Private treatment

[CAH706]

Hi

After a bit of advice if anyone has been in this position.

I have been referred for an appointment at the local hospital for a health issue I have. At the time of the referral I was advised that it was a c13 week wait. This was longer than I would have liked but I understand the current pressure on the NHS at the minute.

Letter arrived from the hospital advising if I hadn’t heard anything by the 13 week mark, give them a call. I hadn’t heard anything so rang them and they advised I was in the system but wait time for appointment was > 49 weeks.

This is too long given the issue I have as I’m sure post appointment I’ll need an op to resolve things so I’m looking to go private.

I’ve contacted Nuffield to see what they offer but a few questions;

Outside of Nuffield are there any other good providers of private treatment I should consider? I only went with them initially as I’ve used them before in the past when I had private Heath care insurance.

I’ll be paying for any treatment. If I get a diagnosis am I able to go back into the NHS health care route for the op or am I private once I start going down this route?

Am I likely to need a referral letter from the doctor? I have a letter from the hospital confirming I’ve been referred from the doctor but that OSS now 15 weeks old.

Thanks

[Collectingbrass]

CAH706 said:

Hi

After a bit of advice if anyone has been in this position.

I have been referred for an appointment at the local hospital for a health issue I have. At the time of the referral I was advised that it was a c13 week wait. This was longer than I would have liked but I understand the current pressure on the NHS at the minute.

Letter arrived from the hospital advising if I hadn’t heard anything by the 13 week mark, give them a call. I hadn’t heard anything so rang them and they advised I was in the system but wait time for appointment was > 49 weeks.

This is too long given the issue I have as I’m sure post appointment I’ll need an op to resolve things so I’m looking to go private.

I’ve contacted Nuffield to see what they offer but a few questions;

Outside of Nuffield are there any other good providers of private treatment I should consider? I only went with them initially as I’ve used them before in the past when I had private Heath care insurance.

I’ll be paying for any treatment. If I get a diagnosis am I able to go back into the NHS health care route for the op or am I private once I start going down this route?

Am I likely to need a referral letter from the doctor? I have a letter from the hospital confirming I’ve been referred from the doctor but that OSS now 15 weeks old.

Thanks

You'll need a referal from your GP and they can do 3 things:

Find you another NHS hospital with a shorter waiting list (stop laughing)
Refer you to a specialist they know locally
Give you a "to whom it may concern referral" and leave you to find your own

The second one is usual for your case, the third is more usual when you have an insurer or preferred private provider to go to.

[Mojooo]

Who do you actually want to see?

I went to see a knee surgeon recently and I didn't need any referral - just paid £250. He works out of Nuffield and Spire hospitals (as well as NHS).

After you get a diagnosis he can then summarise it and send it back to the GP in a letter for NHS to continue or you can carry on and pay private for the Op.

[CAH706]

Thanks both

It’s slightly frustrating as the doctor misdiagnosed me initially. I paid for private treatment based on his diagnosis but when I saw the specialist (paid by me) he diagnosed me with something else. He did advise that I needed to go back to the doctor to get a correct referral as I need MRI and various other tests to determine what Op I would need to correct things.

I went back to the doctor and asked for a hospital referral, which he made for me. We discussed private treatment but given the c13 wait time it didn’t seem necessary. The hospital wait time now though at 40+ weeks is too long given my condition.

I’ll ask the doctor to give me a referral letter and I’ll sort directly from there.

[The Leaper]

I have had both knees replaced in 2023 and 2024, all done privately.

The way the process worked for me was:

1. Saw my GP. She arranged x rays on the NHS, and concluded I needed the surgery.
2. GP gave me an open letter of referral.
3. I sent the letter to my PMI who accepted the claim and indicated options as regards surgeons, private hospitals etc, ie I had a choice.
4. I chose a private hospital 3 miles away, saw the surgeon, he agreed I needed surgery in both knees (one at a time but you can have both done although that's rare), and arranged this for 3 months later.
5. Right leg knee was done May 2023. Took 4 months to recover.
6. In September 2023 surgeon proposed doing my left knee in November 2023 but for various reasons I postponed this to May 2024, so now done and I'm in recovery mode.

Hope this helps.

R.

[Mojooo]

You can also get an MRI done privately and then go back to the private Dr with it.

If it diagnoses something serious you could also take it back to the NHS GP I spose.

