We have certainly spotted this with AMH and when we have the GP has confirmed that requested by the private sector. We have agreed to forward the sample to a private lab after the GP has confirmed with the patient that they are prepared to pay directly and have forwarded this info with the sample - all time-consuming for us but difficult for us to bill primary care patients directly.
I assume like us that the lab tests requested by your GPs are billed by your trust to the CCG. Should we not be asking CCGs if they are happy to pay for these? If they are then not a problem - if not then the CCG should address with the GPs and private clinics and come to an arrangement for reimbursement. AMH are easy to spot but there must be a lot of other instances where this is occurring that the lab cannot detect.
Best wishes
Anne
Dr Anne Dawnay PhD FRCPath
Consultant Biochemist
Clinical Lead UCLH Clinical Biochemistry & Chair UCLH POCT Committee
Tel 020 344 72954 direct dial
Date: Sat, 5 Sep 2015 08:46:53 +0000
From: Jonathan Kay <[log in to unmask]>
Subject: Re: private healthcare / lab tests on NHS?
There is a problem.
There’s something similar within the NHS with tertiary care in London, where investigations need to move across traditional boundaries.
What do we need:
1 Data standards that are consistent in lots of ways, including across primary, secondary and tertiary care.
2 Statements and agreements about professional responsibilities and behaviour across all investigations.
I’m working on both… and need support.
Jonathan
On 5 Sep 2015, at 09:31, Loughrey, Clodagh <[log in to unmask]> wrote:
> 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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