Do I need a GP referral for private treatment? Exploring options...

When opting to use private treatment, it can often be confusing to get started and to know exactly how it differs from the NHS.

We’re exploring everything you need to know about how GP referrals work with private healthcare and what options are available, such as self-paying or health insurance.

What is a GP referral?

A GP referral simply involves your GP referring you to a different healthcare professional. This will usually be a specialist to further assess you or for a particular treatment.

Referrals are made to ensure you get expert help with the diagnosis or treatment that you need. Some of the things you may need a GP referral for include: access to specialist services, tests, or treatments such as hospital outpatient appointments, physiotherapy, or specialised diagnostic scans.

Within the referral your GP will typically cover background information about your medical history and the reason for the referral. They may also request specific tests, scans or procedures.

Do I need a GP referral for private treatment?

Typically, you don’t need a GP referral to access private treatment. Anyone can access private healthcare if they are willing to self-pay and fund the costs.

If you choose to go private this way, you manage the entire process of your private treatment journey. You can arrange the consultation and appointment without the need for a GP referral. 

However, it’s important to note that you would always still need to use the NHS for certain services. Such as accident and emergency, pregnancy and long-term health conditions. Therefore, it isn’t that you use one or the other, private healthcare works to support and compliment the work of the NHS.

NHS Referrals

If you choose to have your treatment on the NHS, then your GP will usually need to refer you to a specialist.

You’re entitled to ask your GP for a referral to a specialist on the NHS, however, it is not guaranteed that you will get the go ahead and it depends what they feel necessary in your case.

Generally, you cannot self-refer to a specialist at a hospital within the NHS. A specialist at the NHS will only see you with a referral from your GP.

Private Referrals

When it comes to seeing a private specialist, it is advised to get a referral to do so. The reason for this is that typically your GP will know you well and your medical history. It allows them to provide advice and the best course of action where necessary.

Once the referral has been written and sent, you can then go ahead and book your appointment with the private provider.

Whilst typically you’re not required to have a GP referral to get access to private treatment (if you’re self-paying), if you do have private medical insurance in place, you may need to get a referral.

Many insurers require a GP referral as part of the process of getting you the private treatment you need. This will usually need to be an open referral, which states what specialism is needed.

You can also use the digital GP service provided by your insurance provider to get this referral. This means you don’t have to wait as long for a GP appointment or deal with long queues on the phone.

Your insurer will also require you to make contact once you have your referral so they can check that what you need is covered on your insurance. 

How long can GP referrals take on the NHS? 

If you’re getting a referral from your NHS GP, it's worth noting the potential wait time and the '8am scramble' for an appointment.

With a digital GP, you can book online and often get an appointment in as little as 30 minutes. You get much more flexibility over your appointment time and it can be done from anywhere.

With the NHS, you'd expect to get treatment within 18 weeks from the referral date. This is for referrals for treatments that the NHS deems as non-urgent. Simply put, this is elective care that does not require immediate treatment and can be safely delayed until a more convenient time.

It’s worth noting that with urgent referrals for things such as suspected cancer, the aim is to have patients seen within 2 weeks on the NHS.

Are referrals quicker with private healthcare?

Typically, having a referral and taking it to a private healthcare specialist should be quicker than having treatment on the NHS. 

You could also book and pay for an appointment with a private GP to speed up the process.

In the situation where you are self-paying and won't need a referral, the process may be quicker. 

But typically, once you have your referral and your insurer has confirmed you are covered, you can go ahead and get your treatment booked.

What private options do I have?

There are a few different considerations and options available when it comes to getting private healthcare, which we will now explore.

Health Insurance

Health insurance is a great way to get peace of mind for you and your family, preparing you and covering you for potentially hefty healthcare bills.

Health insurance helps to spread the cost across affordable monthly payments that means if you do need to claim, you only need to pay an excess and the rest of the bill is managed by your insurer. 

There are also many benefits that come with health insurance including peace of mind, discounted products and services, and access to digital GP services.

Private Medical Insurance is an option if you want your future health protected and know that you don’t want to wait in long NHS queues when you need treatment. 

Self-pay

Self-paying works like a pay as you go service. It means you simply arrange it all yourself and cover the bills yourself.

This can be a preferred option if you've been saving or unexpectedly need to go private to get back to good health quicker. Self-paying for private healthcare can also be used for private GP appointments, a private health assessment or physiotherapy, or dental care. 

Some of those things, however, can be covered in core offerings or as an add-on with a health insurance policy, so it’s worth checking the benefits of health insurance and if it's worth having that cover for you.

Payment plans or finance

There may also be payment plans available with a particular private healthcare provider you choose to have treatment with.

With a payment plan it helps you to manage the bill better than paying it all upfront. Especially if it has occurred unexpectedly and you weren't prepared for the bills. 

For example, Nuffield Health offer 6, 10 or 12 monthly interest-free installments. It's worth noting that only certain treatments offer this option. So it's worth considering if health insurance is more suitable for your needs by providing more cover.

How to know I'm making the right choice about my healthcare?  

When it comes to your health, it’s definitely one of your most important assets. Getting it right and making the right choices is essential. You can do this by using a health insurance comparison service, like Usay Compare, to see what options are available to you. 

Getting free, expert advice is essential when you’re considering your healthcare options. Our team of experts compare policies from the leading UK insurers, such as Bupa, AXA and Vitality. offering the best price guarantee and offering advice and recommendations to suit you. This is beneficial in helping you to understand your options and what’s important to you.

We provide our customers with the best advice and recommendations to be able to make informed decisions about their health. You can ask us questions about your options available and we will provide support.

If private health insurance is something you’d like to consider or get more information on, you can have a chat to our expert advisers to get a free, no-obligation quote.

Fill out the form below to get a quote or give us a call on: 01285 864670.