Information for patients considering going private for services with delays in the NHS.
ADHD and Autism Private Services
Patients can request a referral to be assessed for ADHD/Autism Privately however this has become an increasingly complicated area to navigate with more and more options available. To help you consider the best way forward for you, we have put together the following information which outlines your options, and our responsibilities with respect to each.
NHS referral
- Via Community Mental Health Team
- Comprehensive service providing assessment, diagnosis and treatment including prescriptions and access to local support services
- We can consider taking on shared care (ongoing prescriptions and monitoring in general practice with specialist oversight) using Devon’s formally agreed share care guidelines
NHS right to choose referral
- Private providers that have been commissioned to provide assessment, diagnosis and treatment paid for by the NHS
- Often remote virtual care
- We are unable at this current time to share care with these right to choose providers. The provider would therefore be responsible for prescribing monitoring and follow up.
- The reason we are unable to share care is that there is no stability in the provision of providers who are being overwhelmed and keep opening and closing their offer, which would mean we could be left with patients who have no provider and we would have no one to share care with.
- You can still be referred to the NHS service at any time, but they will not take over your care until you have been seen in their clinic.
- ADHD 360 are currently taking patients 14 and over and we will not be able to provide prescriptions or shared care. This will be the responsibility of the right to choose provider.
Private services
- We cannot share care with private providers. This means that you will be responsible for ongoing costs associated with any treatments and monitoring required (e.g. blood tests, ECGs, blood pressure). Your private provider will be responsible for providing this and any prescriptions.
- You can still be referred to the NHS service at any time, but they will not take over your care until you have been seen in their clinic.
Please ensure that you have done your research on the provider you would like to go with and understand our shared care responsibilities with each provider.
Private Bariatric Surgery
Patients who choose to have bariatric surgery privately (abroad or in the UK) are not entitled to NHS follow-up care for this condition unless they have completed the NHS tier 3 weight management programme prior to going down the private route.
In the first 2 years post bariatric surgery, people require specialist follow-up which cannot be provided by your GP. This should be provided by a specialist in post-bariatric surgery care.
The 2-year care package required after surgery includes.
- Regular blood test monitoring after your operation over 2 years
- Monitoring for any complications of surgery
- Ensuring a person is on the correct lifelong supplements to prevent deficiencies in the body as a result of the surgery.
- In certain situations, lifelong injectable medications are also required to prevent b12 deficiency (depending upon the surgery a person has).
Without continuing life-long supplements, patients can become unwell over time.
Before choosing bariatric surgery, it is important to understand the life-long follow-up care required to ensure that a patient’s nutritional needs are met. Please organise your post-surgery care package before you choose this journey to ensure you are looked after safely.
Weight Loss Injections – Wegovy /Mounjaro
A GP will not advise a private provider if it is safe or not to prescribe such medications and if a request to offer an opinion is requested a non-response from the GP would not be an agreement that there are no contraindications to prescribing.
GPs will not be able to monitor or advise with regards to these medications when prescribed privately.
These medications are only prescribed by specialists in Weight loss clinics in the NHS and so lay outside the area of expertise for a GP and therefore a patient will be taking these medications at their own risk under the supervision of a private provider.
Under GMC regulations it is the responsibility of the PRIVATE prescribing clinician to assure themselves that their prescribing is safe. Ways of doing this would include taking an adequate history, examining the patient and doing and acting on any appropriate pre-prescribing investigations. Patients have access to their own medical record via the NHS App on smartphones which may facilitate their care.
Professional medication safety guidelines (NICE) require examination of the patient. This would seem to include objective and accurate weight measurement, at initial assessment and at regular review. At no point is it expected that the provider asks the patient’s NHS GP to do this private work on behalf of other organisations.
Gender Identity
As per BMA guidance,
General practice responsibility in responding to private healthcare (bma.org.uk)
“NHS GPs are not obliged to perform or request any tests that are required as a result of a patient attending a private provider. This is especially so, if such a test falls outside ordinary care usually provided by the GP and where the interpretation of the result of such test would fall outside the GPs knowledge, skills and competence. Such tests can be requested and actioned by the private provider themselves.
NHS GPs are not obliged to prescribe medications that are required as a result of a patient attending a private provider, nor are they required to convert privately issued prescriptions to a GP issued ones.
All shared care arrangements are voluntary, so even where agreements are in place, practices can decline shared care requests on clinical and capacity grounds. The responsibility for the patient’s care and ongoing prescribing then remains the responsibility of the private provider.
If you are concerned you might not get the investigations and medications you need as part of the care from your private provider, you are advised to purchase or negotiate a package with your private provider that includes all of this. If your private provider simply says, don’t worry, your GP will just do it, they are providing you with false assurance and factually incorrect information.”
For further advice and guidance on this please visit the link above.