NHS AND PRIVATELY-FUNDED HEALTHCARE

The relevant policy statement “Managing the boundaries of NHS and privately-funded healthcare – NHS V Private Funding “, which can be found using the link below, suggests
“Where a patient opts to pay for private care, their entitlement to NHS services remains and may not be withdrawn. The NHS should not subsidise private care; and private and NHS care should be kept separate as clearly as is possible.”

This is explained further by Buckinghamshire, Oxfordshire and Berkshire West (BOB) integrated care board and NHS South, Central and West (NHS SCW), see under
Private to NHS Funding | BOB ICB look under Buckinghamshire and type ”Private” into the search box to bring up the relevant policy statement.

If you then click on the policy statement you can bring up the 6-page document. Some important points include:

KEY POINTS for short term treatment

“Initial referral and treatment

• Patients who opt to be referred for private treatment (i.e., outside the ICB’s contracted services) must pay the full cost of the consultation, any drugs prescribed and for any other interventions that are provided in the course of their private consultation.”

This means that short term treatment such as a short course of antibiotics is the full responsibility of the private consultant to prescribe. For more detailed information see under

• private care

KEY POINTS for long term treatment

“The key points are as follows

• There is no obligation for the GP to prescribe treatment recommended by a private practitioner if it is contrary to local agreement or outside normal clinical practice.
• The NHS will not normally fund treatments that have been recommended by a private practitioner if that treatment is not normally commissioned within the local area.
• The fact that a patient can demonstrate they have benefited from the private treatment does not necessarily provide grounds for continuing the treatment in the NHS as an exception.
• Patients who commence care privately can request that further treatment be provided within the NHS.
• The ICB will not be responsible for retrospective funding of earlier treatment where patients who have received private treatment then transfer to the NHS.”

On-going treatment – drug prescribing in primary care

A patient whose private consultant has recommended further/ongoing treatment with a drug (i.e., repeat long term medication) that is normally available on the NHS within the local area, can have that drug prescribed by their GP on an NHS prescription, as long as:

• the GP considers it is clinically necessary;
• the drug is listed on the approved Formulary; (in Buckinghamshire this is the Buckinghamshire formulary which is further discussed under Medicine Management)
• the drug is normally funded by the ICB for that condition (N.B. Specific policy criteria may apply)

Other considerations

• The ICB will not normally accept requests for funding of a tertiary referral (i.e., a request for advice from a national specialist centre) from a private consultant; there is particular concern when such a referral is made from a consultant’s private practice to his or her own NHS clinic. The ICB would normally expect requests for funding of a tertiary referral to be submitted by an NHS consultant.
• The private healthcare provider must inform the patient that they will be required to pay all the related costs of private treatment, and set out clearly what those costs will be.

This is all expanded on further under

• private care

Ear wax removal

Many GP practices do not perform ear syringing for a variety of reasons which include the lack of expertise, the risk of litigation and that it is not a funded service for GP practices.

Further information on ear wax

From the NHS, Patient info and NICE

Ear wax build up

• Earwax build-up – NHS
• Earwax | Causes, Treatment and Build-up Prevention | Patient
• Earwax | Health topics A to Z | CKS | NICE

Many large high street optician chains (in addition to other private providers) now offer a paid for earwax removal service. They generally use microsuction which is considered a safe way to remove wax.