[Mojooo]

What I have done in past with my knee

1 - Go to physio -be told its bad
2 - Go to private surgeon and be told to get MRI
3 - Get MRI private
4 - Go back to private surgeon and confirm op needed
5 - private surgeon puts me on his NHS waiting list

More recently I have skipped 1 and 2 and got the MRI done first and then went to the surgeon to get diagnosis. He wanted me to get an X Ray which I also did privately and now need to go back and discuss

If I need an Op I will either have to pay private or he can refer me back to the NHS but with the associated wait.

[CAH706]

Thanks all

That’s really useful information and helps a lot!

[WyrleyD]

Mojooo said:

What I have done in past with my knee

1 - Go to physio -be told its bad
2 - Go to private surgeon and be told to get MRI
3 - Get MRI private
4 - Go back to private surgeon and confirm op needed
5 - private surgeon puts me on his NHS waiting list

More recently I have skipped 1 and 2 and got the MRI done first and then went to the surgeon to get diagnosis. He wanted me to get an X Ray which I also did privately and now need to go back and discuss

If I need an Op I will either have to pay private or he can refer me back to the NHS but with the associated wait.

This happened to a mate of mine with his hip replacements, paid for a private consultation and op for the first one and the surgeon put him on his NHS list as he operated at Spire and the NHS, had his second one done in the Spire clinic but funded by the NHS.

[Mojooo]

FWIW I was told my NHS Hospital has a wait of 60 weeks and this must come down to 52 weeks by next year.

They will farm out simpler operations to private hospitals but not more complex/expensive ones.

[The Hypno-Toad]

Shop around.

I found the prices were about the same for my procedure through 2 different providers but the atmosphere in one hospital was so much better than the other. I got the feeling that the first one wanted to mine your insurance company for as much as possible and if you weren’t an insurance customer, you weren’t really wanted. The surgeon came across as utterly obnoxious too.

The second one I went to was totally different. Friendly and welcoming, the surgeon was infinitely more approachable than the other guy. This impression was confirmed when I had the operation, they couldn’t have been more helpful and it was a great success. Felt very guilty going private beforehand but not after, couldn’t have gone better.

So just try a couple of providers and work out the vibes of the place and pick the place where you feel most comfortable would be my advice.

[Big E 118]

Good advice above, to add I'd ask all the hospitals you contact if they do any fixed price packages for the type of condition you need treated. If it's an operation you may pay your initial consultation up front then they can offer a fixed price package to cover consultant/hospital/anaesthetist and any biopsy/lab fees plus a follow up or two.

If you don't get a fixed price package make sure you are clear of all the costs up front, it can be a lot more expensive than you anticipate.

[The Gauge]

I'm considering joining a private healthcare scheme provided my my employer, costs £88/month for family membership. It describes itself as a

'self financing scheme set up under a trust deed to provide private medical advice and treatment'

I need to obtain some finer details of the scheme first so I know what's included, but at age 52 I'm already seeing changes in my health.

[CAH706]

Thanks again for the excellent advice.

I’ve used a couple of different hospitals privately in the past and been happy with them so I’d ideally like to find someone who operates out from one of them.

The main difference this time is I’m paying myself rather than via a health insurance scheme.

[The Leaper]

The Gauge said:

I'm considering joining a private healthcare scheme provided my my employer, costs £88/month for family membership. It describes itself as a

'self financing scheme set up under a trust deed to provide private medical advice and treatment'

I need to obtain some finer details of the scheme first so I know what's included, but at age 52 I'm already seeing changes in my health.

Things I'd look for/consider include the following:

1. Who is the underlying insurance company? Some have good reputations, others not so good.
2. About £1000 pa for family cover looks very good. Does the employer pay any part of the total monthly cost? If so, it will count as a BIK so you pay income tax on that amount.
3. Most private heathcare plans cover in patient costs 100%. Most plans do not cover out patient costs 100%: usually there's an annual limit (sometimes called an excess) and once exceeded you pay the costs. So, such items as pre op consultations, pre op medical assessment including all blood tests, pre op physical assessments, post op consultations, post op physiotherapy sessions, all count as out patient costs and fall in to the annual limit.
4. Drugs and medicines prescribed while an in patient will be fully covered. Drugs and medicines prescribed at the time of hospital discharge are not usually covered and also are not covered by the NHS as you have had private treatment, so the cost is to be met by you.

R.