile a letter or fill out a form for you, but such work will be chargeable, in line with our current fees policy.

Fees for non-NHS work

TESTS AND/OR MEDICATIONS AFTER ATTENDANCE Please note that where GPs have made a referral to a private provider, whether this is at your own or at the GP's instigation, this does not obligate the GP to carry out any tests or prescribe any medications should these be requested by the private provider. Please see the section immediately below on investigations, medications and shared care.

As indicated above, any patient can refer themselves to a private provider without GP input, however, if you require a referral from the GP to your private provider, you will need to sign a statement indicating that you understand that any tests and/or medication requests from the private provider may not be honoured by us. The reasons for this are detailed below.

 

TEST REQUESTS AND MEDICATION

Contrary to popular belief, NHS GPs actually have no obligation to perform any investigations or prescribe medications following attendance at a private provider. The following section describes each type of request in more detail.

 

INVESTIGATIONS NHS GPs are not obliged to perform or request any tests that are required as a result of a patient attending a private provider. This is especially so, if such a test falls outside ordinary care usually provided by the GP and where the interpretation of the result of such test would fall outside the GPs knowledge, skills and competence. Such tests can be requested and actioned by the private provider themselves.

Download info leaflet  

MEDICATIONS Again, NHS GPs are not obliged to prescribe medications that are required as a result of a patient attending a private provider, nor are they required to convert privately issued prescriptions to a GP issued ones.

However, where such requested medications are within the scope of ordinary care from a GP and where we would normally issue such medications, we will consider such requests on an individual basis and if agreed, prescriptions will be processed in line with our non-urgent medication process and timescale. It must be emphasised, if we choose to write an NHS script, it is processed as non-urgent. If your private provider indicates that you need your medication urgently, then in line with usual hospital processes, they must supply it themselves.

 

SHARED CARE MEDICATIONS Shared care is a process whereby responsibility for a patient's medication is shared between a GP and consultant. In such a situation, the consultant will assess a patient's suitability for the medication, perform any necessary baseline investigations and counsel the patient fully on the medication, before prescribing the medication and adjusting the dose until the patient is stable.

Once the patient is stable, the consultant then writes to the GP to ask them to consider shared care. If the GP accepts, they then take over the prescribing and monitoring of the patient, notifying the consultant should any problems arise. The patient must remain under the care of the consultant. For shared care to be valid, there must also be a written agreement on the duties and responsibilities of each party.

The whole process of shared care is to facilitate appropriate clinical oversight and to maintain patient safety, all in the patient's best interests.

Having said the above, it must be noted that shared care is entirely voluntary for GPs and GPs are NOT obliged to enter into shared care, for whatever reason.

In general, we do not participate in shared care arrangements with private providers. Specifically, we will not consider shared care arrangements if ANY of the following conditions apply (most of these describe situations that are, by definition, not shared care):

• There is no written shared care agreement NOT SHARED CARE
• There is a shared care agreement, but it does not match the equivalent NHS shared care agreement for the same cohort of patients NO EQUIVALENCE
• The private provider is an assessment or diagnosis only service, that is, it does not prescribe medication at all NOT SHARED CARE
• The private provider has not completed an appropriate assessment of patient's suitability for the medication, performed baseline investigations or provided counselling for the medication (for example, information on side effects, interactions) NOT SHARED CARE
• The private provider has not initiated the patient on medication and/or has not adjusted dosage accordingly and/or has not stabilised the patient on the medication NOT SHARED CARE
• The private provider has discharged the patient back to sole GP care NOT SHARED CARE
• The medication being recommended is one that falls outside the GP's knowledge, experience or competence to prescribe CANNOT PRESCRIBE
• The private provider is recommending use of medication that falls outside its licensed indications (for instance, it is being used for a different age group or different reason from the manufacturer's recommendations) NOT LICENSED

The reason why we do not consider prescribing medication in any of the above situations is that there is no proper specialist oversight and consequently patient safety is potentially at risk. Whilst it may seem convenient (and cheaper) to 'get a prescription from the GP', we will not enter into any arrangement that has the potential to put a patient at risk.

If NONE of the above apply, we may consider the request for shared care from a private provider on an individual basis, but please note that such consideration does not guarantee that a prescription will be provided.

As already mentioned, if you are being referred to a private provider, you will need to indicate by a signed disclaimer form that you understand the implications of how we deal with medication requests, including shared care requests, and test requests from private providers.

We hope the above goes some way to explaining the situation regarding requests from private providers.

 

REQUEST BY PRIVATE PROVIDER TO REFER BACK TO THEIR OWN NHS CLINIC

You may be asked by your private provider to ask your GP to do a referral to the private provider's own NHS clinic, perhaps because you may not have the funds to proceed with private healthcare or if your insurance company does not cover you. The private provider may state a GP referral is needed to 'balance the books' or 'to allow the referral to be counted properly' or that they are 'not able to do this' themselves. All of these reasons are factually incorrect and the request represents completely unnecessary administration being inappropriately passed to the GP.

The NHS referral can be achieved by the private consultant directly without the need for a further GP letter. This is in line with BMA and NHS England advice and if you are asked by a private provider to do this, please return the request back to them.

BMA guidance

Yours sincerely

Ivy Grove Surgery