Policy on Private Work

Private Work at The Greyswood Practice

We are seeing more of our patients requesting private referrals and investigations or treatment through the private sector, driven in part by long NHS waiting lists. Whilst we are grateful for the support of our private consultant colleagues, and sympathise with the delays in seeking specialist assistance, it may not always be appropriate or possible for us to action these requests.

 

Please find further information below regarding our position on private work at the Greyswood Practice.

 

Private blood tests and other investigations

 

The practice occasionally receives requests from private providers to perform investigations such as blood tests or scans for our patients.

 

According to the NHS General Medical Services Regulations, which govern the contract between the NHS and GPs, these investigations should only be performed if the GP considers these to be clinically appropriate and part of the standard approach of assessing/ treating the patient as per NHS guidance. The GP must also be able to interpret the results and manage the care of the patient accordingly.

 

If we feel the proposed investigations lie outside NHS Primary medical services, we will ask you to make alternative arrangements through your private provider.

 

Private Prescriptions

 

The practice also receives requests from private providers asking us to prescribe medications they have recommended.

 

Whenever a GP prescribes a medication, they take over the full responsibility for the drug regardless of whether another doctor recommended it. As a result, we are usually happy to issue prescriptions for medicines that we have experience prescribing.

 

Although we will always try and accommodate prescription requests, 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 or 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.

 

Shared Care Agreements

 

When patients are stable on a long-term medication initiated by a hospital consultant, their GP may be asked to take over the prescribing responsibility with a written document called a Shared Care Agreement.

 

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

 

When we receive shared care agreements from private providers we will need to refer you to an NHS specialist in the first instance. They will be able to confirm your diagnosis and treatment plan and facilitate an NHS Shared Care Agreement that we are then able to take over.