While it is not vital when going private for healthcare, many specialists will not do so without a referral letter from your NHS or private general practitioner (GP). Once you have received your GP referral letter, it is up to you to decide where you go.
Letters of referral are written by a GP, which is often an NHS GP, but they can also be issued privately. Patients receive referral letters when they must seek specialist treatment or advice.
A referral letter will contain the following information:
However, it is not make-or-break. You can still seek out private treatment without the need for a GP referral.
The need for a referral letter can arise in different ways. After speaking to your GP, they could decide that you need specialist treatment and write you a referral letter. Alternatively, you may tell your GP that you wish to go private for a particular treatment. In this case, it is unlikely that they will deny you a referral letter. If you have private medical insurance (PMI), a referral letter is essential. This information will be outlined in your policy.
The GP will aim to have this referral letter completed swiftly. Dr Unnati Desai, National Lead for GP Services at Nuffield Health, explains:
“I give a copy [of the referral letter] to the patient, and it tends to be given at the end of that consultation or by the end of the day. They should have a copy of that letter given to them either as a hardcopy or electronic copy.”
Referral letters are essential for patients with PMI. If you wish to go private with insurance, the insurance company will request open referral letters. An open referral letter will not suggest a specific specialist but instead leave it open-ended. This is because people will have differing levels of PMI and they may be restricted on which hospital or consultant they can visit.
“The most important thing also, regarding information that the GP won’t have but the private medical insurer will have, is whether a consultant is ‘fee assured’,” says Desai. “That means that [they check whether] the entire consultation, or potentially operation, will be covered. Or are there going to be any shortfalls that the patient would have to think about paying?”
A GP referral letter is not needed if you are seeking private treatment as a self-paying patient. However, it is recommended for the consultant to gain a more complete understanding of the patient’s unique medical situation. In addition, the GP can also make a specific consultant recommendation. As it is not an open referral, the self-paying patient is not constrained by a PMI policy and can be treated quicker.
If you have PMI, pre-authorisation from the insurance company will need to be obtained first. Before a consultation can begin, the insurance company state which hospital or consultant can be used based on the level of cover.
“Once they've got that pre-authorization, the next step for the patient to phone the secretary to make that appointment. At that time, they're asked to provide a copy of the letter as well as the pre-authorisation,” says Desai. “So, the consultant will have access to that letter before seeing the patient.”
If you are self-paying, then you are free to begin your research. As previously mentioned, you are not constrained by a PMI policy and therefore free to choose. However, caution must be exercised as there are varying costs associated with private healthcare. To avoid any financial blind spots, read about going private without insurance.
In either of these cases, it is critical to do your homework. Comparing local specialists will help you ensure that you receive the best quality of care. GoPrivate can help. We have over 25 years' experience when it comes to making sure patients find the consultant that is right for them. By using our comparison site, we can connect you with a variety of nearby specialists. All it takes is one quick search.
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