The GP’s place in private healthcare
How does a patient’s GP fit into private healthcare?
In the NHS, it’s straightforward: the GP is the ‘gatekeeper’, and more than likely will be the person who has referred the patient for specialist care. Information about the care and treatment provided will routinely be passed back to the GP. Even if the referral has come from another specialist, information will still be passed back to the GP, so that they can fulfil their role as co-ordinator of services for the patient.
But what about private healthcare? The patient may not have told their GP that they are seeking a specialist opinion or treatment. So where do you stand as their private healthcare practitioner?
What does the HCPC & GMC say?
Interestingly, regulatory bodies such as the Health and Care Professions Council (HCPC) and the General Medical Council (GMC) do not recognise a distinction between private and public healthcare. Their guidance states that healthcare practitioners have a duty to respect the confidentiality of patients’ information, and only disclose it in certain circumstances. These include, for example, when required by law, or with the consent of the patient. The GMC guidance goes on to explain that there are circumstances in which patients can be considered to have given implied consent to sharing information. This includes with other members of the healthcare team, although good practice would require displaying posters explaining that this will happen. This, though, leads to one big question:
Would a patient recognise their GP as part of the ‘healthcare team’ if they have booked a private appointment with another healthcare practitioner and not involved their GP?
You certainly cannot assume that this would be the case. In any case, as the GMC guidance makes clear, seeking consent to share confidential information with others, including other members of the healthcare team, is a matter of having respect for the patient. And in purely practical terms, how would you communicate with the patient’s GP if you don’t know who they are?
We suggest that good practice would be to have a conversation about sharing information with the patient at the first consultation. You should explain that it would be helpful if their GP knew about all their healthcare, including private healthcare, because of the GP’s role in co-ordinating care. You could also point out that it avoids the risk of any contradictory prescribing and/or treatment, and so safeguards the patient.
You should set out how you would usually prefer to communicate with the GP, and what you would normally tell them, and ask whether the patient agrees to you doing so. If you are going to be treating the patient on an ongoing basis, this communication should be regular, rather than one-off, and you should explain this too.
You should also encourage the patient to tell their GP about any treatment themselves, not least because it can take time for letters to arrive and be included in records. The patient can often be the fastest carrier of information, and they need to understand how important this could be in the event of any emergency.
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