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 consult one of our doctors beforehand to discuss things such as your expectation of treatment and follow up. Your GP will not usually be in a position to recommend a specific specialist and you are advised to do some research when deciding whether a healthcare provider is safe and suitable.

Please be aware that Munlochy & North Kessock Medical Practice is contracted to provide health services, in line with our General Medical Services contract, on behalf of NHS Highland and is not under any obligation to follow any requests from private health providers.

What happens when you are referred by your GP to see a Consultant/Specialist/Clinician Privately?

This leaflet describes what you can expect to happen if you ask your GP to refer you to see a Specialist privately. This might be a Consultant Doctor, Surgeon, Private GP, specialist nurse, or allied health professional. This leaflet uses the terms clinician and specialist interchangeably to denote a person or team you are seeing privately.

Referral Process:

We can only write referral letters for patients and conditions that we have seen or discussed. Please allow 2 weeks for a referral letter to be typed. We cannot refer for private investigations e.g. ultrasound or MRI as these investigations need to be overseen by a consultant to both request and interpret the results. There will be a charge for a private referral letter.

What happens next?

You should contact the Clinician’s team directly to organise an appointment. Contact them directly if you have any future appointment issues. 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 specialist may request information from your GP; which can be provided for a small fee. If an insurance company or specialist wishes a specific form to be completed, then your GP will charge you for providing this additional work.

What happens if you need a test or procedure?

If the 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. They should also explain 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 the results and explaining what they mean (this may be done in a separate appointment with them or by letter). You should not contact your GP surgery to discuss the results of tests organised by others, it is the specialist’s responsibility to discuss this with you.
• Any after-care after a procedure e.g. removal of sutures and changing of dressings.

This is also true of NHS care; secondary care clinicians should organise tests and have results returned directly to themselves rather than pass tasks to the GP practice to carry out.

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 should not be asked to perform blood tests or other private investigations using NHS resources. A private GP or specialist can refer to NHS secondary care services but should not expect your GP practice to do this for them. If a private specialist informs you to arrange or to expect to hear from your NHS GP to arrange such tests, then this is incorrect. You should, at the time, remind the specialist that all tests need to be carried out privately. Avoiding inappropriate requests for your NHS GP to carry out tests 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 specialist has referred you for a scan and you want to get it done privately?

Please discuss this directly with the NHS specialist who recommended the test. They are responsible for interpreting and explaining the results to you; do not ask your GP to refer you for the scan. You may need to see a specialist privately to have them request a scan and they should be responsible for interpreting and explaining the results to you.

What happens if you need new medicines?

The consultant might suggest prescribing new medicines for you or might want to make changes to the medicines that you are already taking.

The consultant is 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 some circumstances, the GP may be able to continue prescribing the medication. It usually takes two weeks for these letters to be received and actioned by practices.

Private Clinicians may suggest medications to patients which would not normally be prescribed by NHS GPs. This particularly relates to medications which are not included in NHS Highland’s Formulary, medications that require regular monitoring (for example disease modifying anti-rheumatoid drugs, some psychiatric medications, medications for ADHD), medications for sedation before procedures, medications used outside of their license and medications restricted for specialist or hospital use only (e.g. roaccutane). If either the specialist, or your GP, informs you that this is the case for your medication then you will need to continue to receive it from the private service. Please contact the private service directly to organise this.

What happens if you need to transfer my care back to the NHS?

If after seeing the specialist privately you want to be back under NHS care, regulations allow for you to transfer back. You should be transferred back into the NHS system where you would have been at the point you left the private sector (i.e. you do not go back to the start of the queue).

This transfer must be done by the private clinician who is overseeing your care, and you should not be passed back to the GP for this to be done. There are a few reasons why;

• it delays your ongoing care
• your Consultant knows the full details of your condition and where best to refer you to
• it wastes NHS appointments with your GP and adds unnecessary administration to the process

The consultant should arrange for you to be seen in the appropriate NHS clinic by writing a referral letter to this clinic. This might include passing on results of tests and data that has been used to reach a diagnosis; NHS teams may not always agree with diagnoses or treatment plans made elsewhere.

What if you need a Fit Note (previously known as Sick Note)?

If you need to be certified as unfit for work following treatment by a clinician:

Fit notes can and should be issued by doctors and nurses working in the private sector-

• the specialist is responsible for issuing you with a Fit Note.
• the 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.