Private Referral Requests
The surgery is able to provide you with a Private referral; but would ask you to read the following information prior to sourcing private care.
What happens next?
You should contact the Consultants team directly to organise an appointment. If you have private health insurance, your insurer may have a list of approved specialists. You may want to check with your insurer before you proceed.
The specialist may request information from your GP. If this is the case, please contact us to ask for a referral letter for the Consultant/Specialty that you have specified. This will include any relevant medical details about you. If an insurance company wishes for a specific form to be completed please ask them to make contact with us and we will deal with their request for information.
Seeing the Consultant:
What happens if you need a test or procedure?
If the Consultant thinks that you need any tests (including blood tests), or a surgical procedure, the Consultant is 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 the Consultant or by letter). You should not visit your GP surgery to discuss the results of tests organised by others, it is the Consultants responsibility to discuss this with you.
Please note that any tests required should be carried out privately; and are likely to incur a cost.
GP practices cannot perform blood tests or other private investigations using NHS resources. Doing so would inappropriately use NHS resources to carry out private activity. If a private Consultant informs you to arrange or to expect to hear from your NHS GP to arrange such tests, then this is incorrect.
Requests for private diagnostic testing (i.e. X-Ray, MRI, CT)?
We can provide private referrals for diagnostic testing. However, we would always recommend doing this via a Consultant who is best positioned to interpret the results and arrange follow up care.
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 a prescription for any new medicine that you need; this is a private prescription and you should be aware that it will incur a cost for the medication.
The Surgery may consider prescribing, as long as:
- The medication being requested is already on the NI Formulary
- The Consultant has provided the surgery with sufficient information about your medical condition to support the prescribing of the medication.
- The medication being requested is licensed for the condition being managed
- The surgery has a means of communicating with the Consultant who has made the recommendation
- The medication does not require consultant oversight (and you are not under NHS care). These drugs are commonly known as “Amber list “or “Shared Care” drugs. We cannot prescribe drugs that are classed as “Red List” (Hospital only) drugs. The Surgery are unable to prescribe these medications in Primary Care. Your consultant can prescribe these medications privately and carry out any monitoring that is needed to safely do so.
- The medication being requested does not require regular blood monitoring
Amber List Medication at the Request of a Private Provider
When patients see a consultant in outpatient clinic they are often given a prescribing advice chit or letter, requesting that a GP prescribe medication in the community. Your GP will review this request and if felt appropriate and it is safe, will normally prescribe the medication.
Some medications are more complicated and fall into the category of Amber list drugs (Red list drugs are only ever prescribed by hospitals). These Amber list drugs usually are potent medications with the potential for harm if prescribed incorrectly and have specific monitoring requirements such as regular blood testing or physical checks that have to be carried out in order for the medication to be prescribed safely. There are agreed Shared Care Guidelines which outline the responsibilities of the NHS Consultant and the GP. Many of these responsibilities are relatively onerous and carry medico-legal risk. A full list of these medications and the agreed Shared Care guidelines can be found at
https://ipnsm.hscni.net/red-amber/
Within Northern Ireland NHS the Shared Care arrangements are uniform and a voluntary agreement is sought between the consultant and the GP. Where a GP is unable to undertake safe prescribing for whatever reason, the responsibility for prescribing remains with the hospital consultant. Patients then receive their medications from hospital pharmacy and have monitoring undertaken at their hospital clinic. Shared care prescribing in primary care is always voluntary on the part of the GP.
In recent years there has been a huge growth in Private consultants seeing patients in Private hospitals and asking NHS GPs to take over the prescribing of higher risk Amber medications using NHS shared care arrangements. This has created significant problems for us for a number of reasons which include:
- we are unable to confirm the credentials of private practitioners easily, particularly when they are based outside Northern Ireland.
- correspondence from private practitioners can been lacking in detail or clarity to assure us reviews are happening as stipulated
- regular review is difficult as patients must pay each time they see the consultant and this has meant the reviews are not as often as required
- when issues arise the process for contacting private doctors to obtain advice is not commensurate with that in the NHS and this raises significant safety concerns.
- there is no funding or resource allocated to Primary Care to cover the work private practitioners generate. Time spent dealing with these issues directly impacts on our ability to provide the NHS care we are actually funded for.
We are aware that most GPs in Northern Ireland are now declining to get involved in shared care arrangements with private providers. We have discussed this issue among all of the Partners in the surgery and have decided that in the interests of safety and our ability to provide an equitable NHS service for all our patients that we will not be able to prescribe Amber list drugs suggested by a private doctor.
From now on patients who choose to pay privately to see a consultant and are advised that they need an Amber list medication will have to pay for this medication as part of their private treatment. These prescriptions will need to be privately prescribed by the consultant concerned. We cannot make exceptions.
If patients hold private medical insurance this may cover the cost of medication. Any patient can be referred into the NHS at any time and, if they are seen by an NHS Consultant and the advice remains that an Amber list drug is needed, we will prescribe this under the NHS Shared Care arrangements where it is safe to do so. We know there are long waiting lists for NHS treatment and we share your frustrations with these delays. If you feel you are directly disadvantaged by the poor provision of NHS care we would encourage you to speak to your MLA to try to improve things.
We have a number of patients who are already receiving amber list medications through the NHS under shared care with a private consultant. We will presently be contacting them to transfer their care back to the private doctor who can prescribe privately and engage in whatever monitoring they feel is needed.
If any of our patients are receiving medication from a private doctor we would advise that they let us know in case there are any interactions with other treatments.
What happens if I need to transfer my care back to the NHS?
If after seeing the Consultant privately you want to be back under NHS care, regulations allow for you to transfer back. This transfer must be done by the private Consultant 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 precious 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.
What if I need a follow-up appointment?
The Consultant will discuss with you whether you should attend hospital for ongoing follow-up care or whether you should be discharged back to your GP.
If the Consultant thinks you do need to be seen again, the private clinic will give you another appointment or tell you when to expect this. If you do not hear anything, please contact the Clinic office, rather than your GP surgery.
Post-operative care/wound management/dressings
The Department of Health In Northern Ireland have advised that patients requiring post-operative care, wound checks, dressings or stitch removals following treatment in the private sector should ensure all pre and post treatment costs are factored into the overall package of care.
The surgery will not provide this care to patients who source treatment in the private sector (this does not include patients who are transferred under an NHS waiting list initiative)
Bariatric Surgery in the private sector?
Unfortunately, bariatric surgery is not a commissioned service in Northern Ireland. Patients who chose to pursue this type of treatment must be aware that all pre and post treatment costs will remain within the private sector and will be chargeable (this includes ongoing blood monitoring required).
We would caution patients from sourcing bariatric treatment outside of the UK/Ireland as follow up care will be logistically difficult and language barriers may delay urgent follow up.
We are unable to provide any advice, medication, blood monitoring or follow up diagnostic tests should you chose to proceed with private bariatric treatment privately.
Download the Department of Health’s policy in relation to pre and post treatment care for patients who wish to avail of private health care within the UK (PDF, 791KB)