Following a number of emails asking for more information on this topic, I have copied the relevant paragraphs from the CCSC Consultant's Handbook from the BMA Website below . These clearly state that a patient is expected to be private throughout their episode. This means that asking the GP to do the tests is breaking the rules. Usually I have found that referring the consultant to that information source is effective and I have not had to take further action.

TIM






Private Practice

Private practice in the NHS
Involvement of other specialties
When patients are admitted privately, the primary consultant should explain to the patient that the professional services of an anaesthetist and the opinion of a pathologist or radiologist may also be required and that fees will be payable for these services. It is essential that colleagues in the diagnostic specialties are properly involved in the treatment of private patients, so that a personal service may be expected.

Problems have arisen in the past over the practice of arranging the investigations of private patients through the NHS rather than privately. This practice developed for the historical reason that, until the contract changed in 1979, most pathologists and radiologists held whole-time contracts and therefore were not entitled to undertake any private practice. However, the guidance set out in the NHS Executive's Green Book helped to clarify the position that private patients are normally expected to remain private throughout the whole treatment episode.

Information: Section 65 of the NHS Act 1977 (as amended) - Authorised Accommodation for Private Patients.
Section 63 of the NHS Act 1977 - Amenity Beds.
Section 23 of the NHS and Community Care Act 1990.
Management of Private Practice in Health Service Hospitals in England and Wales. 1986
Pathology Services and Private Patients of Clinical Consultants: Suggested Code of Good Practice - CCHMS 1984.
Radiology Services and Private Patients: Suggested Code of Good Practice - CCHMS 1985.
Health and Medicines Act 1988.
HC(89)9, Determination of Charges for Private Patients and Overseas Visitors.
Northern Ireland: HSS(F) 12/92, Authorisation of Accommodation and services for Private Patients - Calculation of Charges for Private Patients.
Scotland: Sections 57 and 58 of the NHS(Scotland)Act 1978 as amended.
Management of Private Practice in Health Service Hospitals in Scotland. 1987
NHS Circular No. 1989(GEN)10.
NHSMEL(1998) 57 Manual of Guidance: Overseas Visitors



Management of private practice in the NHS (the Green Book)
Guidance exists on the management of private practice in the NHS, although having been published in 1986 (1987 in Scotland and Northern Ireland) it is now out of date in many respects; the BMA has repeatedly sought revision of it. The guidance covers, practical aspects affecting income from private patients and, includes the principles to be followed in conducting private practice in the NHS, which are:

that the provision of services for private patients does not significantly prejudice non-paying patients;
generally, early private consultations should not lead to earlier NHS admission;
common waiting lists should be used for seriously ill patients, and those requiring urgent treatment;
normally, access to diagnostic and treatment facilities should be governed by clinical considerations;
standards of clinical care and services should be the same for all patients;
single rooms should not be held vacant for potential private use longer than the usual time between NHS patient admissions.

Some trusts have drawn up their own guidelines on the management of private practice, a move the CCSC welcomes and encourages.

Procedures for identifying private patients are described in the Green Book and it is essential that consultants are aware of the procedures adopted in the hospital in which they work. The guidance also stresses that it is the responsibility of consultants themselves to ensure that their private patients are identified as such. A private patient officer should be appointed at hospitals where private patients are treated, and, if consultants require advice on the procedure to be adopted, then this officer should be contacted.

Information: Management of Private Practice in Health Service Hospitals in England and Wales, 1986.
Northern Ireland:  Management of Private Practice in Health Service Hospitals in Northern Ireland.
Scotland:  Management of Private Practice in Health Service Hospitals in Scotland 1987.


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Prof. Tim Reynolds,
Clinical chemistry Dept.,
Queen's Hospital,
Belvedere Rd.,
Burton-on-Trent.
tel: +44 (0) 1283 511511 ext 4035
fax: +44 (0) 1283 593064
email: [log in to unmask]
 [alternative email for when all too frequently NHS Net isn't working   [log in to unmask]]