Private treatment or services accessed in the UK or abroad
If treatments have already been started under private arrangements, the overarching assumption is that a whole package of care has been purchased and its potential complications taken account of and explained to the patient. Any follow up care and maintenance treatment is considered private. Therefore, it would be unreasonable to expect the NHS to pick up the costs associated with private treatment unless there is a medical emergency, or some other exceptional circumstance. Running out of funds, whilst unfortunate, is not exceptional. Not withstanding this point, it is recognised that an individual who has commenced treatment that would have been routinely commissioned by the NHS on a private basis can, at any stage, request to transfer to complete the treatment within the NHS.
However, at the point that the patient seeks to transfer back to NHS care, the patient would be required to be reassessed by an NHS clinician in line with the relevant current policy to ensure compliance with the latest criteria. In addition, where criteria is met, the patient will not be given any preferential treatment by virtue of having accessed part of their care privately and will be subject to standard NHS waiting times. Likewise, if a device has been privately purchased and initiated, the NHS will not pick up the costs of consumables or maintenance, unless the patient meets NHS criteria. For example, a patient who has purchased a continuous glucose monitor would be expected to have sufficient funds to purchase consumables for the life of the device unless they meet the NHS criteria for the device.
This information is supported by the STW ICS Value Based Commissioning & Evidence Based Interventions Policy.
