Private Referrals

Information for Patients attending Private Hospitals and Clinics.

Due to long waiting times for investigations, specialist appointments and operations within the NHS, some people are deciding to attend private hospitals and clinics, locally and abroad.

Your GP will not usually recommend a specific specialist and you are advised to do some research when deciding whether a healthcare provider is safe and suitable.

Please be aware that Pembroke Road Surgery is contracted to provide health services, in line with our General Medical Services contract, on behalf of NHS and is not under any obligation to follow any requests from private health providers.

What happens when you are referred by your GP to see a Consultant/Specialist/Clinician privately?

This leaflet describes what you can expect to happen if you ask your GP to refer you to see a Specialist privately. This might be a Consultant Doctor, Surgeon, Private GP, Specialist Nurse, or allied health professional. This leaflet uses the terms clinician and specialist interchangeably to denote a person or team you are seeing privately. 

What happens next?

You should contact the Clinician’s team directly to organise an appointment. Contact them directly if you have any future appointment issues. If you have private health insurance, your insurer may have a list of approved specialists. You should check with your insurer before you proceed.

The specialist may request information from your GP; please contact your GP practice to ask them to provide a referral letter. This will include relevant medical details about you. If an insurance company or specialist wishes a specific form to be completed, then your GP will charge you for providing this additional work.

What happens if you need a test or procedure?

If the Specialist thinks that you need any tests (including blood tests), or a surgical procedure, they are responsible for:

• arranging the test and any medications (such as sedation) that might be needed for this. They should also explain how and when you will receive a date of any procedure and what to do if the date is not suitable for you.
• giving you the results and explaining what they mean (this may be done in a separate appointment with them or by letter). You should not contact your GP surgery to discuss the results of tests organised by others, it is the specialist’s responsibility to discuss this with you.

This is also true of NHS care; secondary care clinicians should organise tests and have results returned directly to themselves rather than pass tasks to the GP practice to carry out.

The cost of these tests should be paid for within the private sector, which may increase the costs you incur. You may also need to travel to where you saw the specialist.

GP practices should not be asked to perform blood tests or other private investigations using NHS resources. A private GP or specialist can refer to NHS secondary care services but should not expect your GP practice to do this for them.

If a private specialist informs you to arrange or to expect to hear from your NHS GP to arrange such tests, then this is incorrect. You should, at the time, remind the specialist that all tests need to be carried out privately. Avoiding inappropriate requests for your NHS GP to carry out tests will:     

• Avoid delay in having your tests
• Ensure that the right person (your specialist) gets the results directly
• Avoid delays in your Specialist reviewing your results and planning any required follow up

What if my NHS Clinician has referred me for a scan and I want to get it done privately?

Please discuss this directly with the NHS clinician who recommended the test. They are responsible for interpreting and explaining the results to you; do not ask your GP to refer you for the scan. You may need to see a specialist privately to have them request a scan.

What happens if you need new medicines?

The Consultant might suggest prescribing new medicines for you or might want to make changes to the medicines that you are already taking.

The Consultant is responsible for giving you the first prescription for any new medicine that you need to start taking straightaway.

If the consultant recommends a new medication be started, they should write to the GP outlining the reasons for treatment. In some circumstances, the GP may be willing to continue prescribing the medication. It usually takes two weeks for these letters to be received and actioned by practices.

Private Clinicians may suggest medications to patients which would not normally be prescribed by NHS GPs.

This particularly relates to medications which are not included in NHS BNSSG Formulary, medications that require regular monitoring (for example disease modifying anti-rheumatoid drugs, some psychiatric medications, medications for ADHD), medications for sedation before procedures, medications used outside of their license and medications restricted for specialist or hospital use only.

If either the specialist, or your GP, informs you that this is the case for your medication then you will need to continue to receive it from the private service. Please contact the private service directly to organise this.

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

If after seeing the specialist privately you want to be back under NHS care, regulations allow for you to transfer back. You should be transferred back into the NHS system where you would have been at the point you left the private sector (e.g. you do not go back to the start of the queue).

This transfer must be done by the private clinician who is overseeing your care and you should not be passed back to the GP for this to be done. There are a few reasons why:

• it delays your ongoing care
• your Consultant knows the full details of your condition and where best to refer you to
• it wastes precious NHS appointments with your GP and adds unnecessary administration to the process

The consultant should arrange for you to be seen in the appropriate NHS clinic by writing a referral letter to this clinic. This might include passing on results of tests and data that has been used to reach a diagnosis; NHS teams may not always agree with diagnoses or treatment plans made elsewhere.

If I pay for private treatment, how will my NHS care be affected?

What if I need a Fit Note (previously known as Sick Note)?

If you need to be certified as unfit for work following treatment by a clinician:

Fit notes can and should be issued by doctors and nurses working in the private sector:

• the specialist is responsible for issuing you with a Fit Note.
• the Fit Note should cover the period they expect you to be unfit to 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.

Getting a fit note

What if I need a follow-up appointment?

The private provider will discuss with you whether you should have ongoing follow-up care or whether you should be discharged back to your GP. If the Specialist thinks you do need to be seen again, they will give you another appointment or tell you when to expect this. If you do not hear anything, please contact the Specialist’s office, rather than your GP surgery.

What do I do if I have any questions?

If you have any specific questions related to your care, you should contact the Specialist’s team directly. It is important that you make sure you know how you can contact your private provider.

This leaflet has been developed using information from the British Medical Association and NHS Information sources.

Pembroke Road Surgery follows the following guidance regarding requests for blood tests to be done by a private provider:

If a patient has chosen to pay for private healthcare because

a) their treatment is not available on the NHS, or

b) they do not wish to be treated on the NHS

they are responsible for paying for all costs, including tests, and the private provider is responsible for managing every aspect of their healthcare (unless the patient chooses to transfer back to the NHS at a later date to continue treatment).

For that reason, private providers should not be asking GPs to arrange any tests that they deem necessary, and intend to use, to make a diagnosis and recommend a course of treatment with.

It is the private provider’s responsibility to arrange tests for patients whose care they are managing, and the patient’s responsibility to pay for them.

Policy regarding requests from private providers to start or take over prescribing medication

The practice reserves the right to reject any request from a private Specialist to prescribe medications on an ongoing basis. If the specialist wishes for a medication to be added to the patient’s repeat prescriptions, the same approach as per standard NHS guidance should be followed. i.e.

• Specialist writes to GP outlining the reason for the medication being initiated and requests it to be placed on repeat prescription AND Specialist issues a private prescription for 1 month (this allows a reasonable amount of time for a clinic letter to reach the GP practice and be processed).
• Patients who are issued a medication by a private specialist will need to pay the private prescription fee for that item. Requests to transfer private prescriptions to an NHS prescription before a clinic letter has been received will always be rejected.

Requests to take on prescribing of the below classes of medications will NOT be accepted by the practice.

SC – Shared care

SI – Specialist initiated

SO – Specialist only

BL – Black listed medicines

NR – Not recommended

DM – Discontinued medicines

The Practice may consider adding medications that are on the Coventry and Warwickshire approved prescribing committee formulary if they are not in the above classes. The formulary can be found here

If a patient feels a medication in the above classes requires a prescription on repeat basis the following options are available:

• The private specialist continues to prescribe the medication for their patient.
• The private specialist arranges for care to be transferred to an NHS specialist and an NHS shared care agreement can be completed (please note this does not guarantee the GP practice will take on the responsibility of prescribing shared care medications purely that it will be considered).