Good idea to go private? Need advice from someone who knows the system

[apprenticeaddict]

Would welcome some advice on the right thing to do. My friend has been having some symptoms (don't really want to go into detail on here) for some time which have been getting steadily worse. Has taken a long time to get a GP at her practice to take the symptoms seriously, but a few weeks ago when my friend saw her GP the GP agreed that she should be referred to a consultant for tests. The worst case scenario is that the symptoms indicate cancer (the GP has said this) but there are other possible and more benign explanations. Basically, the route from GP appointment to actually seeing a consultant is moving at a slow pace. Following a series of administrative cock ups, three weeks after the original GP appointment the referral letter has still not yet gone to the hospital, although my friend has been assured it now will go imminently. My friend has been advised that it is likely to take a further 6-8 weeks to see a consultant. My friend is now wondering whether to get a referral to see the consultant privately. She does not have health insurance, but would have the money to pay for a consultation and initial tests ordered. However, what we don't know is whether if the results turn out to be bad news, having gone private it would then be impossible to get back into the NHS system (or doing so would end up taking longer than if she had waited to see the consultant on the NHS in the first place). My friend is certainly not rolling in money to the point that she can just pay for whatever treatment she needs regardless of cost. It may be that this is a needless worry and it would be straightforward to get back into the NHS system if necessary, but as neither of us have any experience of this, we just don't know how the system works. Is there anyone who understands the system who can advise? TIA

The answer is that it can vary so she should check. A call to the private drs secretary should be able to clarify this. I have seen a consultant privately then had nhs surgery but and in this case a big but, I was already in their nhs system. I just couldn't stand the waiting times to see the consultant. He also referred me for nhs investigations. It is important not to underestimate the potential costs of investigations, they can be very expensive. An MRI in this instance would have been £1200.

Hope that helps and your friend is fine.

My DH is facing a similar situation and I am marking my place

Thanks Matilda.

Can't help but can she contact PALS?

I have just had a wasted appointment - referral was to a particular consultant but they sent me to a different consultant, I complained to PALS yesterday and I have an appointment for October 30th.

Not ideal but reasonable.

We did this with DS. Paid for a private appointment then went back to the GP and got an NHS referral. We had the letter and prescription from the private consultant so the GP just sorted everything out and we were NHS from then on.

I see a private consultant for thyroid problems and had an operation privately but the issue is now managed by my NHS GP, I do have health insurance but like an earlier poster would urge caution if your friend is thinking of paying for tests - I know that one of my blood tests cost in the region of £400 and it was just one of about 6 different things they tested for. The consultants appointment fees are usually around £150 (for the person I see) it is the tests/scans that can push the cost up very quickly

If the GP suspects that she has cancer and she is presenting with symptoms suggestive of breast cancer then she MUST be referred as a ' target patient' which means she must be seen within 2 weeks.

If this is the case she must go back to the GP (or ring) and ask for an explanation as to why this hasn't been done.

If she went private she'd also have to pay for any diagnostic testing in addition the initial consultation fee and TBH under the 2ww rules it shouldn't be necessary to go private.

Your friend could initially pay to see the Consultant - this would be around the £200 mark, although a call to the Consultant's secretary would confirm this.

At the appointment the Consultant should explain what tests he would like carried out and why. The Consultant may have an idea of how much the diagnostic tests cost, however I would always double check costings with the hospital. (I have known two Consultants to get this wrong.) Don't be embarrassed to discuss financial situation with the Consultant.

If after speaking to the Consultant your friend thinks that she won't be able to proceed with private diagnostic tests she can just revert back to the NHS - don't cancel any NHS appointments until a decision has been made to have the diagnostic tests carried out privately. The Consultant should also be able to advise on NHS waiting time guidelines.

Wishing your friend all the best.

Meant to add that I have known someone who had tests carried out privately and then transferred onto the NHS for treatment - no delay as they had a confirmed cancer dx.

I've been seen privately and had the consultant refer me back to herself on the NHS. I think it is a great way to get the ball rolling as you see the right person for your first appointment and they generally give you 30 mins, so longer than a standard NHS appointment.

