Private Healthcare – A Guide

Knoll Medical Practice and Private Healthcare: A Guide for Our Patients

At Knoll Medical Practice, we strive to offer excellent care for all patients. We respect those who opt for private treatment. This page clarifies how our NHS practice works with private healthcare providers to avoid misunderstandings.

Seeking a Private Specialist Opinion

For patients with health insurance:

If your GP decides a private specialist referral is appropriate, they will write a letter with medical details. This can be emailed to you (ensure we have your correct email) or directly to the specialist’s secretary. Wait until you or the secretary receive the letter before booking an appointment, as it contains important information.

Please be advised that completing specific forms required by your insurance company may incur an additional charge for the extra work involved.

For patients without health insurance:

You can book with a private clinic without a referral letter. A summary of your medical history may be helpful for the specialist, which we can provide if needed. Contact the specialist’s team or your healthcare provider/insurer directly for appointments and queries.

Seeing the Specialist

Tests and Procedures:

The specialist is responsible for scheduling and explaining tests, managing pre-test medications, and communicating results.

Due to high demand, our NHS practice cannot provide blood monitoring or procedures requested by private specialists. We will notify the specialist to make alternative arrangements.

Please don’t contact us about test results organised by other doctors. The specialist will discuss these with you, as we likely won’t have access to or be able to interpret the results.

New Medicines:

The specialist will issue the initial prescription for any new medication that needs to be started immediately. Note that private prescriptions presented at NHS pharmacies will incur the full cost of the medication rather than the standard NHS prescription charge.

Your GP may continue prescribing some medications recommended by a specialist on an NHS prescription. This decision is at the GP’s discretion and requires a detailed clinic letter from the specialist outlining the treatment rationale, prescription details (including what it is being used to treat, duration, and required monitoring). Please allow at least seven days for this letter to arrive before contacting the practice.

For urgent prescriptions, please contact the specialist’s team directly.

Private specialists may recommend medications not typically prescribed by NHS GPs. In such cases, you will need to continue obtaining these medications from the specialist.

NHS Prescribing and the South East London Formulary:

Our priority is providing safe and effective care. We adhere to the South East London Joint Medicines Formulary, which categorises medications based on their suitability for GP prescribing.

We may not be able to issue an NHS prescription following a private consultation under the following circumstances:

  • The practice deems there is no clear clinical indication, and an NHS patient would not receive the same treatment.
  • The specialist recommends a new, experimental, or off-license treatment, or one that falls outside formulary recommendations.
  • The GP feels it is outside their competence.
  • The prescription does not adhere to licensed doses or uses as per the British National Formulary.
  • The medication is not generally provided within the NHS.

Shared Care Protocols:

Shared Care Protocols (SCPs) are agreements between specialists and GPs that outline responsibilities for patients requiring specialist medications. These protocols often involve regular blood tests. Without an SCP, it is not safe to prescribe and monitor certain medications, including Disease Modifying Drugs, IVF-related medications, and those for ADHD. SCPs are typically used within the NHS context.

In cases where NHS waiting times are lengthy, SCPs from private providers may be accepted under limited circumstances, provided they align with the South East London Joint Medicines Formularyand are essentially identical to NHS SCPs. Private providers are expected to have facilities for necessary blood tests and physiological measurements.

If an NHS prescription cannot be issued, medication can be obtained privately. It is advisable to consider the cost of the medication and associated monitoring beforehand. For further information, refer to the GMC Safe Prescribing Guidance: www.gmc-uk.org/prescribing-and-managing-medicines-and-devices

Transferring Care Back to the NHS:

To return to NHS care after private treatment, have your specialist manage the transfer. If they can’t, ask them to write to us directly.

Acute Private Consultations:

Requests for tests or imaging from private primary care consultations may be declined, because these providers might not have access to your complete NHS medical record.

Private Blood Testing:

We recognise the concerns regarding private blood testing companies’ potential impact on NHS resources. Requests for investigations into issues potentially caused by these tests will be evaluated at the GP’s discretion.

Private Services for Businesses:

Private services for businesses, including medical assessments, are available. Please contact us to discuss your organisation’s needs. These services will not interfere with NHS patient access.

