The Rycote Practice

Thame Health Centre
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Private Patients

We do not routinely offer the opportunity for patients to register privately with the practice. The practice is committed to the NHS and providing those patients with the best possible NHS care. However in exceptional circumstances we will consider an application to be treated as a private patient. For example if you have a very prominent public profile and feel that your confidentiality might be compromised in the course of your treatment we will consider an application as a private patient. Please be aware that there are costs associated with each aspect of your care as a private patient.

Private Services for NHS Patients

As an NHS patient there is nothing to prevent you seeking a private referral should you need specialist treatment. You can read more about seeing a private specialist on our referrals page.

The Rycote Practice and Private Providers of Healthcare

We understand that some patients will opt to have some of their treatment privately and we support your right to do so.

However, to prevent any misunderstanding we would like to take this opportunity to explain how The Rycote Practice (as an NHS General Practice) works alongside private providers of healthcare.

Seeking a private specialist opinion:

What happens if I want to see a private specialist (For patients making use of health insurance)?

Your GP will write a referral letter if they feel this is appropriate and it can be emailed to you (please ensure that you confirm your email address with the practice if you would like to use this option) or it can be emailed directly to the secretary of the private specialist, this will include any relevant medical details about you. We would encourage you to wait until you or the private secretary have received this letter before making an appointment with the private Specialist, as the details within it will help the doctor you book to see.

Please note that if an insurance company wishes for a specific form to be completed you may be charged for this additional work.

What happens if I want to see a private specialist (For patients who do not have a health insurance policy)?

If you do not have health insurance and wish to book directly with a private clinic, you do not require a letter and can arrange the appointment as you wish. However, it may be useful to have a letter summarizing your medical history for the specialist. We can provide this information if required.

You should contact the Specialist’s team or your Private Health Care Provider or Insurer to organise an appointment.

Should you have any questions regarding your appointment you should contact them directly.

Seeing the Specialist:

What happens if I need a test or procedure?

If the specialist thinks that you need any tests- including blood tests- or a surgical procedure, then the specialist is responsible for:

  • Arranging tests and any medications that might be needed prior to the test, as well as explaining how and when you will receive a date for the test, and what to do if the date is not suitable for you
  • Giving you your results and explaining what they mean. This may be via letter or a further face to face appointment

GP practices are being asked to do an increasing amount of blood monitoring, and other procedures for private specialists and the GP is expected to take responsibility for the result. Due to rising demands on primary care, we are unable to do this unfunded work.

If we receive a request from a specialist for us to take on blood monitoring, we are likely to write back to them (copying to the patient) asking them to make alternative arrangements for their patient.

Please do not contact the practice to discuss the results of tests organised by other doctors. It is the specialist’s responsibility to discuss this with you, and the practice will likely not have access to the results or be able to interpret them.

What happens if I need new medicines?

The specialist might suggest prescribing new medicines for you or might want to make changes to the medicines that you are already taking. They will be responsible for giving you the first prescription of any new medicine that you need to start taking straight away. Please note if you take a private prescription to any NHS Pharmacy you will have to pay the actual cost of the medication rather than the current NHS standard prescription charge, which may be dependent on the medication prescribed.

In some cases, your GP may be able to continue to prescribe these medications on an NHS prescription. This will need to be considered by the practice and is at the discretion of the GPs. Prior to this, a full clinic letter from the specialist is required, outlining the reasons for treatment, explaining the precise details of the prescription; what it is being used to treat; how long the treatment is intended for; and what monitoring or follow up is required before the practice can decide whether we can continue to prescribe.

Please allow at least seven days to allow this letter to arrive before contacting your GP.

If a prescription is needed sooner, you should contact the specialist’s team (usually via the secretary) for them to prescribe it.

Private specialists may suggest medications to patients which wouldn’t normally be prescribed by NHS GPs. If this is the case, you will need to continue to receive them from the Specialist. Please contact them directly to organise this (see below).

The clinicians at The Rycote Practice believe that providing the best quality care to our patients is our top priority. When a prescription is necessary our main considerations are effectiveness and safety.

In order to prioritise patient safety and the best value to the NHS, we are bound to prescribing from an approved list of medications called the Oxfordshire Formulary. This is a list of medicine,s colour coded according to whether they can be safely prescribed by GPs (Green); whether they must be started and monitored by a hospital doctor or recommended by a specialist to be initiated by a GP (Amber); whether should only be prescribed in secondary care by a specialist (Red) or whether are not recommended for use because of lack of evidence of clinical effectiveness, cost effectiveness or safety.

