top of page
Private Referral Guidance
Given the current climate of lengthy waiting lists to access NHS outpatient care, many patients are seeking care in the private sector. This section of our website is designed to give some guidance regarding the interaction between primary care and private healthcare.
Accessing a private appointment
1.) Private Insurance
There are a number of private insurance providers, who provide varying degrees of cover for diagnostic or treatment purposes. Prior to accessing a designated specialist, the insurance company will usually require a referral letter from a GP. Once the patient has forwarded this to their provider, they will confirm whether the condition/ speciality is covered. Some insurance companies, (for example Vitality) may also ask the patient to provide a detailed medical report from the GP. This will incur an additional cost to the patient.
2.) Self- funding
Patients without insurance may choose to 'self fund' in order to access care in the private sector. This can prove costly, depending on the nature and extent of investigation or treatment indicated. The private provider should be able to provide the cost for initial consultation before an appointment is made, but this may fall significantly short of the final payment due.
General guidance when accessing private treatment:
One of the issues which can sometimes arise in the interaction between primary care and the private sector relates to prescribing. GPs must adhere to certain safety guidance; for example when prescribing medication which requires continued Specialist input and monitoring. In the case of 'amber list' medication such as those prescribed for ADHD or certain Rheumatology conditions, this would require an understanding from the patient and private specialist that there must be ongoing, regular six monthly review, as well as access to Specialist care if issues with medication arise.
Another potential pitfall can occur when a private provider requests the Practice to carry out additional investigations (for example blood tests or x rays). We are not permitted to comply with these requests; doing so would inappropriately use NHS resources to carry out private activity.
3) Onward referral
If further referrals (NHS or private) are deemed necessary by the Private healthcare team, these should be made by them at the time of appointment.
4) Accessing Private care abroad
The Department of Health have issued guidance for patients accessing private healthcare outside of Northern Ireland:
'Where an individual avails of health care on a private capacity, it will be important for the individual to ensure that all pre and post treatment costs are included in the overall package of care procured from the private healthcare provider. In any such instances, an individual will not be entitled to related pre or post treatment support from primary or secondary care services in Northern Ireland.'
This is relevant, for example in the case of those accessing bariatric (weight reducing) surgery abroad, where post treatment care involves blood monitoring. Unfortunately this cannot be accessed through the NHS and the individual must understand the need for ongoing blood monitoring in the private sector on return to N. Ireland.
bottom of page