Shared Care Agreements

At Knoll Medical Practice, we are committed to providing high-quality care to all of our patients. However, there are important reasons why we do not accept shared care agreements from private healthcare providers. These reasons are based on national guidance from the British Medical Association (BMA) and reflect our responsibility to ensure patient safety, maintain quality care, and manage our workload effectively.

What is a Shared Care Agreement?

A shared care agreement is an arrangement where a patient’s care is divided between a private healthcare provider and a General Practitioner (GP) in the NHS. Typically, the private provider will initiate treatment or prescribe medication, and the GP will then be asked to take over part of the treatment or ongoing monitoring of the patient, as outlined in the shared care agreement.

1. NHS and Private Care Work in Different Systems

The NHS and private healthcare systems operate independently, with different frameworks, funding, and expectations. The NHS is publicly funded, and GP practices like ours are required to prioritise NHS-funded work. Accepting shared care agreements from private healthcare providers introduces a complex administrative burden, as we must align private treatments with our NHS responsibilities, often without sufficient funding or resources to do so.

2. Workload and Capacity Management

The BMA’s guidance highlights the pressures on GP practices to manage growing patient demand within an already stretched healthcare system. GP practices are responsible for the ongoing care of all registered patients, which includes monitoring long-term conditions, providing preventive care, and responding to urgent medical needs.

3. Responsibility for Clinical Care and Accountability

As GPs, we are responsible for ensuring the safety and well-being of our patients. This includes making clinical decisions based on the best available evidence and guidelines.

Shared care agreements can create complications in clinical accountability. When a patient is treated privately, the GP may not have access to the full details of their treatment plan, test results, or ongoing management, which can make it difficult to provide safe and effective care. The BMA’s guidance advises that GPs should not take on responsibility for the clinical care provided by a private healthcare provider, as we cannot oversee or control these treatments in the same way we would for NHS treatments. This could potentially lead to clinical risks if adverse reactions or complications arise that the GP is unaware of due to a lack of information or direct involvement.

4. Financial and Resource Implications

Providing care for patients who have been treated privately often requires additional time, effort, and administrative work. GPs may be asked to monitor a patient’s condition, adjust prescriptions, or perform follow-up tests, all of which take valuable time and resources.

Under NHS funding, GP practices are not reimbursed for the time spent managing private care. This could unfairly divert resources away from NHS patients, further exacerbating pressures on the practice and the healthcare system as a whole.

Our Commitment to NHS Care

At Knoll Medical Practice, our priority is providing safe, effective, and comprehensive care to our NHS patients. By not accepting shared care agreements from private healthcare providers, we ensure that our resources are focused on meeting the needs of our NHS patients, without compromise.

We understand that navigating between private and NHS care can sometimes be challenging. If you are receiving private healthcare and have concerns or need support, we encourage you to speak directly with your private healthcare provider to discuss how best to manage your care moving forward.

We appreciate your understanding and cooperation as we continue to deliver the best care possible within the resources available to us.

Occupational Health

We do not provide occupational health services.

This means we cannot:

  • Complete occupational health reports for employment.
  • Provide medical opinions regarding an individual’s fitness for work.
  • Carry out pre-employment medical assessments.
  • Offer advice on workplace health and safety.

Why don’t GPs provide occupational health services?

  • Resource limitations: GPs have limited time and resources to dedicate to comprehensive occupational health assessments, which often require in-depth investigations and specialised tests.
  • Focus on patient care: GP surgeries prioritise the health and well-being of our patients within a general medical setting.
  • Specialised expertise: Occupational health requires specific expertise in areas like workplace risk assessment, ergonomics, and workplace health and safety legislation. GPs may not have the in-depth training or resources to provide these specialized services effectively.
  • Where can I get occupational health services?
  • Occupational Health Clinics: These clinics specialise in providing a range of occupational health services, including pre-employment screening, health surveillance, and return-to-work assessments.
  • Independent Occupational Health Physicians: These are qualified doctors who specialise in occupational medicine and can provide a wide range of occupational health services.
  • Company Occupational Health Departments: Some larger companies may have their own internal occupational health departments.

Firearms Licensing

Please be advised that due to our ethical stance on gun ownership, we are unable to process firearms licence applications. This decision is based on guidance from the General Medical Council (GMC) on conscientious objection.

