Requests arising from private healthcare

Requests arising from private healthcare

We understand that patients may choose to see a private consultant or provider. However, requests arising from private consultations can create additional clinical and administrative work for general practice. Our capacity is limited, and our priority must remain the safe and timely care of patients using NHS primary care services.

Tests and investigations requested by private providers

We are generally unable to arrange tests or investigations requested solely by a private provider where:

• the test is not part of the GP’s own clinical management plan;
• the private provider has not arranged the test themselves;
• the practice does not have the appropriate clinical responsibility or expertise to interpret and act on the result; or
• undertaking the work would be outside our NHS contractual responsibilities or available capacity.

If a private provider requires a test or investigation, you should normally ask that provider to arrange it directly. If the GP considers that an investigation is clinically necessary as part of your NHS care, and the GP is able to interpret the result and take responsibility for any follow-up, the practice may consider arranging it. This will be a clinical decision and cannot be guaranteed.

Prescriptions recommended by private providers

A private consultant may recommend or prescribe treatment following a private consultation. This does not automatically mean that the NHS GP practice can issue the medication on an NHS prescription.

Any request will need to be reviewed by a GP who must be satisfied that:

• they have sufficient knowledge of your relevant medical history;
• the treatment is clinically appropriate and necessary;
• they have the necessary competence and expertise to prescribe and monitor it safely;
• any required tests and monitoring arrangements are in place;
• the treatment is consistent with relevant NHS and local prescribing guidance; and
• they are willing to accept clinical responsibility for the prescription.

The prescribing doctor retains responsibility for the prescription. We will not prescribe medication where the clinician is not comfortable accepting responsibility, does not consider it clinically appropriate, lacks the necessary expertise, or believes that the medication should remain the responsibility of the private consultant or specialist.

Requests for routine prescriptions from private providers may need to wait for the practice’s usual clinical review and prescription-processing arrangements. A private provider should not advise a patient that their NHS GP will automatically issue the prescription.

Where medication is urgently required following a consultation, the private provider should make appropriate arrangements for its immediate provision. NHS England guidance states that where a patient has an immediate clinical need for medication following an outpatient consultation, the secondary-care provider should provide sufficient medication until the GP can reasonably receive the relevant information and accept responsibility, where appropriate. This principle also applies to private providers.

Shared-care arrangements

We do not automatically accept shared-care requests from private providers. A shared-care arrangement requires appropriate written communication, clearly defined responsibilities, suitable monitoring, and agreement by the GP and the practice.

Many practices are unable to enter into new shared-care arrangements with private providers because of capacity limitations, safety concerns, insufficient specialist support and the absence of appropriate commissioned arrangements. Where shared care is not agreed, the private consultant or provider remains responsible for prescribing and monitoring the treatment.

Patients should not stop prescribed medication without discussing this with the clinician responsible for their care. If you are concerned about an urgent interruption to medication, please contact the prescribing specialist or an appropriate urgent NHS service.

We appreciate that this policy may be disappointing. It is necessary to ensure that prescribing and investigations are undertaken safely, with clear clinical responsibility, and without reducing the practice’s capacity to provide core NHS care.