Referrals From Private Providers Incl Medication Requests

Protocol following a private referral

There has been a significant increase in patients going privately, and then asking the GP to prescribe specialist medication as an NHS prescription on behalf of the private provider. This is not the same as NHS shared care.

We cannot guarantee we will issue any new specialist medication prescriptions on behalf of private specialists. This will be looked at on a case by case basis and we will need to follow the same guidance as if you were seeing someone on the NHS.  We will follow the guidance on the Surrey Prescribing database. Shared care for private providers is more difficult as we need to be assured that you will continue to see the private provider in the long term

Patient safety

Private providers may not adhere to the same safety standards as NHS providers. Patient safety is our priority, and we need to be as certain as we can that we are prescribing safely.

Problems often arise when patients no longer pay to see the private specialist, leaving the GP to prescribe the medication without access to any specialist input. This is risky for patients and GPs are not indemnified for this. We will not do this

Commissioning

GPs are not funded to carry out non-NHS work. Undertaking significant amounts of private work can lead to GPs subsidising the cost of private healthcare. At a time of ever increasing demands on primary care, this takes away significant resources from other patients, and promotes health inequality.

We can refer you to NHS services and will be able to enter into shared care prescribing with them, once an appropriate agreement is in place if you wish.

To ensure this policy is fair and non-discriminatory, this will apply to specialist prescribing on behalf of all private providers, not for specific patient groups or health conditions.

Organising tests requested by private providers

Sometimes we receive requests from private providers to arrange tests or investigations, for patients that they have seen privately. We appreciate that this may be to save you the cost of these investigations, however complying with this request is outside the scope of NHS general practice work and NHS guidance above.

Our contract states that a GP should only carry out investigations and prescribe medication for a patient where the GP is the responsible doctor and it is necessary for the care of the patient. This means that the GP has had the full consultation with the patient themselves and has agreed, with the patient, the investigations that are needed.

 The reason for this is not only because we are not contracted (and therefore not paid) to do this work, we also may not have the knowledge, resource or capacity to be able to perform these tests on behalf of private providers. When we get these requests will may advise you and the private provider that these services do not fall within NHS primary medical services and suggest they make alternative arrangements to get the investigations done.

 Referring to an NHS service following a private consultation

Sometimes, after a private consultation, the private specialist may suggest that you are referred to an NHS service.

Please note that private providers can make referrals to NHS services, without referral back to the GP, provided the patient would be eligible for NHS referral. Any patients referred should be treated based on clinical need. Read NHS England guidance around consultant-to-consultant referrals within the NHS.