We understand the importance of responsible gun ownership and the legal requirements for obtaining a firearms licence. However, we believe that our primary duty is to protect life and reduce harm.

If you require a medical assessment for a firearms licence, we recommend contacting:

Occupational Health Services: Some occupational health services may be able to offer this service, particularly if your employment requires a firearms licence.

Another GP Practice: You may wish to contact another GP practice in your area.

Private Medical Services: Private GPs or medical clinics may be able to provide the necessary medical assessment.

Knoll Medical Practice is aware of our responsibilities and obligations under GMC guidance on conscientious objection.

Women’s Health

We offer a range of clinics and services here at Knoll Medical Practice to support women’s health and help maintain a healthy lifestyle.

Breast Screening

The National Breast Screening Programme was introduced in 1988 as an early detection service for breast cancer. It states that all women who are aged between 50 – 70 years of age will be routinely invited for free breast screening every three years. The programme is very successful and currently saves around 1,400 lives per year.

Breast screening aims to find breast cancer at an early stage, often before there are any symptoms. To do this, an x-ray is taken of each breast (mammogram). Early detection may often mean simpler and more successful treatment. When women are invited for their mammogram depends on which GP they are registered with, not when their birthday is.

The screening office runs a rolling programme which invites women by area. The requirement is that all women will receive their first invitation before their 53rd birthday, but ideally when they are 50.  If you are under 50 and concerned about any aspect of breast care, please contact the surgery to make an appointment with your GP.

Useful links: West London Breast Screening

Cervical Screening Test

Cervical screening, or smear test, is a method of detecting abnormal (pre-cancerous) cells in the cervix in order to prevent cervical cancer. The cervix is the entrance to the womb from the vagina. Cervical screening is recommended every three years for women aged 25 to 49 and every five years for women aged 50 to 64 or more frequently if smear results indicates abnormal changes.

Cervical screening is not a test for cancer; it is a test to check the health of the cells of the cervix. Most women’s test results show that everything is normal, but for 1 in 20 women the test will show some abnormal changes in the cells of the cervix.

Most of these changes will not lead to cervical cancer and the cells may go back to normal on their own. However, in some cases, the abnormal cells need to be treated to prevent them becoming cancerous.

Our nurses are qualified to carry out cervical screening and tests in the form of cervical smears. In order to have a cervical smear the patient must have received a letter requesting that they have a cervical smear and the appointment must please be made for when the patient is not menstruating.

These appointments typically take around 15 minutes. For any further information or to book an appointment, please call the surgery.

Useful links

Emergency Contraception

If you’ve forgotten to take your pill, your condom split or you’ve had unprotected sex in the last 72 hours then you may need emergency contraception, and the sooner you take it the better.

Emergency contraception is available free from Contraception and Sexual Health Services, some GPs (family doctors) and most pharmacies (chemists), even if you’re under 16.

If you’ve had unprotected sex or your condom failed, it is also really important to consider your risk for sexually transmitted infections and to think about your long-term contraception needs. Please phone the surgery to book an emergency appointment.

If you miss the 72 hours it is still possible to have an emergency coil fitted up to 5 days after unprotected sex. You can have an emergency coil fitted for free at your local sexual health clinic.

Female Vaginal Swabs

Please click he link below to view instructions on how to perform a Self-Swab

Self-Swab-Vaginal-instructions (1)

Post-natal Checks

We offer all eligible patients a post-natal check at around 8 weeks post birth. Our GPs will perform the relevant checks, alongside your baby’s neo-natal checks and aim to schedule the appointment for the same day as baby’s first immunisations, with the Nurse.

In most cases, the Practice will contact new mums to arrange for this to happen. On rare occasions where we are unaware of the birth, please feel free to give us a call and arrange an appointment.

Vaccinations

We offer a range of clinics and services here at Knoll Medical Practice for all your vaccination needs and advice.

Childhood Immunisations

One of the most important things that a parent can do for their child is to make sure that they have all their routine childhood vaccinations. It’s the most effective way of keeping them protected against infectious diseases.

Ideally, children should have their jabs at the right age to protect them as early as possible and minimise the risk of infection.

Find out which jabs your child needs, when they need them, and what the benefits of each jab are.