Oxfordshire Formulary: http://www.oxfordshireformulary.nhs.uk/

The Practice may not be able to issue you with an NHS prescription following a private consultation for the following reasons:

  • If the Practice considers that there is not a clear clinical indication for the prescription, and that in the same circumstances an NHS patient would not be offered this treatment.
  • If the private doctor recommends a new or experimental treatment or recommends prescribing a medication outside of its licensed indication or outside of our formulary recommendations.
  • If the GP feels that they would be acting outside of their competence by issuing the medication.
  • The prescription doesn’t recommend licensed doses or uses as per the British National Formulary.
  • If the medication is not generally provided within the NHS

Shared Care Protocols

If the medication is of a very specialised nature requiring ongoing monitoring whilst it is being taken it usually issued in the context of a medication agreement between the specialist and the GP.

Shared Care Protocols (SCPs) are documents of agreement between a specialist and GP. These documents outline the responsibilities of either party for the care of the patient who requires specialist medication. For example, some medications need regular blood tests (usually taken in the GP practice) so they can be taken safely over the long period of time.

Without a Shared Care Protocol in place, we are unable to safely prescribe and monitor certain medications. This would include, but is not limited to, what are known as Disease Modifying Drugs, IVF associated medications and those to treat ADHD. These SCPs have been drawn up by, and for use between, Oxfordshire Clinical Commissioning Group or the Buckinghamshire, Oxfordshire and Berkshire West Integrated Care System (BOB ICB), Oxford Health and OUH clinicians only.

This means that if you are issued medication from the private specialist or provider which would need to be issued in the context of a SCPs if it was issued in the NHS, then we would not normally be able to issue this medication.

However, we do recognise that there are some inordinate delays to accessing NHS services. We are sympathetic to the plight of patients who make wait years for specialist assessment.

In some situations, a SCP from a private specialist may respect the Oxford Formulary (which governs our prescribing behaviour) and be essentially identical to the relevant SCP operating within in the NHS context. Therefore, in some very limited circumstances we may be able to accept a Shared Care Protocol from a private provider.

We generally expect any legitimate private provider whose service necessitates blood testing and physiological measurement to have their own access to these facilities.

If we are unable to issue an NHS prescription you can still obtain the medication recommended via a private prescription from the Specialist, you have seen but we would recommend that you investigate the cost of this and associated monitoring before proceeding.

GMC Safe Prescribing Guidance: www.gmc-uk.org/prescribing-and-managing-medicines-and-devices

What happens if I need to transfer my care back to the NHS?

If after seeing the Specialist privately you want to be back under NHS care, national regulations allow for you to transfer back. This transfer ideally needs to be done by the private Specialist who is overseeing your care but if this is not possible, please request that your Specialist writes directly to the practice to request this.

Acute Private Consultations

Increasingly, some patients access private primary care (GP) consultations. In some situations, the assessment by these private clinicians generates actions e.g. blood tests or imaging. Patient may often present to NHS primary care for this tests to be actioned. However, there may be several appropriate reasons why we may decline to action these tests. For example, private primary care providers will not have access to the extensive information that patient may have on their NHS medical record outlining previous investigations and tests, such information might drastically alter the appropriateness of requesting a test suggested without the ‘whole picture’.

Private Blood Testing (including genetics testing)

The Rycote Practice believes that private blood testing companies may have negative effects on the resources of publicly funded health services like the NHS. While some companies offer a review of results by a medical practitioner (which may be charged separately), others do not. Patients often ask NHS GPs to review the results of blood tests that they have purchased privately, even tests not recommended by the NHS. These may be of uncertain quality, and liable to give false positive results, with follow-up consuming GPs’ and NHS laboratory time. The testing companies, meantime, may take no responsibility for management of results or the costs of subsequent investigations. The Rycote Practice will not ignore legitimate requests to investigate problems which may have been triggered by a private direct-to-consumer blood test, however this will be at the discretion of the GP for the reasons outlined above.

Private Services for Businesses

We will consider applications from organisations to provide private services for their employees. We would suggest that if you are in need of a private medical arrangement for your employees you contact us. Below are some examples of the services that we might be able to offer your organisation:

  • medical assessments and travel immunisations for companies with a large number employees who regularly travel aboard
  • medical assessments for long haul drivers of transport companies
  • medical assessments for construction workers who perform safety critical operations

Please not that we will endeavour to tailor a service to meet your needs and ensure that you are not competing with NHS patients for access to our services.