We understand that some patients will chose to access health care privately, which is a choice you are entitled to make. Whilst we are grateful for the support of our private consultant colleagues and sympathise with the potential delays for hospital appointments, there are a few things that you need to be aware of before making this decision.

Please read the information below regarding our position on private work at Kearsley Medical Centre.

NHS guidance states:

Patients can pay for additional private healthcare while continuing to receive care from the NHS. However, in order to ensure that there is no risk of the NHS subsidising private care:

• It should always be clear whether an individual procedure or treatment is privately funded or NHS funded.
• Private and NHS care should be kept as clearly separate as possible.
• The patient should bear the full costs of any private services. NHS resources should never be used to subsidise the use of private care.
• The arrangements put in place to deliver additional private care should be designed to ensure as clear a separation as possible of funding, legal status, liability and accountability between NHS care and any private care that a patient receives

Organising tests requested by private providers:

Sometimes Kearsley Medical Centre receives requests from private providers asking for investigations such as blood tests or scans but complying with these requests is outside the scope of NHS primary medical services.

Our contract with the NHS states that a GP should only carry out investigations and prescribe medications for a patient where it is necessary for the GP’s care of the patient and the GP is the responsible doctor. These decisions would usually be made after the GP has had a consultation with the patient directly and agreed a plan.

At Kearsley Medical Centre, if we consider the proposed investigations to be clinically appropriate and feel competent to both interpret them and manage the care of the patient accordingly, then we may proceed with arranging the tests or investigations once we have done our own assessment in a consultation. However, if we do not have the knowledge or capacity to undertake these actions, we will decline and advise the patient and the private provider to make alternative arrangements.

Prescribing medication requested by a private provider:

GMC Good Medical Practice states that doctors in the NHS and private sector should "prescribe drugs or treatment, including repeat prescriptions, only when they have adequate knowledge of the patient’s health and are satisfied that the drugs or treatment serve the patient’s needs."

At Kearsley Medical Centre, if we prescribe a medication, we take over the full responsibility for that prescription, regardless of whether a private provider has requested it. If we feel competent to prescribe a medication suggested by a specialist and it is within the guidance, we are happy to do this. However, there are instances where we may not be able to prescribe medications recommended by your private provider. Examples include:

• Where the GP or practice does not have the expertise to safely prescribe and/ or monitor a specialist drug.
• Where we have been asked to prescribe a medication which would only be prescribed by a hospital consultant in the NHS. Common examples include ADHD medications, mood stabilisers such as Lithium and immunosuppressant medications such as Methotrexate/Hydroxychloroquine.
• Where there has been insufficient information from the private provider regarding the rationale for using a medication.
• Where the use of the proposed medication is not in line with local or national prescribing guidance.
• Where the proposed medication is not licensed for the medical condition described.

If we are unable to prescribe a medication requested by a private provider for one of these reasons, we will pass this back to the private provider. 

If we feel able to prescribe the medication requested by the private provider, we would expect them to provide the first prescription lasting at least 28 days (this is the same with NHS clinics), to give us time to receive, process and then action the request.

‘Shared Care’ with private providers:

Sometimes the care of a patient is shared between two doctors, usually a GP and a specialist, and there is a formalised written ‘shared care agreement’ setting out the position of each, to which both parties have willingly agreed. Where these arrangements are in place, GP providers can arrange the prescriptions and appropriate investigations, and the results are fully dealt with by clinicians with the necessary competence under the shared care arrangement.

Whilst this is commonplace in the NHS, with clear guidelines around which medications are appropriate for ‘shared care’ with a specialist, we occasionally receive requests for ‘shared care’ from private providers.

The British Medication Association (BMA) guidance is very clear that ‘Shared Care with private providers is not recommended due to the general NHS constitution principle of keeping as clear a separation as possible between private and NHS care. Shared Care is currently set up as an NHS service, and entering into a shared care arrangement may have implications around governance and quality assurance as well as promoting health inequalities.’

At Kearsley Medical Centre, if a private provider is caring for you and they wish to have a ‘shared care agreement’ with us for a medication that you are being prescribed, it is with regret that we will decline this offer. You will need to have your care fully with the private provider, or you can ask them to refer you to an NHS service so that we can then consider agreeing to ‘shared care’.

Please note that this also applies to mental health referrals to private providers under the ‘right to choose’. If you opt to see a private provider for an Autism, ADHD or Mental health assessment via the ‘right to choose’ and they wish to have a ‘shared care agreement’ with us for a medication that they have suggested or initiated, we will decline. We will only take over the prescribing of this medication once an NHS specialist has seen you and a ‘shared care agreement’ is in place with them.

Reference:

https://www.bma.org.uk/advice-and-support/gp-practices/managing-workload/general-practice-responsibility-in-responding-to-private-healthcare