Please call the surgery to make an appointment.

For more information please visit the websites below:

Useful links

Flu Immunisation

Seasonal flu is a highly infectious illness caused by a flu virus.

The virus infects your lungs and upper airways, causing a sudden high temperature and general aches and pains.

You could also lose your appetite, feel nauseous and have a dry cough. Symptoms can last for up to a week.

We offer ‘at risk’ groups the flu vaccine at a certain time each year to protect you against the flu virus.

You may be invited for a flu jab if you are:

  • over 65 years of age
  • pregnant

or have:

  • a serious heart or chest complaint, including asthma
  • serious kidney disease
  • diabetes
  • lowered immunity due to disease or treatment such as steroid medication or cancer treatment
  • if you have ever had a stroke
  • If you have any queries please contact the surgery.

For more information please visit the websites below:

Useful links

Pneumococcal Vaccine

The pneumococcal vaccine (or ‘pneumo jab’ or pneumonia vaccine as it’s also known) protects against pneumococcal infections.

Pneumococcal infections are caused by the bacterium Streptococcus pneumoniae and can lead to pneumonia, septicaemia (a kind of blood poisoning) and meningitis.

Read more about why the pneumococcal vaccination is needed.

Who should have the pneumococcal vaccine?

A pneumococcal infection can affect anyone. However, some people need the pneumococcal vaccination because they are at higher risk of complications. These include:

  • all children under the age of two
  • adults aged 65 or over
  • children and adults with certain long-term health conditions, such as a serious heart or kidney condition

Read more about who should have the pneumo jab.

How often is the pneumococcal vaccine given?

Babies receive the pneumococcal vaccine as three separate injections, at 2 months, 4 months and 12-13 months.

People over-65 only need a single pneumococcal vaccination which will protect for life. It is not given annually like the flu jab.

People with a long term health condition may need just a single one-off pneumococcal vaccination or five-yearly vaccination depending on their underlying health problem.

Travel Clinic

In order to assist us to make a full assessment of the potential risks to your health from your planned travel, we would ask that you make a Travel Clinic appointment with our Practice Nurse. Ideally, this appointment should be made around the time of booking your holiday, at least 6 weeks before you travel.

At your appointment we may ask the following questions to help us plan for your trip:

  • When are you departing and for how long?
  • Where are you going, including the destinations within a country?
  • Where are you staying, e.g. backpacking, camping, hotels?
  • Are you planning to undertake any high risk activities?
  • Have you taken out travel insurance and have you informed the company of any existing medical condition?
  • If female and of child bearing age, is there any possibility you could be pregnant, or are you planning a pregnancy?
  • Do you have any medical conditions, or a history of significant medical illness? (these can influence the choice of malaria tablets we recommend)

Please fill out our Travel Risk Assessment Form before your appointment.

It would help us greatly if you had some awareness of the travel problems that you may be at risk from on your trip before you come for your appointment.

Useful links

Supporting a Healthy Lifestyle

We offer a range of clinics and services here at Knoll Medical Practice to support and maintain a healthy lifestyle.

Alcohol Advice

NHS Advice on drinking recommends that men should not regularly drink more than 3-4 units of alcohol a day and women should not regularly drink more than 2-3 units a day, “Regularly” means drinking every day or most days of the week.

Useful links

Chlamydia Screening

Chlamydia screening is available from the surgery.

Simply ask at reception for a kit. It is a completely confidential service where you can send a urine sample in the envelope provided and receive the results easily.

Sexual Health

A range of sexual health services are offered at the surgery including:

  • Contraception and contraception advice
  • Emergency contraception and emergency contraception advice
  • Testing and treatment for sexually transmitted infections (STIs), such as chlamydia, syphilis, gonorrhoea and genital warts
  • Testing and counselling for HIV and AIDS

If you need advice and support with a sexual health matter or you think you have a problem you would like to discuss, please call the surgery to make an appointment with your GP.

Sexual health services are freely available for everyone.

For more information please visit the websites below:

Useful links

Smoking Cessation

If you’re trying to give up smoking, we can help. Studies show that your chances of success will be greatly improved if you get advice and support from health care professionals to help you stop smoking and if you don’t pay for your prescriptions then giving up is free.

