A Pharmacist Partner’s Perspective—And Why It’s Not So Simple for GPs
As demand grows for more flexible, accessible healthcare, many NHS GP practices are exploring whether they can offer private services alongside their NHS provision. However, doing so requires careful consideration of ethical, legal, and contractual boundaries. Here’s a clear breakdown of what is permitted, what is not, and why the distinction matters.
What Does the NHS Allow in Terms of Private Services?
NHS general practice contracts allow some non-NHS (private) services to be offered, provided they meet strict criteria. These include:
- Services that are not part of the NHS contract
- Services delivered without using NHS resources
- Services that are clearly communicated to the patient as private, with associated costs
Examples of acceptable private services include:
- Travel vaccinations not funded by the NHS
- Private medical reports (e.g. for employment, DVLA, insurance)
- Certain minor procedures or screening services not covered by the NHS
Why Is This a Sensitive Area for GPs?
There are specific ethical concerns when it comes to GPs providing private services from within NHS settings. According to guidance from the General Medical Council (GMC) and NHS England, GPs must:
- Avoid any conflict of interest
- Not influence patients to pursue private care that they themselves offer
- Ensure NHS-funded resources are not used for private gain
This is because GPs act as gatekeepers to NHS services. Any private provision must therefore be handled with complete transparency and a clear separation from NHS duties.
What About Pharmacists and Other Clinicians?
Pharmacists and other allied health professionals working within general practice do not hold the same contractual obligations or ethical gatekeeping roles as GPs. As such, they may have more flexibility in offering private services—provided:
- Services are delivered outside of NHS time and responsibilities
- They are not duplicating or replacing NHS services
- Appropriate indemnity cover and governance are in place
This is especially relevant as pharmacist independent prescribers take on a broader clinical role within practices, offering opportunities to expand access to certain services without breaching NHS regulations.
Why Are Private Vaccines Allowed?
“If private services are restricted, why can practices still offer private travel vaccines?”
The answer is simple: these vaccines are not covered by the NHS, so they fall outside the NHS contractual framework. Practices are therefore allowed to:
- Offer these vaccines privately
- Charge patients directly
- Deliver them from NHS premises, as long as they use separate resources and systems
This exception is clearly supported by the BMA and NHS England, provided all services are delivered ethically and transparently.
Key Compliance Considerations
- If a practice is considering offering any form of private care, the following must be in place:
- CQC Registration: Some private services may require separate registration with the Care Quality Commission.
- Clear Premises Agreement: Use of NHS premises for private work must be authorised in partnership or lease agreements.
- Indemnity Cover: Private services must be backed by appropriate medical indemnity or insurance.
- Transparent Patient Communication: Patients must be fully informed that the service is private and charged.
Final Thoughts
Private services, when clearly separated from NHS provision and delivered with integrity, can offer patients more choice and enhanced access—without compromising the core values of NHS general practice. At our practice, we are committed to upholding the highest standards in both NHS and private care.
