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Medicines recommended by private specialists | Ashcroft Surgery, Bradford
Prescriptions and medicines

Medicines recommended by private specialists

We fully support your care, whoever provides it. But before a GP can sign an NHS prescription, they must be sure it is safe. This page explains why that is not always as simple as it sounds – and what you can do to avoid unexpected problems and costs.

Questions to ask before booking private care

We support your care – and we must prescribe safely

We understand why some patients choose to see a private specialist. NHS waiting times can be extremely long, and waiting can be upsetting, frustrating and sometimes life-changing.

Choosing private care does not affect your right to NHS care from Ashcroft Surgery. We will always continue to provide your normal GP care.

However, seeing a private specialist does not automatically mean we can put every medicine they recommend on an NHS prescription. This is not because we doubt you, or do not support your treatment. It is because of who carries the responsibility when a prescription is signed.

Whoever signs the prescription carries the responsibility

What many people expect

It seems simple: a Consultant Specialist has already decided the medicine is right. Surely the GP just copies it onto a repeat prescription?

We completely understand why it looks that way. But in law and in professional practice, it does not work like that.

How it actually works

The clinician who signs a prescription takes full professional and legal responsibility for it – for the medicine being safe, suitable and properly monitored.

That responsibility does not stay with the Consultant Specialist who first recommended it. It transfers to the GP the moment they sign.

A helpful way to think about it

It is a little like a pilot before take-off. Even if an engineer has serviced the plane and says it is fine, the pilot must still do their own checks – because once the plane is in the air, the pilot is the one responsible for everyone on board.

In the same way, a GP cannot sign a prescription simply because someone else has recommended it. They must be personally satisfied that it is safe, that the right checks are in place, and that they can look after you properly on that medicine – sometimes for many years to come. If they cannot be satisfied of that, they must not sign. That is not the GP being difficult. It is the GP doing exactly what the law and the General Medical Council require of them, to keep you safe.

Much more than “putting it on repeat”

A repeat prescription looks like one line on a screen. But for specialist medicines, a great deal of ongoing work sits underneath that one line.

What you see

  • One medicine on your repeat list
  • A prescription sent to your pharmacy

What sits underneath

  • Careful dose adjustment, often over months
  • Regular blood tests, blood-pressure checks or heart tracings (ECGs)
  • Checking the treatment is actually working
  • Watching for physical and psychological side effects
  • Managing interactions with your other medicines
  • Knowing what to do if the medicine stops working
  • Extra care during illness, pregnancy or surgery
  • Quick access to a Consultant Specialist if problems develop

Starting a specialist medicine is often the beginning of a period of adjustment, monitoring and review – not the end of specialist treatment. A GP should never be left holding all of that responsibility without the specialist knowledge, information and back-up needed to manage it safely.

Shared care: how it is meant to work

For some specialist medicines, responsibility can eventually be shared between a Consultant Specialist and the GP practice. This is called shared care. It only works safely when all three people play their part – like a three-legged stool, it falls over if any leg is missing.

The Consultant Specialist

  • Confirms the diagnosis
  • Starts the medicine and adjusts the dose until stable
  • Stays available for advice and regular reviews
  • Takes back responsibility if problems arise

The GP

  • Decides whether shared care can be accepted safely
  • Issues day-to-day prescriptions once treatment is stable
  • Arranges agreed routine monitoring
  • Contacts the specialist if concerns develop

You

  • Attend your monitoring checks and reviews
  • Tell us about side effects or changes
  • Keep your specialist appointments

Important things to know about shared care

  • It is genuinely shared. It is not a specialist recommending a medicine, discharging you, and passing everything to the GP. Sadly, that pattern has become common in some services – especially some ADHD and gender clinics – and it leaves patients without the specialist safety net they need.
  • It is not automatic. A GP is not obliged to accept a shared-care request. The practice must first be satisfied the arrangement is safe, properly supported and suitable for general practice.
  • It usually starts only once treatment is stable, with a clear written agreement setting out who does what.

Sometimes a Consultant Specialist, clinic or hospital department may tell you: “Your GP can prescribe that. Some GPs do – and if yours won’t, they’re just being awkward.” We understand how confusing and upsetting that must be to hear, and we are sorry when it happens. But it is not accurate, and it puts you unfairly in the middle. When we say no, we are not being awkward – we are being safe.