  • The services we offer from the Practice can:
  • Boost your willpower to stop smoking
  • Concentrate your efforts by getting advice from someone who knows your medical background
  • Help you feel that you’re not doing it alone
  • Help you to cope when you are tempted to smoke
  • Monitor improvements to your health so that you can see the benefits

Please call the surgery to arrange an appointment with our smoking cessation advisers.

Useful links

Weight Loss

If you would like to know more about weight and diet advice, we offer a weight management clinic giving you advice on how to lose weight and stay healthy.

A range of options are available to support people with weight loss. To understand which of them may be the best fit for you please arrange an appointment with your GP who will be happy to discuss them with you.

One suitable option may be our Health Trainers who offer 1:1 sessions for people wanting to improve their health and change their behaviour. They can support individuals with healthy eating, weight management and getting physically active.

Many doctors now believe that when it comes to your health, your waist measurement is important.

While knowing your body mass index (BMI) is a good way to decide if you’re overweight, it doesn’t tell the whole story.

BMI is a measure of how healthy your weight is for your height. You can work out what your BMI is by using the NHS Choices BMI healthy weight calculator.

If you have a high BMI, you’re likely to be carrying extra fat. But your health could be at greater risk depending on where you store that fat.

Having a large amount of tummy fat (compared to fat around your bottom or thighs) makes you more likely to develop diabetes and heart problems.

A healthy waist circumference for men is less than 94cm (37 inches), and for women it’s less than 80cm (32 inches).

Losing weight and keeping it off isn’t easy, but it has many benefits. You may only need to make small changes to your lifestyle to maintain a healthy weight.

If you’d like to find out more about how you can lose weight in a healthy way please book an appointment with one of our nurses.

For more general information about weight loss, please see the websites below:

Useful links

Private Medical Report Services

Our practice has decided to outsource our medical reporting to MediData, who will process your medical report using their system, eMR.

What is eMR/MediData?

MediData is a NHS Digital accredited company who have developed a digital system called
eMR, which enables GP practices to create digital, GDPR compliant medical reports.

eMR helps GP Surgeries with data security, speed and efficiency

eMR also helps you to easily see your medical data, stay in control of it and decide who you
want to share it with.
MediData has worked hard to develop their NHS GP IT Futures accredited technology, eMR,
which interfaces with our GP practice’s system to extract your medical record. This means you can receive a full copy of that information securely and share it with others as you wish, keeping your data safe.  If you wish to speak to a member of the MediData team regarding your medical report, or any concerns you may have regarding your data, please contact the MediData directly on:

Phone – 0333 3055 774
Email – connect@medi2data.com

Practice Services

Back to Practice Services

Planning a Family

Antenatal care

Antenatal care is the care and help you receive from health professionals during the course of your pregnancy. It is important you take good care of your own health and that of your unborn baby during pregnancy.

As soon as you find out you are pregnant, you should get in touch with us to find out more information on the services and support that are available to you.

Useful links

Family Planning

Our family planning clinics offer free, confidential advice and information about contraception and sexual health.

We provide a range of services including:

  • Confidential advice about contraception
  • The combined oral contraceptive pill
  • The Progestogen-only pill
  • Progestogen injections
  • Limited supplies of free condoms
  • Free emergency contraception
  • Confidential advice about STIs
  • Cervical screening
  • Unplanned pregnancy advice
  • Free pregnancy tests
  • Pre-conception advice and fertility awareness information
  • Fitting and checking of caps, diaphragms, and coils (intrauterine devices, or IUDs)

Please book an appointment (through reception or via our online services) with your GP to discuss any of the above in more detail.

For more information please visit the websites below:

Useful links

Emergency Contraception

If you’ve forgotten to take your pill, your condom split or you’ve had unprotected sex in the last 72 hours then you may need emergency contraception, and the sooner you take it the better.

Emergency contraception is available free from Contraception and Sexual Health Services, some GPs (family doctors) and most pharmacies (chemists), even if you’re under 16.

If you’ve had unprotected sex or your condom failed, it is also really important to consider your risk for sexually transmitted infections and to think about your long-term contraception needs. Please phone the surgery to book an emergency appointment.

