Context:
The number of patients seeking private care is increasing, and some of those consultations will result in acute or shared care prescribing requests.
There will not be any imminent guidance coming from national or regional NHSE teams regarding this issue, so any guidance or grounds for refusal needs to be coordinated at practice level and we have received assurance from the Northamptonshire ICB Medicines Management team that they would support adherence to our own practice policy if it follows the principles detailed below.
Criteria:
Sharing care with the.private sector can carry higher risks than sharing care with the NHS and therefore decisions on this will be made on a case by case basis and will always be discussed by at least two GPs. Decisions on monitoring and dose changes will be taken by the consultant. The decision to share care, or not to, will be based on review of the following factors:
- Whether the consultant is on the appropriate GMC specialist register, a member of the relevant Royal College and based in the UK.
- Whether the consultant holds, or has held in the past, a substantive NHS consultant post in the same speciality as the one in which they are now practising privately.
- How often the consultant proposes to review the patient. If private review stops then prescribing by the practice will no longer be safe and will have to stop, possibly with little or no notice. For patients who are on an NHS waiting list, sharing care with a private consultant would be an interim measure until care is taken over by the NHS.
- Communication between us and the consultant- we would expect access to email communication for any queries, with prompt replies.
- The nature of the prescribing- shared care is more likely to be possible if the drug is one which is licensed for the indication, would be given by an NHS consultant and for which there are no significant NHS guidelines or reports that recommend against its use.
Outcomes of practice decision:
A form will need to be completed by the non-NHS consultant for each request. It may be necessary to send a copy of our practice policy to the private consultant to help to answer the questions.
If there is a 'No' answer to any question then shared care prescribing will be declined by the practice and the decision shared with the private specialist making the request. The completed form will be scanned into the patient record. On request the policy and completed form will also be shared with the patient or their nominated spokesperson.