Idiots guide to private medicine - please?

[isthereaway]

I live rurally & my local small hospital is very patchy in terms of care quality.
(local paper has just carried yet another story about the care commission finding it was negligent - again - it has no significant adverse event review process)

I need an urgent a 2nd opinion on a cardiology matter, but know that will take months to even be considered here (Scotland). So I am considering private.

how does this work? I looked at the Spire hospital. That says if you know the specialty (I do) you can choose a Consultant & refer yourself direct. An initial consultation is around £350 (yikes, I'm on benefits)
Can I ask for the tests done by the NHS 12 weeks ago to be reviewed, or will I have to consider paying for fresh ones (not only poss v hard £ but tests very stressful & would rather avoid duplication if at all possible)

Will I end up seeing the same Consultant as my local NHS one (no point at all)

Sorry for 20 Qu's, just nervous & don't want to get it all wrong...

You can self refer and pick your own Consultant.

However bear in mind that £350 is just the start, any investigations are on top. Yes they will be quicker but you have to pay for them.

And they may or may not be able to look at anything you had on the NHS -depending on the test the report may be enough but they may need to see the original images or video. They won't be automatically linked to see these.

You may be able to get downloads of them if you ask.

Unfortunately for some specialties the costs add up very fast.

Unlikely they will access your nhs scans unless they work for both, which may mean seeing the same consultant you have already seen. Have you asked for a second opinion on nhs?

You can ask for copies of your ECG reports, or other investigations you’ve had and have them with you at the appointment. You can chose your consultant, though may very well be an NHS one, just not the one you saw. You can also ask for 2nd opinion, but that would be like a new referral and you say you want results sooner.

I have NHS scans accessed by my consultants, plus they see my NHS record. They also update my NHS record quickly after consults.

You choose the consultant OP. I have private healthcare, so BUPA email me a list and I Google them to try to get a feel for their speciality and also whether they have a nice face 😁

Eg. I'm about to have a mammogram privately and the consultant has accessed my last NHS mammogram.

Ideally you want to see someone who does a lot of NHS work not just private.

I've had some referrals that used the NHS data/tests but when DH had a hip replacement done privately, they refused to use the NHS scans as they were not clear enough apparently. I think it depends on the speciality and the individual doc.

I used a private cardiogist on Tuesday but I had seen him befoe bre for an NHS angigram and an echogram.I went private with the same consultant otherwise the appointment NHS was next April! The cost was 200 pounds.

This has reminded me of my DM's experience;

Private clinic 1 - could see nothing from the NHS despite it being NHS treatment

Private clinic 2: consultant gets out his NHS laptop, logs in and can see everything she had at the local hospital as he worked there too

So the answer is, it varies.

Up until the point surgery is agreed everything is an out of pocket cost. Echo,ECG, bloods. It’s doubtful the consultant will use the NHS investigations completed prior. If surgery is required you need a fixed price and package which includes Pre-Assessment and 6 months post-operatively. Look on the PHIN website for consultant outcomes.

If you go private, please dont use the consultant closest to you.
Do some research on what their speciality is and if they know enough about the issue you want them to look at.
Then chose who you think is the best.

Fwiw I've seen a cardiologist privately and his fee was lower than £350.
Initial consultation is £200, follow up £100.

You need to shop around too.

£200 for a first appointment is v low although may depend where you are in the country.

Equally £350 is high unless it includes some initial tests. That's basically Harley Street pricing.

Thank you everyone. I'm Edinburgh way
Ds had dx Myocarditis & LVSD 12 wks ago. Had cMRI. Have seen his NHS Consultant since who says: 'just minor scarring of ventricle, so, all better now'. Only Ds still getting regular sharp chest pain bad enough to wake him at night, or make him clutch chest & arrhythmia. Went back to A&E but Troponin level (5,500 at worst) is now only 5 so sent away 'probably anxiety'. Ds is utterly exhausted, in pain & worried. 'Dr won't listen' (he is ASD). A 2nd opinion here takes months & needs the agreement of 1st opinion Dr. So at a loss what else to do. (& local hospital regularly in papers for serious failures so worrying)
I was hoping a fresh Dr would show us the scans & explain why symptoms 3m after 5 days in high needs unit are 'OK'. (& recheck Ds high cholesterol: NHS Dr not interested). I can't afford private I'm a Carer for Ds (who is Autistic) so I'm on UC. but he's in pain & scared & I just want someone to help him so I'll borrow anything if I need to.