If you miss the 72 hours it is still possible to have an emergency coil fitted up to 5 days after unprotected sex. You can have an emergency coil fitted for free at your local sexual health clinic.

Neo-natal Checks

Some newborn babies are released from hospital without a detailed examination. If this is the case, our GPs are happy to perform the relevant checks, either in the surgery, or in comfort of your own home, depending on which is easier for you.

In most cases, the Practice will contact new mums to arrange for this to happen, on rare occasions where we are unaware of the birth, please feel free to give us a call and arrange an appointment or visit.

Postnatal Care

Postnatal care extends for between 6-8 weeks after the birth of your baby. During this period, routine checks are carried out by the health visitor and you and your baby’s recovery is monitored.

During your postnatal care you will find out about feeding, potty training, illnesses, safety and more. You will be able to ask your health visitor questions and request advice.

Useful links

Preconception Advice

If you are planning to have a baby or you need to know more information about how to look after yourself and your unborn baby, please book an appointment with your GP.

We can provide you with all the information you need to know to have a happy and healthy pregnancy.

Useful links

NHS Health Checks

Working together to improve your health

Everyone is at risk of developing heart disease, stroke, diabetes, kidney disease and some forms of dementia. The good news is that these conditions can often be prevented – even if you have a history of them in your family. Have your free NHS Health Check and you will be better prepared for the future and be able to take steps to maintain or improve your health.

Visit NHS Choices – Health Checks for further information.

Why do I need an NHS Health Check?

We know that your risk of developing heart disease, stroke, type 2 diabetes, kidney disease and dementia increases with age. There are also certain things that will put you at even greater risk. These are:

  • being overweight
  • being physically inactive
  • not eating healthily
  • smoking
  • drinking too much alcohol
  • high blood pressure
  • high cholesterol

Both men and women can develop these conditions, and having once could increase your risk of developing another in the future.

  • In the brain a blocked artery or a bleed can cause a stroke.
  • In the heart a blocked artery can cause a heart attack or angina.
  • The kidneys can be damaged by high blood pressure or diabetes, causing chronic kidney disease and increasing your risk of having a heart attack.
  • Being overweight and physically inactive can lead to type 2 diabetes.
  • If unrecognised or unmanaged, type 2 diabetes could increase your risk of further health problems, including heart disease, kidney disease and stroke.

What happens at the check?

  • This check is to assess your risk of developing heart disease, type 2 diabetes, kidney disease, and stroke.
  • The check will take about 20–30 minutes.
  • You’ll be asked some simple questions. For example, about your family history and choices which may put your health at risk
  • We’ll record your height, weight, age, sex, and ethnicity.
  • We’ll take your blood pressure.
  • We’ll do a simple blood test to check your cholesterol level.

What happens after the check?

  • We will discuss how you can reduce your risk and stay healthy
  • You’ll be taken through your results and told what they mean. Some people may be asked to return at a later date for their results.
  • You’ll be given personalised advice on how to lower your risk and maintain a healthy lifestyle.
  • Some people with raised blood pressure will have their kidneys checked through a blood test.
  • Some people may need to have another blood test to check for type 2 diabetes. Your health professional will be able to tell you more.
  • Treatment or medication may be prescribed to help you maintain your health.

Questions you may have

Why do I need this check? I feel fine!

The NHS Health Check helps to identify potential risks early. By having this check and following the advice of your health professional, you improve your chances of living a healthier life.

But don’t these conditions run in the family?

If you have a history of heart disease, stroke, type 2 diabetes, or kidney disease in your family then you may be more at risk. Taking action now can help you to prevent the onset of these conditions.

I know what I’m doing wrong. How can the doctor help me?

If you would like help, we will work with you to find ways to eat healthily, reach your healthy weight, be more active, cut down your drinking, or stop smoking.

If I am assessed as being at ‘low risk’, does this mean I won’t develop these conditions?

It is impossible to say that someone will or won’t go on to develop one of these conditions. But taking action now can help you lower your potential risk.

Will everyone has this check?

This check is part of a national scheme to help prevent the onset of these health problems. Everyone between the ages of 40 and 74 who has not been diagnosed with the conditions mentioned will be invited for a check once every five years. If you are outside the age range and concerned about your health, you should contact your GP.