PRIVATE REFERRALS
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.
If you are thinking about using a private health provider, either by self-funding or private health insurance, we strongly advise you to first consider the information below.
Please be aware that your GP practice is contracted to provide National Health Services, in line with a General Medical Services (GMS) contract, on behalf of NHS Highland. It is not contracted nor obliged to provide private services out with this contract, unless local arrangements have been agreed with the Health Board.
Your GP would not usually be in a position to recommend a specific specialist and therefore patients are advised to do some research when deciding whether a healthcare provider is safe and suitable.
Below describes what you can expect to happen should you choose to see a Specialist privately.
What happens next?
You should contact the private provider directly to organise an appointment. 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 private provider may request medical information from your GP, this will require your written consent to release relevant medical information. If an insurance company or specialist wishes a specific form to be completed, your GP practice may charge you for providing this additional administrative work.
What happens if you need a test or procedure?
If the private 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.
· Organising 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 your results and explaining what they mean (this may be done in a separate appointment with them or by letter). It is the requesting private clinician’s responsibility to discuss all tests and investigations directly with you. Please do not contact your GP to discuss these results.
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 are not able to perform private blood tests or investigations using NHS resources.
A private GP or specialist can refer directly to NHS secondary care services and therefore should not expect your GP practice to do this for you, on their behalf. If a private specialist informs you to arrange any tests or investigations via your GP, unfortunately this is incorrect.
Tests directly arranged via your private provider 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. You may need to see a specialist privately before any recommended scan is arranged. Should you choose to have a scan arranged privately, your NHS clinician will be able to cancel the scan so that this appointment can be appropriately allocated to another patient awaiting this investigation.
We will not offer interpretation for scans and tests we did not arrange. Should you receive any private tests or investigations, you should speak to your private specialist to discuss these results with you.
What happens if you need new medicines?
The private specialist might suggest prescribing new medicines for you or may make changes and alterations to medicines that you are already taking. They are 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 most 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 GP practices.
Private specialists may suggest medications to patients which would not normally be prescribed by NHS GPs. This relates to medications which are not included in NHS Highland prescribing formulary or medications that can only be prescribed by secondary care specialists as they often require regular monitoring (common examples include disease modifying anti-rheumatoid drugs, some psychiatric medications, medications for ADHD). This includes medications that are unlicensed to treat certain medical conditions. If either the private specialist, or GP, informs you that this is the case for your specific medication, 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 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.
• To avoid delays in your follow-up care
• Your private provider knows the full clinical details of your condition and where best to refer you to and next appropriate steps for your care
The private specialist should arrange for you to be seen in the appropriate NHS clinic by writing a referral letter to this clinic as a handover of care. This ensures results of tests and investigations that have been used to reach a diagnosis are made available the relevant speciality. NHS specialist teams may not always agree with a diagnosis or treatment plan made elsewhere by private providers.
What if I need a Fit Note (previously known as 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 with a Fit Note. Your 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.
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 private provider directly, 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 private specialist’s team directly. It is important that you make sure you know how you can contact your private provider.
This has been developed using information from the British Medical Association and NHS Information Sources.
Helpful Links:
https://www.nhsinform.scot/care-support-and-rights/health-rights/fit-notes/getting-a-fit-note