Please be aware that our GPs do not complete fit-to-fly certificates or medical declarations for air travel, extreme sports or other high-risk activities, such as skydiving, bungee jumping, scuba diving or similar activities.

Assessing whether a patient is “fit to fly” or fit to participate in a high-risk activity is not part of NHS General Medical Services. GPs are not trained or indemnified to make these specific fitness-to-participate decisions, and therefore we are unable to provide certification for these purposes.

The responsibility for assessing fitness to participate lies with the airline, travel provider, sports organisation or activity provider.  If a private provider or organisation needs access to your medical history, you can access your records via the NHS App.  If you need assistance setting up or using the NHS App, our Patient Access team is happy to help.

We appreciate your understanding.

At Kearsley Medical Centre, we understand that some patients choose to access private healthcare because of long NHS waiting times, and we understand that arranging ongoing prescriptions and monitoring can be challenging.  However, Kearsley Medical Centre is unable to enter into shared care agreements with private healthcare providers.

This means that if you receive a prescription from a private specialist, our GPs cannot take over prescribing or the associated monitoring, such as blood tests or ECGs, under a private shared care arrangement. This policy also applies to patients who have accessed a private provider through the NHS Right to Choose pathway.

This policy helps ensure that prescribing and monitoring remain with the specialist service responsible for your treatment.

Which treatments does this affect?

This policy most commonly affects patients receiving specialist treatment for:

• ADHD
• Gender incongruence or gender-related healthcare
• Conditions requiring disease-modifying antirheumatic drugs (DMARDs), such as rheumatoid arthritis and other autoimmune conditions

It may also apply to other treatments that require specialist prescribing and monitoring.

What are your options?

If you are currently receiving treatment from a private specialist, there are several options you may wish to consider.

1. Continue with your private provider

You can continue receiving prescriptions, consultations and any required monitoring through your private healthcare provider. You would remain responsible for the associated costs.

2. Request a referral to an NHS specialist

You can contact the practice to discuss a referral to an appropriate NHS specialist service.

An NHS specialist would need to assess your treatment and establish an appropriate management plan. Your GP may only be able to take over prescribing under shared care once the relevant NHS specialist has reviewed your case and an NHS shared care agreement has been formally agreed.

Please be aware that NHS waiting times may apply.

3. Ask your Right to Choose provider about ongoing prescribing

If you are receiving care through an NHS Right to Choose provider, you can ask whether the provider can continue prescribing your medication and arrange the necessary monitoring for the duration of your treatment.

The arrangements available will depend on the provider and the service it offers.

4. Remain on the NHS waiting list

If you have already been referred to an NHS service, you can remain on the waiting list while considering your options. If you have not yet been referred, you can discuss an NHS referral with the practice.

Why does the practice have this policy?

Our priority is to provide safe, consistent and sustainable care for all our patients. Shared care arrangements require clear responsibilities between the specialist and the GP, as well as appropriate arrangements for prescribing, monitoring and clinical advice.

Our policy reflects several important considerations:

• Clinical safety: Some specialist medicines require specific monitoring and expert interpretation of results. The clinician responsible for treatment must be able to provide appropriate oversight and advice.
• Clear clinical responsibility: Shared care requires an agreed division of responsibilities between the specialist and the GP, including arrangements for reviewing results, managing side effects and responding to concerns.
• Resources and NHS funding: GP practices have limited NHS resources and must ensure that the work they undertake can be supported safely and appropriately.
• Continuity of care: Prescribing arrangements need to remain safe and sustainable, including when a patient's circumstances or access to specialist services change.
• Consistency: Applying a consistent policy helps the practice manage requests in a transparent and equitable way.

For these reasons, Kearsley Medical Centre does not accept shared care agreements with private healthcare providers.

Need further advice?

If you are unsure how this policy affects your treatment, please contact the practice to discuss the appropriate next steps.

Please do not stop or change your medication without seeking advice from your prescribing clinician. If you are concerned that your prescription may run out, contact your current specialist or prescribing provider as soon as possible to discuss your options.

We understand that some patients will chose to access health care privately, which is a choice you are entitled to make. Whilst we are grateful for the support of our private consultant colleagues and sympathise with the potential delays for hospital appointments, there are a few things that you need to be aware of before making this decision.

Please read the information below regarding our position on private work at Kearsley Medical Centre.

NHS guidance states:

Patients can pay for additional private healthcare while continuing to receive care from the NHS. However, in order to ensure that there is no risk of the NHS subsidising private care:

• It should always be clear whether an individual procedure or treatment is privately funded or NHS funded.
• Private and NHS care should be kept as clearly separate as possible.
• The patient should bear the full costs of any private services. NHS resources should never be used to subsidise the use of private care.
• The arrangements put in place to deliver additional private care should be designed to ensure as clear a separation as possible of funding, legal status, liability and accountability between NHS care and any private care that a patient receives

Organising tests requested by private providers:

Sometimes Kearsley Medical Centre receives requests from private providers asking for investigations such as blood tests or scans but complying with these requests is outside the scope of NHS primary medical services.

Our contract with the NHS states that a GP should only carry out investigations and prescribe medications for a patient where it is necessary for the GP’s care of the patient and the GP is the responsible doctor. These decisions would usually be made after the GP has had a consultation with the patient directly and agreed a plan.

At Kearsley Medical Centre, if we consider the proposed investigations to be clinically appropriate and feel competent to both interpret them and manage the care of the patient accordingly, then we may proceed with arranging the tests or investigations once we have done our own assessment in a consultation. However, if we do not have the knowledge or capacity to undertake these actions, we will decline and advise the patient and the private provider to make alternative arrangements.

Prescribing medication requested by a private provider:

GMC Good Medical Practice states that doctors in the NHS and private sector should "prescribe drugs or treatment, including repeat prescriptions, only when they have adequate knowledge of the patient’s health and are satisfied that the drugs or treatment serve the patient’s needs."

At Kearsley Medical Centre, if we prescribe a medication, we take over the full responsibility for that prescription, regardless of whether a private provider has requested it. If we feel competent to prescribe a medication suggested by a specialist and it is within the guidance, we are happy to do this. However, there are instances where we may not be able to prescribe medications recommended by your private provider. Examples include:

• Where the GP or practice does not have the expertise to safely prescribe and/ or monitor a specialist drug.
• Where we have been asked to prescribe a medication which would only be prescribed by a hospital consultant in the NHS. Common examples include ADHD medications, mood stabilisers such as Lithium and immunosuppressant medications such as Methotrexate/Hydroxychloroquine.
• Where there has been insufficient information from the private provider regarding the rationale for using a medication.
• Where the use of the proposed medication is not in line with local or national prescribing guidance.
• Where the proposed medication is not licensed for the medical condition described.

If we are unable to prescribe a medication requested by a private provider for one of these reasons, we will pass this back to the private provider. 

If we feel able to prescribe the medication requested by the private provider, we would expect them to provide the first prescription lasting at least 28 days (this is the same with NHS clinics), to give us time to receive, process and then action the request.