Swapping back and forth between NHS and private treatment

[PositivelyGlowing]

For the past couple of months I've been suffering from a medical condition for which I needed to see a specialist - the waiting list for my NHS (I live in Wales) was over 6 months so I opted to go private. I found somebody suitable, but in England - my GP wrote a letter of referral and the specialist, after seeing me and doing some physical tests, stated that I needed a couple of MRI scans to rule out some of the most likely causes.

So I had the MRI scans and no issues were found. All well and good but the cause of my condition remained unknown.

The specialist then recommended that I have quite a number of blood tests (testing about 12 different things) and he wrote to my GP with this recommendation.

On speaking to my GP he (politely) stated that he couldn't authorise the tests on the NHS because I was 'swapping and changing' between private and NHS treatment, I guess the NHS frown on this even though I am at least partly saving them time and money by seeing the specialist for the initial private consultation and MRI tests ........

I wasn't surprised by my GP's response but it was of course disappointing.

When I told the specialist about this he said that the response from my GP was very rare.

I guess that paying for the blood tests is my only option now? I could write to my GP and politely air my disappointment but I guess that won't get me anywhere.

The problem here is though is that ‘the nhs’ isn’t one entity and isn’t run on just one pot of cash. You haven’t saved the gp any time or money by going private - those appointments/scans/tests would have come from the hospital budget. Passing this back to the GP is actually increasing the cost and time for them.

I could, but that lie would soon be discovered.

I am tempted to write a long letter to the head of practice at my GP's surgery and, very nicely, put forward my 'complaint', however I don't feel that this will achieve anything and I don't want to fall out with the practice.

Untrue really because the gp cost is identical to what the cost would have been if consultant care was nhs.

Where people use private GPs the gp cost is also reduced. So eg my friend recently had an infected hand. There was no gp appointment and so he saw a gp privately, saving an appointment. The infection didn’t respond so a swab was required which required an nhs gp visit . The gp confirmed that they would have prescribed the same antibiotics as the private gp. In this case using both saved the nhs one gp appointment.

Thank you ☺️

I’m an NHS consultant. If I want a patient to have investigations I’m meant to sort them out myself, not dump them on the GP, who gets less per year per patient than it would take to insure a pet hamster.

thank you! Wish your colleagues all felt the same.....

That's strange, because of the long waiting lists I have seen a private and nhs dermatologist for skin cancer, the NHS 2 week wait ended up being months. The same with my rheumatologist whose NHS list was over a year, no one has ever complained, refused to see me and my NHS dermatologist was happy I had received treatment. My GP prescribes what's recommended by either, I've not been taken off any NHS follow up lists either, everyone just seemed happy for me to get tests done and treatment. The alternative is to wait months for urgent tests. All the private doctors also work for the same trust NHS rightly or wrongly.

The patients you are complaining about… the ones who have had the temerity to see a consultant privately because NHS waiting lists are so long they are actively harmful… are also your patients, yes? Otherwise you wouldn’t be seeing them at all. Why do those patients matter less to you than the others on your list?

Our GP actually recommended a private appointment to see the Cardiologist for DH. He's got an appointment next month instead of 18 months quoted on the NHS wait list, for persistent and debilitating atrial fibrilation. He will have to have the treatment on the NHS at a regional specialist but that's because it's not available privately. We must be fortunate, but when he did this last time, we paid for all tests privately - echocardiogram, bloods, x rays etc.

Many NHS consultants are only offering phone appointments, some of my appointments are "virtual", so blood tests are done by the GP (I'm rural) if it is outside the times that I am at the hospital. Also some things that are possibly caused by the chemo are pushed back into the GP's domain. GPs definitely feature in consultant led care.

No, because your NHS consultant would be ordering those tests themselves from the hospital budget, not sending you to the GP.

As a GP I refuse all the 'we did a remote appt so can you do the bloods' requests and they get escalated to the medical director of our local trust.

Are you the dogsbody of NHS consultants?

What does this mean 'sort them out myself'. Only today have I rung the GP to book in blood tests because I was given a form by the consultant for them to be done. Thats normal, thats happened lots of times before.

I have done this, it worked out well for me. And helped me achieve a dx very quickly, when I suffered an acute first presentation of Multiple Sclerosis. My GP was delighted that I could be seen quickly, no negativity whatsoever.

If your practice is resourced for phlebotomy, that's fine - the consultant did the form. Consultant here hasn't done the form or made any effort other than telling the GP to do it.

Well I was told to either book it at the hospital or book it in at the surgery, the surgery is more convenient so thats where I booked it in.

Absolutely, your surgery obviously has funded phlebotomy. In my area of London almost no GPs do.

This happened to me ten years ago. Private consultant referred me straight back to the NHS with his recommendations, which GP said the practice did not fund. It was a waste of money to see the private consultant for this. Just because I didn’t have private health insurance didn’t mean that I was broke, and I would have seen it through privately had the consultant not firmly suggested going back to my GP.

So in other words then, if a GP refers a desperate patient to a private practice for a specific reason because of horrendous NHS waiting lists and the private tests don't find anything wrong, then the patient is fucked? Even though the referral was for one particular thing which has now been ruled out?

GPs think of themselves as autononmous professionals now then? Just who is it who pays the GPs to run their practice?

Oh yes. Ultimately - the taxpayer. In case you'd forgotten.

And I've never met a poor GP either, so don't get your violin out.

I complete the request on the electronic ordering system, then organise for them to be performed either by the children's community nurses, or on the children's ward. (We don't have paediatric phlebotomists). I then act on the results.

no, I'm happy to see the patient and manage them as I always will, referring if necessary.

I don't do tests on behalf of anyone else. Quite apart from anything else, one more link in the chain introduces extra risk.

And I'd like to have time to do the job for which the taxpayer provides this largesse of around £100 per patient per year (do try and insure your pet for that....). Most clinical days I spend over an hour sorting out things that someone else in the NHS should have done, were they doing their job properly. That's several primary care patients who don't get an appointment with me.

Is this an insurance thing by the GP? So normally if a consultant in a hospital needs bloods done then they request it directly not via the GP. So perhaps the GP is worried that they are not covered if the blood tests are not asked for by them but asked for by a consultant and they have no direct control how the results will be used ?