It's a familiar scenario - I have no idea how much we subsidise PP. Usually seems to get caught in a viscious loop of patient seen in private, with recommendation of treatment/investigations but PP aspect closed once they leave the clinicians office.
One colleague is honest - "it costs too much for self-pay to have tests done at***** hospital" but at least he takes old fashioned request forms from lab with him, marking them as "private patient"
I find that fertility clinics are the biggest problem (we of those we catch). Suspect patients told "just get these tests done at your GP". Where test is unusual/expensive from a GP source we usually catch those and I email surgery to ask them to confirm if patient is being treated on NHS or private.
Answer - ? devolve budget to the GPs??? They hate spending money :-), alternatively if problem is big enough as NHS counter fraud to look at it!
DJ
-----Original Message-----
From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Loughrey, Clodagh
Sent: 05 September 2015 09:31
To: [log in to unmask]
Subject: private healthcare / lab tests on NHS?
Is anyone having problems with test requests at the private / NHS interface? I am specifically referring to the scenario of a private healthcare provider asking patients to attend their GP for tests that are needed for their management and getting the GP to pass the results on to the HC provider. This seems to be a small but steadily growing problem and I was wondering if it is being recognised elsewhere what others have done about it.
Part of the problem is that some (many? most?) GPs are complying with this, either because they feel the patient shouldn't have to pay for private healthcare, or for a quiet life, or both. But the bigger problem is that the private providers should not be putting GPs in this position in the first place by asking patients to attend them for tests needed for their private healthcare. We have a facility for GP practices to have a private cypher code for private tests so they are billed directly (and so should bill the patient themselves if they want to get involved in taking the blood). But not all have taken this option so have no means to bill patients.
The most common scenario that we can identify (and the source of such requests is not often readily discernible) is weekly hormone profiles requested by private fertility clinics. The timing of these is obviously important so it seems reasonable for the private provider to ask the GP to be involved if the timing doesn't fit with when the clinic runs, pay the GP and practice for their time and consumables, and pay for the testing via the private cypher code. But most don't offer this at all. Clinics are even asking GPs to do AMH.
But the most blatant example is possibly in the follow up of bariatric surgery patients - a GP forwarded us a copy of a letter from a nurse in a private healthcare facility who had recently reviewed a patient following bariatric surgery in the same facility, and said "I would be grateful if you would do the following blood tests and fax the results to us : U+E, LFT, bone profile, magnesium, full blood picture, ferritin B12 and folate, vitamin D, parathormone, zinc". This work is not time-sensitive at all and I see no excuse to be asking GPs to do it, other than cutting private costs/saving the company money.
I am in the process of drafting a letter to the various private healthcare facilities advising that they can't use our labs or our GPs like this (and a similar letter to the GPs supporting their asking for payment). We are happy to work with them, but not to do their work for them, gratis.
Grateful for any wider experience of this issue.
Clodagh
CM Loughrey MD MRCP FRCPath MA
Consultant Chemical Pathologist
Clinical Director Laboratories
Belfast HSC Trust
Tel: 0044 28 950-48823
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