The real fix is not for GPs to take on specialist treatment without specialist back-up. It is for those services – gender health services are a clear example – to be given the staff and funding they need, so waiting times fall and every patient gets proper specialist care, with the specialist staying involved.

What normally happens, step by step

After an NHS specialist assessment

  1. The NHS Consultant Specialist assesses you and starts any medicine, staying responsible while the dose is adjusted.
  2. Once you are stable, they may ask us to consider shared care under an established NHS pathway.
  3. We review the request. Even within the NHS, not every medicine can be transferred to a GP.
  4. If shared care is accepted, the specialist stays involved and available for advice and review.

After private treatment

  1. The private provider is normally responsible for prescribing, testing, monitoring, dose changes and ongoing specialist advice.
  2. They may write asking us to prescribe on the NHS. We consider the information carefully – but their recommendation does not transfer their responsibility to us.
  3. If safe arrangements are not in place, the private specialist should continue to prescribe and monitor privately.
  4. This can mean ongoing private costs. Please ask about these before paying for an assessment.

When we may be unable to prescribe

We may not be able to issue an NHS prescription when, for example:

  • the medicine needs specialist knowledge or supervision;
  • treatment has not yet been stabilised, or the required monitoring has not been done;
  • there is no suitable shared-care agreement or locally commissioned NHS pathway;
  • the specialist will not provide continuing reviews or advice;
  • the medicine is being used in an unusual or unlicensed way, or outside NHS prescribing guidance;
  • the practice does not have the capacity or expertise to manage it safely; or
  • the GP asked to sign is simply not satisfied that signing would be safe.

In these situations, saying “no” to the prescription is the GP saying “yes” to your safety.

Specific situations explained

ADHD medication

Medicines for ADHD must be started and monitored by an appropriately qualified ADHD Consultant Specialist. The specialist confirms the diagnosis, checks the medicine is suitable, starts treatment, adjusts the dose and monitors its effects – including checks such as blood pressure and heart rate.

Once treatment is stable, a specialist may ask us to consider shared care. We consider every request individually, looking at the proposed agreement, the ongoing support offered, local NHS arrangements, and whether our clinicians can prescribe and monitor the medicine safely.

A private ADHD diagnosis does not by itself guarantee NHS prescriptions from the practice. If we cannot accept shared care, it does not mean we reject your diagnosis or think you do not deserve treatment. It means the provider responsible for your treatment must continue prescribing and monitoring it.

Autism itself is not treated with a specific medicine, though medication is sometimes recommended for an associated condition. The same principles apply to any specialist medicine recommended after an assessment.

Read about ADHD on the NHS website (opens the NHS website)

Gender-affirming treatment

We recognise that waits for NHS gender identity services can be exceptionally long, and we understand the distress and uncertainty this causes. Transgender and gender-diverse patients are entitled to the same dignity, respect and NHS primary care as every other patient, and Ashcroft Surgery supports compassionate, evidence-based healthcare for all our patients.

Hormone treatment can require specialist assessment, individualised prescribing, blood tests and their interpretation, dose adjustment and continuing specialist review. Before agreeing to prescribe, a GP must be satisfied there is a safe and properly supported arrangement.

Where hormone treatment has been started privately, we do not take over the prescribing or monitoring. This is because there is no shared-care engagement in place: the Consultant Specialist who started the treatment needs to stay involved, available and responsible for it. Without that ongoing specialist partnership, it would not be safe for a GP to prescribe. The private provider therefore remains responsible for the treatment they have started, including reviews, blood tests and dose changes.

We are also unable to refer you part-way into the NHS specialist service so that it picks up a privately started treatment. Doing so would mean stepping past every patient who has been waiting patiently in the queue, and that would not be fair on them. What we can do is make an appropriate NHS referral in the normal way, and continue providing all your usual NHS GP care while you wait.

If this affects you, we will explain our position as clearly and sensitively as we can. This is a clinical-safety decision. It is never a judgement about your identity or your entitlement to care.

NHS Right to Choose – how is it different?

NHS Right to Choose is different from paying for private care. Under Right to Choose, an NHS referral can be made to an eligible provider that holds an NHS contract, even if that provider is an independent organisation. The assessment is NHS-funded, not privately purchased.

