Prescriptions from Private Doctors
We are aware that given current NHS wait times, some of our patients opt to see a private doctor. This policy is to clarify our position on prescriptions.
If a patient is seen privately by a doctor for a single episode of care, any short-term medication required should be paid for by the patient as part of that package of care, e.g. if a patient has a private hip replacement – painkillers, blood thinners and antibiotics required as a result of the operation should be prescribed by the private provider.
A private consultation may identify a long-term condition which needs medication. If a patient asks us to take over prescribing of a medication recommended by a private doctor, we will need to be satisfied that prescribing is appropriate, responsible and what we would prescribe for other NHS patients with the same diagnosis.
Whenever we prescribe medicine for a patient we are taking full responsibility for their care, even if the medicine is recommended for you by another doctor.
Therefore we will not prescribe medication in the following circumstances:
- We have not received adequate communication from the private doctor to explain the reasons the patient needs the medicine and that they have discussed the safety of the medication.
- The medication is not prescribed on the NHS [blacklisted] (e.g. liothyronine)
- The medication is only suitable for specialist-only prescribing and we do not have the specialist expertise to safely monitor the medication e.g.
- Methylphenidate
- Lisdexamfetamine – ADHD medications
- Amiodarone – specialist cardiac medication
- Isotretinoin – acne treatment
- Lithium – mood stabiliser
- Goserelin – when used as a puberty blocker
- Immunosuppressants and chemotherapy
- The use of the medication is not compatible with national or local prescribing guidelines – our local formulary can be viewed at https://www.nottinghamshireformulary.nhs.uk/default.asp?siteType=Full
- The medication is not licenced in the UK or is being used for a purpose not included in its UK licence (e.g. spironolactone for acne)
- We do not believe the medication is appropriate or necessary for the patient.
- The patient is seen by a private doctor without a GP referral (i.e. we cannot be sure that the doctor is fully aware of the patient’s medical history).
Please note that the same rules apply for other NHS doctors (e.g hospital specialists) asking GPs to take over prescribing of a medication.
The above are essential safeguards for us as doctors and prescribers. The General Medical Council advises us in “Duties of a Doctor” to prescribe in the best interest of the patient and only within our level of competence.
It is important to consider all potential costs when accessing a private consultant and this includes medication costs. If the medication applies to one of the above categories, you should speak to your private doctor to decide what to do next.
You retain the option of a private prescription through your private doctor. Or, we would be happy to facilitate a referral to an NHS specialist if your medication is specialist-only.
Further information is available from:
- British Medical Association Ethics Committee May 2009: The interface between NHS and private treatment: a practical guide for doctors in England, Wales and Northern Ireland http://bma.org.uk/practical-support-at-work
- Department of Health March 2009: Guidance on NHS patients who wish to pay for additional private care. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/404423/patients-add-priv-care.pdf
- General Medical Council April 2021: Good practice in prescribing and managing medicines and devices https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/good-practice-in-prescribing-and-managing-medicines-and-devices
