Reducing the risks

So how can doctors ensure they don't inadvertently find themselves in a similar situation? These are some of the ways you might reduce the risk of any confusion or misunderstanding if the patient does raise a query about private care:

As outlined by the GMC, doctors are expected to answer questions accurately and this also applies to questions asked about private practice. It is also reasonable to explain to patients how long they may wait for a procedure but raising the issue of long waiting lists in the NHS versus shorter ones in the private sector yourself could be viewed as an attempt to persuade patients to seek private care. As such, it's prudent to avoid saying anything which may be perceived as suggesting the service available on the NHS is inferior to private alternatives or anything that may be seen as disparaging about the staff involved in NHS care (such as junior doctors).
Any discussion about private care should be documented in the notes and ideally also referred to in the GP letter. In this way consultants can demonstrate that they are being transparent about any conversations with the patient. These notes may also be invaluable if a complaint is received as they will help support how the discussion started, what exactly was discussed and how the conversation concluded.
If you're faced with a situation where a treatment that has a greater potential benefit for a patient is only available in the private sector, it would be advisable to seek input from your NHS employer as to how such matters should be raised with patients in these situations.
Any answers to patient questions about private treatment should be balanced, avoid bias and be entirely factual. It can be helpful to make it clear to the patient that there are alternative consultants who also provide private services that they may wish to consider.

Complaints about these types of conversations tend to arise when patients feel the discussion was uninvited, financially motivated or heavily biased towards the benefits of private treatment, rather than being in the patient's interests. Complaints are also more likely when the patient is left feeling anxious that the best treatment is beyond their means or that they are under pressure to choose the private option.

Taking these points into consideration should help to ensure the patient understands your intentions and reduce the risk of a complaint.

If you've got questions about your responsibilities surrounding offering NHS and independent care, the MDU's team of medico-legal advisers are available 365 days a year.

Asking about alternatives

Dr Ellie Mein

Asking about alternatives