Private prescriptions from private healthcare providers.

As a practice, we understand that some patients may wish to opt for some or all their treatment to be conducted privately and support your right to this.

However, to mitigate any misunderstanding we would like to take this opportunity to explain how the NHS and Tal-Y-Bont surgery work along private providers of health care. This document illustrates what you would expect if you chose to see a clinician privately.

What you need to do if you wish to receive private healthcare

For patients making use of their private 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 after 3 working days. Once you have received this letter you should then liaise with your private provider over booking the private appointment (some providers have restrictions over the consultants and hospitals you can use). This letter 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 see.

If you do not have health insurance and wish to book directly with a private clinic, your GP will write you a letter, you can then choose to collect this letter yourself from reception or we can email it directly to the private hospital of choice. You should then contact the Consultant’s team or your private health care provider to organise an appointment. Should you have any questions regarding your appointment you should contact them directly.

Tests and procedures

If a private clinician wishes for you to have any tests or procedures (such as blood tests or surgery), then the private healthcare provider is responsible for arranging the test/procedure and any medications that may need to be taken prior to it. The provider is also responsible for explaining how and when you will receive a date for the test, and what to do if the date is not suitable for you. The provider is responsible for explaining to you what your results mean.

Please do not contact the practice to discuss tests or procedures that have been provided privately. Clinicians in Tal-Y-Bont surgery may not have access to test results or be in an appropriate position to interpret them.

New medicines initiated by private healthcare providers

Your private healthcare provider may wish to commence you on new medicines or make changes to medicines that you are already taking.

It is the responsibility of the private healthcare provider to give you your first prescription for any new medicine that you need to start taking immediately.

Taking your private prescription to any NHS pharmacy in Wales will result in you paying for the actual cost of the medicine at point of collection from pharmacy, along with a dispensing cost.

In some cases, the private healthcare provider may wish that your medicine is continued to be prescribed via your NHS GP practice and issue a prescription recommendation letter. This would need to be considered by the practice and is at the discretion of the prescribers in the practice whether they issue medication on an NHS prescription. 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. Each prescription and private provider are considered separately.

Please allow at least seven days for clinical letters and documents to arrive before contacting your GP. If a prescription is needed sooner than this, you should contact the private clinician’s team (usually via the secretary) for them to prescribe.

How we ensure safety and effectiveness in prescribing

The team at Tal-Y-Bont surgery are committed to providing the best quality of care to our patients. When a prescription from a private provider is necessary, our main considerations are effectiveness and safety. To prioritise safe and effective practice, our clinicians use a wide range of local and national resources to provide them with evidence-based guidance in their decision making so that patients are prescribed appropriate treatments. Some of these resources include NICE, the BNF, the Swansea Bay University Health Board (SBUHB) Formulary, the DSM-5, GOLD, and many others.

The SBUHB formulary is specific to the local area. It is used to help provide guidance to clinical staff working within general practice and is colour coded to whether they can be safely prescribed by GPs (green), whether they must be started by a specialist (orange), or whether they are not recommended to be prescribed in GP practice (red), usually due to specialist supervision being always required e.g. radiotherapy, isotretinoin.

Private shared care prescriptions

Some medicines in the SBUHB formulary may be suitable for prescribing in general practice provided they have been started by a specialist and the specialist has provided information on how to monitor and prescribe the medicine going forward in a shared care agreement.

Shared care with private providers does not exist in Wales. Any patient who is seen under the care of a private provider will need to be referred to the corresponding NHS service to receive NHS care. GP surgeries can only start prescribing shared care medicines when care is accepted by the NHS service, and they have provided an agreement document. Patients will need to pay for private prescriptions, blood tests and any other services relating to their private consultations and arrange them via their private consultant until the NHS can take over care.

Why we may not be able to issue prescriptions recommended or started by private healthcare providers

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.
• 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 a shared care agreement.
• Without such a shared care agreement in place with an NHS provider of care we are unable to safely prescribe and monitor certain medication.

Transferring back to NHS care

If after seeing your private healthcare provider 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.

References used to formulate guidelines

• AWMSG Shared care and monitoring guidance (published Feb 2021);
• GPC England guidance on private shared care agreements, published in BMA August 31st 2023;
• Chelston Hall Branch Surgery at Barton, Private script requests’ policy.