How a private specialist referral is arranged

How a private referral works

A private referral moves your care from a generalist to a consultant who specialises in your problem. A GP usually writes the referral after seeing you, and a care liaison can then find the right consultant, book the first appointment, arrange any tests so the results are ready, and bring the consultant’s letter back to your own doctor [1].

A specialist often sharpens the diagnosis a referral starts with. In a study of 286 patients referred from primary care to an academic centre, the final diagnosis was better defined in 66% and distinctly different in 21% [2]. That is the point of a good referral, a clearer answer and a plan.

What a referral letter contains

A good referral letter gives the consultant everything needed to see you once and decide. It sets out the question to be answered, your symptoms and how long you have had them, the examination findings, results already done, your medicines and allergies, and anything that makes the case urgent.

The letter that comes back matters as much. Guidance from the Academy of Medical Royal Colleges says a clinic letter should include the reason for the visit, the history and findings, the questions asked with their answers, the agreed plan, a list of medicines with explanations of any changes, and who does what next [3]. It also encourages consultants to write to you directly in plain English [3].

Choosing the consultant

The right consultant is the one whose practice fits your problem, which is a narrower question than who is nearest or best known. A liaison can explain why a name was chosen before you agree, and can ask for a particular consultant, though nobody can promise a named consultant on a named day [1].

You can look a consultant up yourself. The Private Healthcare Information Network publishes information about the safety, quality and costs of private healthcare, with a search for consultants and hospitals [4].

How long you wait

Private waits are usually short, though they depend on the specialty and on the consultant’s diary. Through navigation, a first appointment is offered within 48 hours when the case is urgent and within 5 working days when it is routine, meaning a real date with a real clinic that you can accept or decline [1].

Some consultants decline a referral because the problem is outside their practice or their list is closed. When that happens you hear the same day and are offered the next name [1]. Specialists, scans and hospital care arranged for members are at member rates, with the price given before anything is booked [5].

Which costs are billed separately

The referral, the consultant and any tests are separate fees, and you should know each before you agree. Under an Order made by the Competition and Markets Authority, a consultant seeing private patients must give you the estimated cost of the outpatient consultation in writing when the appointment is confirmed [6]. Before further tests or treatment, the consultant must give the reason, an estimate of the consultant costs and a statement of anything the estimate leaves out [6].

At The Wellness the navigation fee pays for your liaison, the finding, the booking and the letter back into your record, while the consultant and any tests or scans are billed by the people who do them [1]. If you are insured, the consultant and tests are often covered with a GP referral, the navigation fee usually is not, and you receive an itemised receipt [1]. Check the terms of your policy with your insurer before the first appointment [6].

Questions to ask before you agree

Ask these of whoever arranges the referral, and keep the answers in writing.

• Why this consultant, for this problem?
• How soon is the first appointment, and where?
• What is the consultant’s fee for the first consultation?
• Which tests are needed first, and what do they cost?
• Does my insurer need a referral in a particular form?
• Who receives the consultant’s letter, and who explains it to me?

When a referral is the right route

A referral suits a problem that needs a specialist’s examination, test or treatment, a diagnosis you want confirmed, or a condition your GP wants a specialist to plan. Many problems are settled by a GP without one, so ask whether a referral will change what happens next.

A referral is not an emergency route. For chest pain, signs of a stroke or a serious injury, call 999 in the UK or the local emergency number [1].

How The Wellness can help

Navigation is £295 a case, or included in membership [1]. You do not need a letter to start. If you have one, your liaison works from it, and if you do not, one of our GPs sees you first, usually the same or next day, and writes the referral, charged at the usual GP fee of £150 for a standard appointment [1] [7]. You approve every booking, and the letter comes back to your record, where your doctor reads it with you [1].

Every doctor is GMC registered, and regulated services are delivered through registered partner clinics and accredited laboratories. Our clinics are on Baker Street in Marylebone and Eccleston Street in Belgravia, and appointments can be arranged with partners in 12 cities beyond London.