Transfer of Care

We are seeing increasing numbers of patients asking for us to take over their care following a private consultation or care provided abroad outside of the NHS, and there are times when we are not in a position to provide the tests or follow up that has been requested. For example, we are often being asked to provide care which is not within the remit or clinical sphere of knowledge of a GP. It is not always appropriate or safe for a GP to undertake monitoring or follow up for conditions normally looked after by specialists. We also do not have access to some of the specialist tests and monitoring that is available at hospitals or via private providers.

It is not possible for us to list in full what we can and cannot provide by way of testing and follow up, however :

• We do not undertake blood tests or monitoring unless a GP within the practice has added a blood test request to your records, or a local NHS consultant has provided you with a blood test form.
• GPs must be able to interpret the results of any tests requested at the practice, in many cases we are being asked to carry out tests and follow up on results that GPs are not trained to interpret.
• We do not have access to the same range of blood tests as they do within hospitals – your specialist may be able to get certain tests that we cannot.
• We can’t prescribe every drug. NHS Surrey Heartlands ICB provides GPs with a formulary of drugs which they can prescribe from. Though your specialist or private provider may want you to have certain medications, this does not mean we are always able to prescribe them.

We appreciate that some patients have to travel long distances to access highly specialist care, unfortunately this does not mean we are able to take over follow up unless the GP feels they are clinically safe to do so. This decision is for the GP, even if the specialist is happy to hand over care it, the final decision rests with the GP.

Private providers especially may suggest treatment or procedures that are not available via the NHS. There are sometimes routes that can be taken to apply for specific funding via the ICB, but this is for a very limited range of conditions, can be difficult to secure and falls outside of our remit. We ask patients to understand that where we do decline to take over follow up or monitoring, it is for their own safety.

What happens if I need to transfer my care back to the NHS?

If after seeing  a specialist privately you want to be back under NHS care, national regulations allow for you to transfer back. This transfer should be done by the private specialist who is overseeing your care to avoid delays  and because they know the full details of your condition and where best to refer you to.  .

Follow Up Care Following Procedures Carried Out Outside the UK

We are also experiencing patients returning from surgery abroad with no correspondence covering the procedure that has been carried out and what after care is needed.  You need to return to the UK with all of the information you need to ensure your recovery, which you will need to arrange with another private provider in the UK.  Local providers can’t provide your follow up without hospital or clinic letters covering your procedure and GPs are are not able to take over routine surgical follow up for procedures carried out abroad.  Acute issues such as post-operative infections may be seen on the NHS by a GP or hospital as appropriate.

Bariatric or Weight Loss Surgery (gastric bands/sleeves/bypass)

Alongside plastic surgery these procedures are by far the most common reason that patient’s travel abroad for cheaper access to surgery that isn’t widely available on the NHS.  Patients need to be aware that NHS GPs do not provide surgical follow up and monitoring for any patients who have had bariatric surgery, they simply don’t have the expertise.  This needs to be provided by a specialist, at least until the patient has stabilised a year or two after the procedure.  If patients have a procedure of this nature on the NHS they are often followed up by the specialist for 2 years post op, before they are stable enough to return to routine GP care.  You need to make similar arrangements for follow up and monitoring where you have your procedure carried out privately.

We ask all patients to understand that we are a primary care general practice and that is what we are funded and trained to provide, there will always be times when specialist input is the only thing that is safe and appropriate.