@isthereaway did you post when your DS went into hospital? If so it sounds like you had a battle all the way through.

I would definitely suggest finding a private consultant.

You usually figure out who you want to see, and contact their secretary to book an appointment. The secretary can check with the consultant and ask if they will view the NHS scans for you before you commit to the appointment. They very often have on their website if they see second opinions.

A good place to start is here

https://www.finder.bupa.co.uk/Consultant/search/?first=1&ffeeAssured=1&qk=Cardiology.+&ql=Edinburgh&qn=&giottoFormFlag_consultant=1#start

You can search the area nearest you and it will show you the consultant. If you click on :private clinic' it will show you where they predominantly work. You don't need bupa to access this website.

The medical secretaries have, in my experience been nothing short of exceptionally good and helpful and kind. So don't be put off.

Yep 350 for initial chat ( 30 mins ) that probably doesn’t include anything other than talk / opinion.

they won’t have nhs results and probably won’t opine on the reports ( depends on what the operator saw at the time etc ) and will certainly want more blood tests etc to reflect the current situation.

what didn’t you agree with about the first opinion ? A chat might be enough to persuade you.

current state of private medicine is its understaffed as well and so they can and do charge what they like and you will have to wait ( eg we waited 6 weeks for simple “ yep we will do the minor eyelid op” when the gp and oprician knew the diagnosis and what was needed , and the another 4 weeks for op date ! That was self pay) . In years gone by when I had insurance I could get a slot for a non urgent issue in a week or 2 at a time of my choice …other things are just not available for filthy cash - eg needed a dementia assessment - not one consultant locally would take for a face to face - you could have a telephone diagnosis though 😱

It sounds to me that your top priority is finding someone who is good at communicating.

You can see a top doctor privately who is very skilled but just grunts at you.

Or you can spend an hour with someone who maybe isn't internationally renowned but listens properly and answers your questions clearly and compassionately.

There should be reviews on line so you can gauge if the person you are looking at is known for this.

Thats an unusual diagnosis for someone that young isn’t it?

Id really look for someone who knows about paediatric cardiology.
Maybe someone who is also well versed with the effect of Covid (which might it might be related).

In any case, I can see why you want a second opinion! Poor chap 😢😢

It's an unusual diagnosis full stop but prob more common in young people.

You either need someone who does both adult and paediatric cardiology. Or a cardiac MRI specialist - as they will usually do things like myocarditis, heart failure, COVID which are all related to your DS's issues.

And if it isn’t obvious from their webpage that they’re used to treat children like yours, then I’d ask them before taking an appointment.

@Imalongtimepostingmum yes I posted at the time & had a lot of support here as we had a difficult time in hospital.

@Helenloveslee4eva it wasn't that we 'disagreed' with the 1st opinion but its hard to be confident about it. Ds Consultant barely saw him in 5 days (5m total? & didn't speak to us at all just the 3 other Consultants all of whom disagreed with each other) We left with a provisional dx but Dr said he couldn’t be certain without a biopsy however it defo wasn't a heart attack: 'young people don't have heart attacks'.
I don't understand why, when Dr says its over, that Ds chest pain & arrhythmia is getting worse. It's painful & he is scared. He's also got colder hands & feet, is exhausted & pale skin.
something is causing it. I can go back to GP to rule out anything else but I can only get a 2nd opinion if 1st Dr agrees which seems unlikely to me. So I'd like someone to show us the scarring on the MRI, explain to Ds why 'its not causing chest pain' & tell him what is (& how to recover from it).

I’ve used Spire in Edinburgh and read the consultant profiles on the website, had an idea of which two were probably my preferred and then rang the reception number to explain my diagnosis so far and they confirmed they’d be the best people and made me an appointment with one. They’ll tell you if you can self refer (I needed a GP referral but already had one for the NhS so that was fine) and initial costs etc. they’re really helpful! Do not underestimate the cost of tests etc. you’re probably looking at 4 figures for an MRI and the initial full set of bloods I had done was hundreds.