However, choosing a Right to Choose provider does not guarantee that Ashcroft Surgery will later take over specialist prescribing. Before choosing a provider, it helps to ask:

  • Will the provider prescribe the medicine itself, including during dose adjustment?
  • Will it keep prescribing if the GP cannot accept shared care?
  • How often will it review me, and will it arrange the physical checks and blood tests?
  • Will it stay available for specialist advice?
  • What happens if the treatment stops working or causes side effects?

The answers differ between providers, so it is worth checking before you choose.

Tests requested by a private provider

A private Consultant Specialist should normally arrange and fund the tests and monitoring needed for the private treatment they provide. A request from a private provider does not automatically make a blood test, scan or ECG the responsibility of the NHS practice.

For this reason, we do not carry out tests requested by private specialists. The only exception is when one of our own clinicians independently decides that a test is needed as part of the NHS care we ourselves are providing to you. The private provider remains responsible for arranging, funding, reviewing and acting on the results of any tests their treatment requires.

Our overriding question is always the same: is this arrangement safe for you?

You may feel completely sure the medicine is safe. Perhaps it has already helped you, and you feel well on it. We genuinely understand that – and how you feel matters a great deal to us.

But safety in prescribing is about more than how a medicine makes you feel today. It also covers things that cannot be seen or felt: how a medicine may quietly affect your heart, blood pressure, liver or mood over months and years; how it mixes with your other medicines; and what could happen during an illness, a pregnancy or an operation.

It is a little like buying a house. A house can look beautiful and feel completely solid to live in – yet a surveyor is trained to spot the hairline crack in the foundations that nobody else would notice. Doctors are trained to spot the medical equivalent. That is why the safety decision has to sit with a doctor rather than with the person taking the medicine.

This is never about not trusting you, and it certainly does not mean we do not care. It is quite the opposite: sometimes caring about you and saying no are the same thing.

10 questions to ask before paying for private care

Asking these questions first can save you from unexpected costs and disappointment later.

  • Who will prescribe if medication is recommended?
  • Are prescription costs included in the price?
  • Who will arrange and pay for blood tests or other monitoring?
  • How long is dose adjustment likely to take?
  • How often will I be reviewed?
  • Will you continue prescribing if my GP cannot take over?
  • Will you remain available to advise my GP?
  • What happens if I develop side effects or my condition changes?
  • Is there a shared-care agreement supported by my local NHS system?
  • What are the likely total costs of continuing treatment?

Please do not assume the practice will issue NHS prescriptions after a private assessment. Confirm the arrangements with the private provider before committing to treatment.

Frustrated by long NHS waits? So are we

We share your concerns about long waits for specialist services, particularly ADHD and gender identity services. GP practices do not control specialist waiting lists, or the funding and capacity behind them. We will make an appropriate NHS or Right to Choose referral where the criteria are met, but we cannot bypass waiting lists or run a specialist prescribing service within the practice.

Your voice matters. You may wish to share your experience with:

Sharing your experience helps those who plan and fund services understand the real effect long waits are having on patients.

Never stop a specialist medicine suddenly

If prescribing arrangements change, do not stop taking a specialist medicine suddenly without advice – some medicines need to be reduced gradually. Speak to the clinician who prescribes it, your pharmacist, or the practice.

If you feel unwell and need medical help now, use NHS 111 online (opens the NHS 111 website) or call 111. In an emergency, always call 999.

Our commitment to you

Being told the practice cannot take over a prescription can feel disappointing, worrying or unfair – especially after a long wait, or after paying for private care. Please be assured: such a decision never means we do not believe you, support you, or want you to receive treatment.

Our GPs must prescribe only when they have enough information, suitable expertise, proper monitoring arrangements and reliable specialist back-up. Without those safeguards, signing a prescription would put you – not just the GP – at risk.

Whatever happens, we will:

  • listen to your concerns respectfully;
  • continue providing your usual NHS general-practice care;
  • consider clinical information sent by your Consultant Specialist;
  • explain our decision wherever possible;
  • make appropriate NHS referrals;
  • share relevant medical information with another clinician, with your consent; and
  • support you while you wait for specialist care.

Our aim is never to put an obstacle in the way of your treatment. It is to make sure that any treatment we take responsibility for can be given safely, responsibly, and with the right specialist support behind it.

Last reviewed: July 2026
Next review due: July 2027

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