Private to NHS
Patients seen privately should usually have any medication or treatment intervention provided privately as part of that episode of care. The private Clinician recommending a medicine should provide a private prescription.
Patients who request to be referred privately are expected to pay the full cost of any treatment they receive in relation to the ‘episode of care’ that is provided privately, this includes any: consultation fees, drugs prescribed or treatment provided by a Clinician in the course of a private consultation should be funded by the patient. This also includes any associated investigations/tests required (including IVF) .
In certain situations we may be able to prescribe some medications recommended privately via the NHS however in order to do so we need to know the indications for each drug and any relevant results IE we need a detailed clinic letter from the specialist recommending these medications. We are not able to prescribe without a clinic letter. Please be aware, therefore, that private prescriptions submitted without a full clinic letter will be automatically rejected- if the medications are needed prior to a clinic letter being available they will need to be obtained privately. If you are unsure about the urgency with which the medication is required please liaise with your private specialist- again we cannot advise on whether medications are urgent untl we have a full clinic letter detailing why they are required and the indication.
Apart from the initial private referral any further administration associated with a private referral ie insurance forms and reports are chargeable. Please refer to our ‘Private Fees’ section for further details.
An ‘episode of care’ ends when the patient is discharged back into the NHS.
We would appreciate a full clinic letter after each visit to keep us updated of tests or treatment recommendations ensure your record is complete and accurate.
Private to NHS care
If a patient wishes to transfer to NHS care, for reasons of equity, they should be prepared to accept the same treatment offered to any other NHS patient with the same condition (inlcuding only off initial bloods for IVF etc).
In practice this means for specialist medications/investigations/treatment we would refer the patient to an NHS specialist for review/ongoing management.
For non-specialist medication we would prescribe according to our local formulary which is based on cost effectiveness ie you may not get the exact medication prescribed if there are similar more cost effective alternatives.
Please be aware the NHS prescribing guidelines state that we need to prescribe generic medications except for a few circumstances like inhalers, antiepileptics and contraceptive medications.
All private to NHS referrals are subject to the same usual NHS pathways with the usual associated waiting times. Unfortunately, we have no control over the waiting times. We do appreciate that they waiting times may often appear long.
Please be aware that our NHS normal referrals go via a local referral managment service. These referrals are vetted locally by a panel of doctors from Camden, Haringey and Islington Referral Support Service (CHI RSS). The doctor peer reviewers may send back your referral with comments for you to review if it doesn’t fit these guidelines or they feel we should do or try more things first.
For referrals that do not meet the criteria for referral to secondary care, CHI RSS may return referrals if they haven't followed either NICE guidance or local clinical pathways.
The CHI RSS may not authorise our referral for other reasons. This may be as or as this condition may not be covered by the NHS or that the condition may be covered but that we need to apply for funding and get approval first.
Evidence Based Interventions and Clinical Standards (formerly PoLCE) is the referral process for patients needing a procedure where certain criteria or a threshold must be met before funding is approved. Please be aware the name of this program changed from PoLCE on 8 October 2019 to EBICS from September 2019.
Finally, once a referral reaches the a hospital, their own specialist doctors then also review the referral and they may adjust the urgency of the referral or sometimes decline the referral if they feel that the condition does not meet their own thresholds or that other things ie treatments/tests need to be done first.
The waiting times are generally long at present on the NHS. We have no control over this. Many times referrals are 'deferred to provider' which means placed on a holding list with the hospital until they are able to book an appointment, which is when the patient will be contacted. We would encourage patients to contact the hospital directly as we have no influence over these waiting times. Similarly, we would encourage initially patients to liaise with CHI RSS directly to take the soonest available appointment, which may not be at their hospital of preferance and before accepting to be 'deferred to provider' enquiry about indictive waiting times and considering alternative options ie other hospitals a bit further away, if they have much shorter waiting times.
Please also note the Royal Free Hospital is based not only in Hampstead, but also has sites in Edgware, Chase Farm and Barnet Hospital. For surgical issues, much of the activity including the outpatients and operations occur at Chase Farm, which is not close. Please consider how easy it is for your attend this site and if it is difficult, it may be better to be referred to University College London, The Whittington Hospital or St Mary's Hospital which are all much closer.
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