Private consultant appointment - confused!

[GiraffesCantDoMentalArithmetic]

My GP recently referred me to a consultant, but the next available appointment on the NHS isn't for months at any of the local hospitals. My in-laws have very kindly offered to pay for a private consultation to get the ball rolling with treatment. I've managed to get an appointment (next week!) but I really have no clue how any of this works. Does anyone have any experience of using private healthcare?

• Should I get a copy of the blood test results my GP did to take with me to the appointment? Are GPs happy to provide these?
• If the consultant gives me a prescription, will this be a private prescription? Does that mean I'll have to pay the full cost of the drugs? Is there any way to get an NHS prescription from a private consultation?
• I won't be able to continue with private care after the initial consultation, so how to I go about transferring back to the NHS for follow-up care?

I am so totally clueless about this!!

Thanks in advance to anyone who can help.

This was years ago but may be relevant.

I was diagnosed with endometriosis in 2004. The consultant I saw on the NHS didn’t have a fucking clue what he was doing.

I researched specialists and found there was a national referral centre in Oxford but the GP refused to refer me. I paid to see one of those consultants in his private practice. He then wrote to my GP advising of a medication to prescribe and he himself transferred me to his NHS list. I had surgery with him on the NHS around six months later.

Oh and also... my toddler has had a squint for months. We’ve been waiting to see the opthalmologist but his appointment wasn’t until the end of June.

I emailed a private consultant as it seems to be affecting his development - the guy responded saying that he should be seen on the NHS, and the next day I had a call to say the consultant had kicked up a fuss and moved his appointment to this Friday.

Even if the consultant you see is in another trust he may still be able to do something similar and get your referral transferred.

one of the top consultants for DDs condition has a NHS waiting list of around two years , so what a lot of people do is get on the NHS waiting list, then book a private appointment with him. He'll then order the relevant tests as NHS appointments, and by the time they all get done, you're nearing the top of the waiting list. His private secretary is very experienced in getting patients the help they need, just annoying that it has to be this way.

He brings his NHS notes to the private appointments as well (not totally convinced that's allowed, but he's so senior, there's not many people are going to tell him off), and happily writes to NHS GPs telling them what's going on, and what they should be doing.

It's juts a case of knowing how the system works, and what workarounds lots of consultants have put in place, as IME they hate the waiting lists as much as the patients.

Blimey the queue jumping and waiting list manipulation here is shocking . it's the medical equivalent on MN of 11 plus
OP I've a good idea what your condition might be. If the private consultant gives you the diagnosis you think then your GP would prescribe and monitor the drug. Methotrexate requires a lot of blood test / monitoring in the early months, but again a GP would do that.

I won't be able to continue with private care after the initial consultation, so how to I go about transferring back to the NHS for follow-up care?
This does happen but it is considered very poor practice, both from a jumping the queue perspective, but also consultant using their private practice to benefit them. Some consultants do get away with it because it is not made known to the Clinical Commissioning Group, but if it is, they could make the decision that this can't happen. Some CCGs have already put policies in place to stop this practice and private hospitals (who often do NHS work too) know better than to challenge.

Saying that, your suggestion of keeping your NHS appointment is fine, but you can't be guaranteed that you will see the same consultant or that he/she could consider the information gathered from your first appointment.

The benefit of it really depends on the reason to go private. If it is for an outpatient appointment and then an MRI/ultrasound for instance and you are prepared for the latter, than it might be worth it. If it is outpatient and then cheap medication, then again, that's fine. However, if it is to start a process that you suspect will require follow-up, then don't expect that the process will be sped up by jumping the clue. If it is to get prescribe medication but then expect that this will be available on the NHS, it is highly likely that won't happen until you see the NHS consultant.

My OH has suggested at time that I go private, but for the above reasons, I've always said it was pointless. Saying that, you can ask to go ANYWHERE for an outpatient appointment, so you could do your research and if you're prepared to travel, ask where you could go. You might be able to contact a commissioner to and ask for advice, they might be aware of providers they commission from with shorter waits.

You can use choose & book for conditions not needing surgery, when you get your referral from your GP it will give you options of all hospitals NHS & private hospitals that deal with your condition in a given area around your GP practice, you then choose which one to go to, if you go online you can look at which one has the shortest waiting times or ring ones you are interested in & ask for an idea of how long you would be waiting.

I actually don’t care that I ‘queue jumped’ to get my diagnosis , if our local trust had managed to diagnose my illness during the 3 hospital admission that I had had in the 6 months prior , including one week long stay when I actually told them what I thought was wrong with me , then I’d be £1500 richer .

TBH I don't care much that my DM queue jumped either.

She had a condition that could have left her with no sight and had left her in severe pain for several months. It wasn't diagnosed until I suggested it and then she was told it was unlikely - she had it.

Her treatment pathway has been complex and she didn't tolerate standard treatment, when she has a relapse she needs seeing immediately - and what she gets offered is the next NHS appointment in 3 months time because the clinics are rammed.

