The surgery will be able to Provide you with private referral letter if looking to seek treatment through the Private Sector.
If the consultant you are under feels you need any tests or procedures arranged they are responsible for arranging these. Follow up with results should also be carried out and explained by your consultant, you should not be contacting your GP to find results of tests/procedures carried out by them.
Please note that any tests required should be carried out privately; and are likely to incur a cost. GP Practices cannot carry out out blood tests or procedures requested by private sector using NHS resources.
New Medication
If the consultant suggests prescribing new medication or making any changes then they are responsible for giving you a prescription for any new medication (this will likely incur a cost for the medication).
The Surgery may consider prescribing, as long as:
- The medication being requested is already on the NI Formulary
- The Consultant has provided the surgery with sufficient information about your medical condition to support the prescribing of the medication.
- The medication being requested is licensed for the condition being managed
- The surgery has a means of communicating with the Consultant who has made the recommendation
- The medication is not an "Amber list drug". (See below).
Amber list drugs at the request of a private provider
When patients see a consultant in outpatient clinic they are often given a prescribing advice chit or letter, requesting that a GP prescribe medication in the community. Your GP will review this request and if felt appropriate and it is safe, will normally prescribe the medication.
Some medications are more complicated and fall into the category of Amber list drugs (Red list drugs are only ever prescribed by hospitals). These medications include medications used to treat ADHD and a variety of inflammatory conditions. . These Amber list drugs usually are potent medications with the potential for harm if prescribed incorrectly and have specific monitoring requirements such as regular blood testing or physical checks that have to be carried out in order for the medication to be prescribed safely. There are agreed Shared Care Guidelines which outline the responsibilities of the NHS Consultant and the GP. Many of these responsibilities are relatively onerous and carry medico-legal risk. A full list of these medications and the agreed Shared Care guidelines can be found at
https://ipnsm.hscni.net/red-amber/
​Within Northern Ireland NHS the Shared Care arrangements are uniform and a voluntary agreement is sought between the consultant and the GP. Where a GP is unable to undertake safe prescribing for whatever reason, the responsibility for prescribing remains with the hospital consultant. Patients then receive their medications from hospital pharmacy and have monitoring undertaken at their hospital clinic. Shared care prescribing in primary care is always voluntary on the part of the GP.
In recent years there has been a huge growth in Private consultants seeing patients in Private hospitals and asking NHS GPs to take over the prescribing of higher risk Amber medications using NHS shared care arrangements. This has created significant problems for us for a number of reasons which include:
We are unable to confirm the credentials of private practitioners easily, particularly when they are based outside Northern Ireland.
Correspondence from private practitioners can been lacking in detail or clarity to assure us reviews are happening as stipulated
Regular review is difficult as patients must pay each time they see the consultant and this has meant they reviews are not as often as required
When issues arise the process for contacting private doctors to obtain advice is not commensurate with that in the NHS and this raises significant safety concerns.
There is no funding or resource allocated to Primary Care to cover the work private practitioners generate. Time spent dealing with these issues directly impacts on our ability to provide the NHS care we are actually funded for.
We are aware that most GPs in Northern Ireland are now declining to get involved in shared care arrangements with private providers. We have discussed this issue among all of the Partners in Salisbury Medical Centre and have decided that in the interests of safety and our ability to provide an equitable NHS service for all our patients that we will not be able to prescribe Amber list drugs suggested by a private doctor.
From now on patients who choose to pay privately to see a consultant and are advised that they need an Amber list medication will have to pay for this medication as part of their private treatment. These prescriptions will need to be privately issued by the consultant concerned. We cannot make exceptions.
If patients hold private medical insurance this may cover the cost of medication. Any patient can be referred into the NHS at any time and if they are seen by an NHS Consultant and the advice remains that an Amber list drug is needed, we will prescribe this under the NHS Shared Care arrangements where it is safe to do so. We know there are long waiting lists for NHS treatment and we share your frustrations with these delays. If you feel you are directly disadvantaged by the poor provision of NHS care we would encourage you to speak to your Political representatives to try to improve things.
If any of our patients are receiving medication from a private doctor we would advise that they let us know in case there are any interactions with other treatments.
- The medication being requested does not require regular blood monitoring
Private Healthcare Provision and Prescribing Responsibility for Medicines (PDF, 402KB)
Follow up
If after seeing the Consultant privately you want to be back under NHS care, this transfer must be done by the Private Consultant who is overseeing your care and you should not be passed back to the GP for this to be done. This avoids delays in care and ensures accurate information is passed on to most relevant person and avoids any unnecessary appointments with your GP or other NHS providers. Your consultant should organise your referral letter to arrange for you to be seen at the most appropriate NHS clinic.
The Department of Health In Northern Ireland have advised that patients requiring post-operative care, wound checks, dressings or stitch removals following treatment in the private sector should ensure all pre and post treatment costs are factored into the overall package of care.
The surgery may not be able to provide this care to patients who source treatment in the private sector (this does not include patients who are transferred under an NHS waiting list initiative).
Read the Department of Health’s policy in relation to pre and post treatment care for patients who wish to avail of private health care within the UK (PDF, 791KB)