Any work that is not part of any NHS contract is non-NHS (private) work. The most common types of private work are medical reports and medical examinations, such as for driving or adoption, or for insurance companies. We are usually able to complete these as requested, as they are fairly standard.
Other requests for private work include things like letters, completion of various certificates or reports and other ad-hoc documents. Depending on the nature of the request, we may or may not be able to carry out the work. If we do carry out the Non-NHS work then you will be charged a fee that is payable before any work is completed, this is due to Non-NHS work not being funded and supported – all individual requests take time and the surgery currently have over 5,000 patients with many requests each month.
Please note that we do not issue diazepam for fear of flying, complete firearms licenses, or sign any forms stating that people are ‘fit to’ do any activity, such as sports or charity events.
As an alternative, you may wish to seek the services of a private GP to do the work for you. Please note that they do not have access to your medical records, however.
There is no obligation for the surgery to do any private work. Where we are able to help then we will. However there are times or circumstances when we cannot. There are a variety of reasons for this, including time constraints or the nature of the work not being covered by our medical indemnity (the insurance that GPs have in the event that something goes wrong). As above, you may wish to seek the services of a private GP to do the work for you.
There are some circumstances in which no-one is contracted. This may be because it is not deemed essential (e.g. the NHS can no longer afford to remove many non-cancerous skin lesions or routinely do some types of surgery), or it may be because there is just not a contract that covers the situation. Whilst there may be an assumption that general practice will the fill the gap, the reality is that this is not the case. This can feel very uncomfortable for both doctors and patients, but it is not something that your practice can resolve.
Some situations arise relatively often, and it is important that people realise where they may find gaps. Here are some examples.
- If you go for a procedure abroad, and the aftercare isn’t something that is usually provided by primary care if the procedure was done in the NHS, then we cannot provide the service. A common example of this is weight loss surgery done abroad. At times, people are unaware of the need for post-operative monitoring and expect that this is carried out by their GP, but this is not so. In the NHS, this aftercare sits within the hospital for around 2 years post-operatively. However, hospitals are also not commissioned to provide monitoring for people who have surgery abroad. Therefore, you will need to pay for this from a private provider.
- Medication requests from private healthcare providers is another area which can be a problem. If a GP receives a request for a prescription from a private consultation, they are not obliged to issue it. We may decline if there are reasons we do not feel it is appropriate, we don’t have enough information, or we are unfamiliar with its use. The consultant will be able to issue you a private prescription, however, but you will have to pay. Likewise, we cannot issue prescriptions based on the recommendations of a dentist, or convert dental prescriptions to NHS prescriptions.
- We are sometimes asked to issue prescriptions before procedures, such as for diazepam if someone is fearful of having scan or going to the dentist. These medications are not without risk. If you are told to contact your GP for this, then unfortunately you are being misinformed. If they feel the medication is needed, then it is their duty to prescribe it, as they are the ones who will need to monitor the effects. You will need to contact them.
- ‘Shared care’ is an arrangement where primary care issues NHS prescriptions for a medication, but secondary care (hospitals) continue overall management of the condition. GPs may feel it is unsafe to issue NHS prescriptions under a shared care agreement with a private consultant due to lack of assurances that the care will indeed be shared. In this instance, either your prescriptions will need to be issued by the consultant, or your care will need to be transferred to the NHS, with prescriptions continued privately until this transfer is complete. Shared care is considered to be an enhanced service, and not all practices have opted in to shared care. Where shared care does not exist, the ICB have arranged alternative provision, but this will require transfer into the NHS services, via a usual referral process and subsequent waiting time.
ADHD Medication and Right to Choose
Due to the long waiting times for assessments, people sometimes ask for a referral under the ‘right to choose’ scheme. This means that they are able to choose who they are referred to, from a group of organisations. It is important that patients make sure that the provider they choose is one who prescribes medication, as we will not be able to prescribe on their behalf. The surgery may choose to accept a shared care agreement from your consultant once you have been on a stable dose for a minimum of three months. Please note this is done on a case by case basis.
If you choose to have a private assessment with a provider who is not under the right to choose programme, you will not be able to get any NHS prescriptions. In this situation, if you want NHS prescriptions for ADHD treatment then we will be happy to refer you into the NHS system. However, you will start at the back of the waiting list, even if you already have an ADHD diagnosis and the referral is just for medication.
Please click the link to find the ADHD UK right to choose website Right to Choose – ADHD UK which can inform you of the different providers and waiting times. Please note that not all of these providers prescribe medications, so if you would like to initiate, treatment please choose an appropriate provider. Unfortunately the surgery cannot assist you in choosing a provider so please ensure that you carry out your own research!