Winchcombe Medical Centre Guidance re: Private providers
(References: The BMA and Michael Wong at Ivy Grove Surgery)
With nearly 7.6 million people on NHS waiting lists in December 2023, patients are increasingly resorting to seeking private healthcare to deal with their health problems. This is adding extra workload for general practices due to private providers making requests for onward referrals/medical information/tests and prescriptions.
We respect the universal right of any patient to choose (and pay for) a private provider. However, NHS guidance and the BMA recommendations state that private and NHS care should be kept as clearly separate as possible. This is so that funding, legal status, liability, and accountability are appropriately defined, that the patient should bear the full costs of any private services, and that NHS resources should never be used to subsidise the use of private care.
With that in mind we would like you to read some frequently asked questions to clarify the role and responsibilities of your NHS GP and your private provider to ensure you can make an informed decision about your healthcare.
FAQ
What is a private provider? A private provider is any doctor, hospital, or other organisation that charges for healthcare.
Can you recommend someone? No, 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.
The private provider has asked for information from my medical record, how can I get this? Our practice does not share records directly with private providers. Patients have the right to access their own medical records. We encourage the use of the NHS app for convenient and up to date access. If a patient is unable to access their records via the app they can request a SARS (Subject access request). This takes 28 days to process. Once patients have obtained their records it is their responsibility to handle the sharing of them with private providers and then obtain the NHS app for ongoing access.
The private provider has asked if you can do the tests I need? NHS GPs are not obliged to perform or request any tests that are required because 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.
The private provider has asked if you can prescribe the medication I need? 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.
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 usual medication process and timescale. If your private provider indicates that you need your medication urgently, then in line with usual hospital processes, they must supply it directly themselves.
The private provider has asked if you will refer me back to an 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 NHS referral can be achieved by the private doctor directly without the need for a further letter from your NHS GP. 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.
The private provider has asked if you will agree to a shared care agreement? In general, we do not participate in shared care arrangements with private providers. Shared care is entirely voluntary for GPs and GPs are NOT obliged to enter shared care.
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.
- There is a shared care agreement, but it does not match the equivalent NHS shared care agreement for the same cohort of patients.
- The private provider is an assessment or diagnosis only service, that is, it does not prescribe medication at all.
- 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)
- 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.
- The private provider has discharged the patient back to sole GP care.
- The medication being recommended is one that falls outside the GP’s knowledge, experience, or competence to 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)