As someone else said get her to ring the gp and find out if the referral has been fast tracked. If gp suspects cancer it will be fast tracked under the two week wait guidance

Your friend could look for the consultant she would like to see at her nhs hospital, then Google their name to see where they pratice privately most do either at Bupa hospital Nuffield hospital etc

I did this paid private consultation£200) and then told consultant I would like to see them next time as an NHS patient(via nhs hospital) and he was fine about it. Obviously when back on nhs its a waiting time again

Agree test can be expensive but when she's in with consultant they would tell her what tests if any were needed then she could find out from hospital the charges before saying yes.

It does depend on the consultant tho. Here many will not do private to nhs transfers, you would be in exactly the same place as you always have been.

And yes if there actually is any chance of cancer the referral is fast tracked so I doubt that is the case if it has been checked.

Thank you everyone for taking the time to reply - much appreciated.

On the issue of fast tracking for suspected cancer, I have tried to clarify this. I understand that the GP said that she didn't think it was cancer. But from what I can gather, this was said in a way which indicated, "I don't believe cancer is the most likely explanation for these symptoms", rather than "Cancer is such a remote possibility that I really wouldn't worry about it". I assume that if the GP doesn't think it is cancer then the referral doesn't qualify for fast tracking.

In terms of a plan of action, it sounds like my friend should:

1. Get categorical confirmation from the GP surgery that the referral letter for the NHS consultant has actually been sent and the date that it was sent.

1. Wait for a week after that date and then phone up the NHS hospital concerned who should be able to confirm that my friend has been logged and is in the system, even if it will be some weeks before she actually gets an appointment. (I am concerned to avoid scenario where friend waits patiently for appointment letter to come through, only to discover weeks later that there has been a further admin cock up and she has not even made it on to the waiting list at all.)

1. Google the consultant to whom she has been referred on the NHS to find out whether he also sees patients privately. Assuming he does, speak to the consultant's secretary at the private hospital to find out:

(a) cost of an initial consultation and how quickly an appointment could be arranged and whether she needs a GP referral letter to see the consultant privately (- I believe friend has had some initial blood tests, so probably good to have a GP referral letter to avoid blood tests being unnecessarily duplicated?);

(b) whether the consultant would refer her back to the NHS if (i) the investigations which the consultant considers necessary cost more than friend can afford to pay for privately; and (ii) if investigations are carried out privately but reveal a need for further treatment which friend can't afford to pay for privately. (I assume answer might vary between (i) and (ii).)

If anyone has any comments on whether what I've said sounds like a sensible plan, I would welcome your advice.

What determines whether a private consultant will or won't make an NHS referral? Is it purely down to personal preference of the consultant, with some not wanting their time taken up with lots of patients who pay for one consultation and then go back to the NHS?

My son was already on a consultants waiting list but we couldn't wait any longer so saw him privately (£180) and my son was operated on 3 weeks later on the NHS.

Yes friend will defo need referral letter for private consultant. Normally gp secretary attaches any blood test she as had with the letter(so consultant knows what's been tested)

I think if the consultant works in nhs hospital and she sees him privately she has to say " can I see/be put on your nhs clinic. I think quite a few people do it this way. You usually get an appointment within a week( depends how many clinics they do at private hospital. If it's say bupa, she just goes on Bupa site looks gor consultant and will see when their clinics are for that hospital.

I had a cancer diagnosis a few months ago and saw the consultant privately, the same one I'd have seen in the nhs, as things were moving at a glacial pace. I had all the tests done on the same day as the appointment. We discussed surgery and he gave me a date for doing it privately and a date for doing it on the nhs (a couple of weeks later - my situ was pretty urgent).

It's not good that the letter to the consultant is delayed.
We have private health cover and letters for consultants have been ready to collect at the surgery within a couple of days of asking. We would collect and deliver by hand ( or post) either a day or two before the appt or at the time of the appt.

What I am saying is that referral letters can be bashed out quickly if drs want to.

I don't see why there should be any delay whether it's NHS or not- unless there is some funding issue and the GP is 'staggering' referrals to save the practice money.

If your friend would not need tests on the spot, she could make an appt to see the consultant for their opinion and then revert back to the NHS for tests. It all depends on what tests might be needed; an examination and medical history don't need tests, but X-ryas, scans and blood/ pathology do of course.

Mini- some consultants do allow self-referrals without a letter from the GP. I've gone down that route myself.