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Private healthcare allows you to be treated quickly without the NHS waiting list. However, if you pay to be treated privately, you may not have the funds for all your treatment, or your health insurance may not cover it. Here's how mixing NHS and private treatment works.
Chris is our resident private health insurance and healthcare expert. He has over a decade of experience writing about private medical insurance and treatment. He's Chartered Insurance Institute qualified and is regularly quoted by the national press.
You can access private care for various reasons. If you're facing a long wait for an initial appointment or diagnosis via the NHS, a private consultation and tests could give you a diagnosis much quicker. You could also decide to have private surgery, which private hospitals offer on a self-pay basis.
Alternatively, if you have private medical insuxrance, this can fund treatment privately and may cover surgery and other outpatient therapies depending on your policy.
As a private client, you can contact a private hospital for an appointment and a treatment quote before proceeding.
You might need to go back to the NHS after receiving private care for many reasons. Here are some of the most common.
Opting to pay privately for a consultant appointment and diagnostic tests can help you to get a quick diagnosis, which can benefit patients with certain types of cancer or if you're living with constant pain but facing a long wait for treatment.
When you have a diagnosis, your consultant may advise you on a treatment plan and give you a quote for further private care. If the quote exceeds your means, your consultant can refer you to an NHS hospital for continued treatment.
While some conditions will benefit from surgery, this isn't always the case. Alternatively, surgery may be a last resort if other forms of treatment haven't worked. For example, your doctor may recommend weight reduction, physiotherapy and medication before considering surgery.
While some of these alternatives are available with health insurance, others may require long-term monitoring by your GP or an NHS consultant.
Private cancer care can offer treatments that aren't available on the NHS. However, without health insurance, these treatments can sometimes cost hundreds of thousands of pounds. So, it's essential to check whether specialist treatments will benefit you.
If you've had a private diagnosis, your consultant will likely ask your GP to make an urgent treatment referral to ensure you're seen quickly.
Some private care providers offer access to urgent care clinics where you can walk in and be seen quickly for a fee. However, these are typically only available in major cities. They also don't treat life-threatening injuries and aren't a substitute for A&E.
If you've had surgery privately, your follow-up care will be included in the cost. However, if you experience life-threatening complications, you'll need NHS care. Regardless of the reason for the complications, the NHS will always treat you in an emergency.
You can mix NHS care with private treatment if you need to. Guidance is in place to ensure that your NHS and private care stay separate.
Your NHS care will always be free, and you'll only be asked to pay for things like prescriptions. The NHS won't pay for or subsidise any private care.
Typically, you must have your private care at a different time and location from any NHS care. For example, you might be seen at a private hospital, in a private room, or in a separate building at an NHS hospital. Many NHS consultants also offer private treatment, and their clinics should normally run outside NHS hours or at a different place.
You also won't be able to mix different parts of the same treatment plan between the NHS and private care. The NHS guidance gives the example of a cataract operation. Private surgery can offer you special lens implants unavailable via the NHS. You can't pay for the lenses and have the NHS surgery. Instead, you must have both the operation and the lenses privately or opt for NHS surgery with the standard lenses.
If you're already on an NHS waiting list and decide to pay to see a consultant privately, your position on the waiting list won't be affected. You will only be able to skip the NHS treatment queue if you then receive an urgent treatment referral. You'll be seen based on the usual NHS criteria, such as your level of need.
You don't necessarily need a referral from your GP if you want to access private care. However, seeing your GP before you decide to pay privately can be helpful.
For example, your GP might tell you you need specific tests or scans. Some, such as blood tests or x-rays, might be available quickly at your GP surgery or via a walk-in service at your local hospital. Others might take longer. Alternatively, your GP may have told you you need surgery, but you'll face a long wait via the NHS.
In these circumstances, a referral from your GP can give your private consultant useful clinical information to ensure you get the treatment you need.
As mentioned, your private consultation may not lead to surgery. A private GP or consultant may issue a private prescription to see if medication solves the problem. However, if you need a repeat prescription, a private doctor won't be able to issue this. BMA guidance states that they should, however, take a complete medical history from you, including details of any medication you currently take, to ensure that any new prescriptions are safe for you to take.
If you need to take your new medication long-term, you must be referred back to your GP for NHS care. They'll then be able to monitor your condition and issue repeat prescriptions as appropriate.
The NHS has been there to provide us with high-quality medical care that's free at the point of use since 1948. However, waiting times have increased, with 7.4 million patients currently waiting for treatment. If you want to explore the possibility of paying to go private, you can find out more here.
Private health insurance can also provide comprehensive coverage that lets you access private treatment for various conditions. A specialist broker can help you through the process, sourcing quotes and comparing policies so you can make an informed choice.
Disclaimer: This information is general and what is best for you will depend on your personal circumstances. Please speak with a financial adviser or do your own research before making a decision.
Many NHS consultants also offer private care and can tell you about their private services if you ask. They may also notify you about treatments that could benefit you but aren't available on the NHS.
A private appointment with a consultant can help you to get a diagnosis more quickly, and you'll likely be treated sooner if you decide to go private for the rest of your care. However, if you go back to the NHS for treatment after your diagnosis, you'll still be assessed and seen based on your level of need.
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*Based on 461 quotes between 01/22-01/23
