Referrals

We understand that some patients will opt to have some, or all of their treatment privately and support your right to do so.

However, to prevent any misunderstanding we would like to take this opportunity to explain how the NHS and general practice work alongside Private providers of care.

This below information describes what you can expect to happen if you see a doctor privately.

For patients making use of health insurance e.g., Bupa

Your GP will write a referral letter if they feel this is appropriate and it will be available to collect from reception, or it can be emailed to you (please ensure you confirm your email address with the practice if you would like to use this option), this will include any relevant medical details about you. We would encourage you to wait until you have this letter before making an appointment, as the details within it will help the doctor you book to see.

Please note that if an insurance company wishes for a specific form to be completed you may be charged for this additional work.

For patients who do not have a health insurance policy

If you do not have health insurance and wish to book directly with a private clinic, you do not require a letter and can arrange the appointment as you wish.

You should contact the consultant’s team or your private health care provider or Insurer to organise an appointment. Should you have any questions regarding your appointment you should contact them directly.

What happens if I need a test or procedure?

If the consultant thinks that you need any tests, including blood tests or a surgical procedure, then the consultant is responsible for:

• Arranging tests and any medications that might be needed prior to the test, as well as explaining how and when you will receive a date for the test, and what to do if the date is not suitable for you
• Giving you your results and explaining what they mean. This may be via letter or a further face to face appointment

GP practices are being asked to do an increasing amount of blood monitoring, and other procedures for private consultants and the GP is expected to take responsibility for the result. Due to rising demands on primary care, we are unable to do this unfunded work. In the future if we receive a request from a specialist for us to take on blood monitoring, we are likely to write back to them (copying to the patient) asking them to make alternative arrangements for their patient.

Please do not contact the practice to discuss the results of tests organised by other doctors. It is the consultant’s responsibility to discuss this with you, and the practice will likely not have access to the results or be able to interpret them.

What happens if I 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. They will be responsible for giving you the first prescription of any new medicine that you need to start taking straight away. Please note if you take a private prescription to any NHS Pharmacy you will have to pay the actual cost of the medication rather than the current NHS standard prescription charge, which may be dependent on the medication prescribed.

In some cases, your GP may be able to continue to prescribe these medications on an NHS prescription. This will need to be considered by the practice and is at the discretion of the GPs. Prior to this, a full clinic letter from the consultant is required, outlining the reasons for treatment, explaining the precise details of the prescription; what it is being used to treat; how long the treatment is intended for; and what monitoring or follow up is required before the practice can decide whether we can continue to prescribe.

Please allow at least seven days to allow this letter to arrive before contacting your GP.

If a prescription is needed sooner you should contact the consultant’s team (usually via the secretary) for them to prescribe it.

Private consultants may suggest medications to patients which wouldn’t normally be prescribed by NHS GPs. If this is the case, you will need to continue to receive them from the consultant.

The clinicians at Chipping Norton Health Centre believe that providing the best quality care to our patients is our top priority. When a prescription is necessary our main considerations are effectiveness and safety.

In order to prioritise patient safety and the best value to the NHS, we are bound to prescribing from an approved list of medications called the Oxfordshire Formulary. This is a list of medicines colour coded according to whether they can be safely prescribed by GPs (Green); whether they must be started and monitored by a hospital doctor or recommended by a specialist to be initiated by a GP (Amber); whether should only be prescribed in secondary care by a specialist (Red) or whether are not recommended for use because of lack of evidence of clinical effectiveness, cost effectiveness or safety.

Oxfordshire Formulary: www.oxfordshireformulary.nhs.uk

The practice may not be able to issue you with an NHS prescription following a private consultation for the following reasons

• If the practice considers that there is not a clear clinical indication for the prescription, and that in the same circumstances an NHS patient would not be offered this treatment.
• If the private doctor recommends a new or experimental treatment or recommends prescribing a medication outside of its licensed indication or outside of our formulary recommendations.
• This includes all prescriptions outside recommended licensed doses or uses as per the British National Formulary.
• If the medication is not generally provided within the NHS
• If the medication is of a very specialised nature requiring ongoing monitoring, we may be unable to accept responsibility for the prescription. This includes medication that we can prescribe on the NHS but requires what is known as a Shared Care Protocol (SCPs).
• Without such a shared care protocol in place with an NHS provider of care we are unable to safely prescribe and monitor certain medication. This would include, but is not limited to, what are known as disease modifying drugs, IVF associated medications and those to treat ADHD.
  These SCPs have been drawn up by, and for use between, Oxfordshire Clinical Commissioning Group or the Buckinghamshire, Oxfordshire and Berkshire West Integrated Care System (BOB ICB), Oxford Health and OUH clinicians only, so private provided are not included. This means that if you would need those medications in the NHS, we will require you to ask your private specialist to refer you to the appropriate NHS specialist to be re-assessed for NHS treatment within the same regime of priorities applicable to NHS patients.
  • For information about changes to the ADHD referral and treatment pathway in May 2024, please view this patient letter (PDF).

Therefore, to maintain prescribing safety and quality, we are unable to accept shared care agreements with private clinics of any sort, nor provide drug monitoring (blood tests, blood pressures, ECGs etc.) for private providers. All such prescriptions will have to be provided and monitored by the clinic themselves, and we expect any legitimate private provider whose service necessitates blood testing and physiological measurement to have their own access to these facilities.

If we are unable to issue an NHS prescription you can still obtain the medication recommended via a private prescription from the consultant, you have seen but we would recommend that you investigate the cost of this and associated monitoring before proceeding.

GMC Safe Prescribing Guidance: www.gmc-uk.org/prescribing-and-managing-medicines-and-devices

If after seeing the consultant privately you want to be back under NHS care, national regulations allow for you to transfer back. This transfer ideally needs to be done by the private consultant who is overseeing your care but if this is not possible, please request that your consultant writes directly to the practice to request this.