Private consultation
RAG rating
Document type
Primary Care prescribing resource
Hertfordshire and West Essex ICB
Output type
Pharmacy / Prescribing


Guidance on Requests for NHS Prescribing following a Private Consultation


  • This guidance applies to requests to prescribe a treatment on the NHS (either by a patient or private specialist), following a private consultation that has taken place inside or outside the UK.
  • This guidance will ensure that all patients whether opting to use private healthcare or not will receive the same consistent, high-quality care from the NHS. This will ensure that those from less affluent backgrounds will not be disadvantaged compared to those who are able to choose to have a private consultation.
  • This guidance will affect all patients and medical conditions equally.
  • The guidance would not have a particular positive or negative impact on any specific patient group if implemented consistently.
  • The guidance does not limit medicines or access to treatment to particular patient groups beyond that which the NHS provides to all patients.


  1. Patients who are entitled to NHS care can opt in and out of receiving NHS treatment at any point. Should a patient decide to seek treatment privately, they are solely responsible for paying all associated costs that arise. The NHS will not subsidise or pay for any private treatment.
  2. The decision to prescribe a treatment on an NHS prescription would result in the clinical and legal responsibilities resting with the NHS, and the incurred costs would be an NHS expense.
  3. If an NHS prescriber deems the ongoing supply of medication to be clinically appropriate and necessary, it should be prescribed in accordance with local and national guidance. If the recommendation does not follow local or national guidance a prescriber can substitute the drug with a clinically appropriate alternative if they feel this is necessary and appropriate, based on local guidance. Any switch should be made on an individual basis and in discussion with the patient, explaining the reasons for the change.
  4. An NHS prescriber should not issue NHS prescriptions for shared care medications for conditions where patients are being treated privately. This is because it is important to ensure that private specialists treating patients remain in control of, and are responsible for, prescribing treatments for the conditions they are managing. The current expectation is for these to continue to be prescribed on a private basis from their private provider. Please see link to patient information leaflet on sharing care with private providers.
  5.  An NHS prescriber can decline a request to prescribe should they feel the treatment does not fall in line with locally agreed decisions/national guidelines or is likely to be beyond the scope of their current clinical practice (i.e., specialist treatment or unlicensed preparations/off-label use).
  6. If an NHS prescriber does not feel confident or competent to take over the prescribing responsibility from a private clinician, they are under no obligations to do so.
  7. The following items are not permitted to be prescribed on the NHS, and therefore should only be prescribed via a private prescription: blacklisted preparations, malaria prophylaxis, travel vaccinations that are not permitted on the NHS, and prescribing of Selected List Scheme (SLS) preparations outside of their ACBS criteria.

Further guidance:

PrescQIPP Bulletin 238: Prescribing on the NHS following a private consultation (log in required, please register if working in GP practices). Copies of this guidance can be requested from the PMOT ( if required.

Version number
Developed by
Leen Kubba, Pharmaceutical Advisor, Herts and West Essex ICB
Approved by
Date approved / updated
October 2023
Review date
The recommendation is based upon the evidence available at the time of publication. This recommendation will be reviewed upon request in the light of new evidence becoming available
Superseded version