So we have no qualms about booking her in to see her NHS consultant privately if she is having a relapse. She gets seen within a week and each time it has been money very well spent.

No idea on Private appointments but I can say my GP prescribed Methotrexate when I needed it on NHS without any issue. It's a common treatment, although you usually start in the tablet form and if found not to tolerate it so well they prescribe the Metoject injection 'pens'. Good Luck x

I don't really agree with private medicine but when the alternative is possibly losing my business through not being well enough to work and looking at a six month wait on the NHS I decided to pay. IME I didn't jump the NHS queue once I was referred back though as went to the back of the list and got no priority treatment.

but also consultant using their private practice to benefit them

That's the whole point of consultants doing private work. I've been private twice and was astonished that the consultants were allowed to do what they did. That includes arranging x-rays, ECG's and scans via the NHS, (queue jumping). They also had the full NHS hospital file which they must have simply taken out of the hospital and brought with them to their private clinic room across the road. Then putting me back on the NHS for subsequent treatment/consultations (queue jumping again). OK, it was brilliant for me as all it cost me was the private consultations to get to the front of the queue, but it's a bit off that the consultant basically got a wad of money and that the NHS still funded all treatments, tests, etc. That's just taking advantage of the NHS and profiteering for his own sake. Definitely shouldn't be allowed, but of course, consultants are a law unto themselves.

I've recently gone private for an endocrinologist as NHS waiting times are 12 weeks in my area. It was actually my GP who suggested going private to circumvent the waiting times. The GP faxed through all relevant information incl blood test results. The private consultant recommended I was put on levothyroxine, he let the GP know, and GP gave me an NHS prescription.
I don't know if that's any different for other medication, but I didn't have to pay. It was all very straightforward and I'll be going private again when needed going forward.

IME they hate the waiting lists as much as the patients.
Surely if that were the case they would run extra clinics for free out of the kindness of their hearts.

TBH I don't care much that my DM queue jumped either.
It's the reason why more efforts are put in place to stop the practice because the NHS is about access to all, not those who can afford a private appointment and then want to continue with free treatment.

Nothing wrong with going fully private, that's an option people can opt for, obviously needing to budget for.

Surely if that were the case they would run extra clinics for free out of the kindness of their hearts
Where, in their home? It cost money to run clinics, not just the cost of the consultant fee.

Well the consultant was great, and in my opinion worth the money to see the consultant I chose as a specialist in my particular condition. He has arranged a private blood test (not available on NHS) but would have arranged other tests on the NHS if possible. I don't feel that's queue jumping as there isn't really a queue as such for blood tests. He has also asked my GP to administer a steroid injection rather than me having it done privately. He says the GP should have done that anyway prior to making the NHS referral. So far, I don't feel I've done anything to the detriment of NHS patients or done anything which would cause other patients to wait longer. If things progress as we expect, he will put me onto his clinical trial which he's running, which will be NHS treatment but the nature of the trial means there's no waiting time (for any patients).

@ISeeTheLight do you mind me asking what sort of results you had that got you a referral? Mine are all over the place and my doctor isn’t being much help.

Glad it went well Giraffe. Yes it sucks that the system is so screwed that people have to do this, but don’t feel bad about working within the system as it stands - you’re not responsible for the long waiting times, chronic underfunding is the problem.

I had slightly raised TSH in a few blood tests - as in 4.2 or so when the normal range was up to 4. I had/have really bad symptoms though. It helped that my GP is wonderful and was really supportive.

Endo did some additional tests which came back normal, so he didn't originally want to prescribe me the levothyroxine. But once he had the other test results he did. He said they need at least 2 tests which show raised TSH or antibodies.

I'd say if your GP isn't helpful see if you can get a different GP. I've been suffering for years, no one ever took me serious. We recently moved and I registered at the same GP as MIL. He's German, pretty old-fashioned but takes his time with patients and actually listens.

Yeah, I’ve been struggling with symptoms for 11 years now. My TSH has always been low but other levels all over the place. It was 2.3 in February but just had a test back last week and it’s now 5.95 but according to NHS guidelines are that it’s not hypothyroidism until it reaches 10! Seeing my GP next week so will see what they say.

My TPO antibodies are 16, which is well within range but apparently can still mean a problem if you have them at all.

Ask for your full test results, including normal accepted ranges. If you're even slightly outside TSH range they should give you medication. My antibodies count was normal too.

I had the tests done privately myself so I have the results- just need to hope they’ll listen now my TSH has nearly tripled in under 3 months!

Sorry for the hijack, got lost as to which post this was!

Hope the treatment helps Giraffe

My husband is usually a private patient through Bupa. All of the consultants he sees (x4) are also nhs consultants . One consults privately but will only perform the operations through the nhs (requirement for post surgery intensive care and he feels the large teaching nhs hospital has the best resources). This has never caused us any problems and on paper we have flipped between the 2 at least 6 times.

I would say if possible make sure you can access the private consultant through the nhs too so you are not changing consultants.