The NHS provides world class access to treatment and allows all of us in the UK to receive the highest levels of specialist care if we need it. This works well for serious diagnoses such as cancer and emergency care. However, the NHS does less well on speed of access for non-life threatening problems. The waiting time for a routine NHS Dermatology appointment can be over 6 months in some parts of the UK.
It is therefore not surpirsing that some people consider paying to visit a private clinic. Only 10% of the UK population have health insurance, often via company schemes. Before choosing to pay yourself it is important to consider what private clinics are good at and when you are better waiting for the NHS.
Issues to consider
- Private clinics vary significantly. Some of the large private hospitals in London will have all of the services of a modern NHS hospital whereas smaller clinics will offer far fewer services.
- Most private clinics will not have specialist Dermatology nurses. This means that complex dressings including lower leg compression bandaging for leg ulcers will often not be available.
- Most private clinics will not have phototherapy services for treating psoriasis and eczema. The equipment needs alot of maintenance and monitoring and is often only available in NHS departments
- If you need tablet or injection treatment for eczema or psoriasis blood tests are required at the start and during monitoring. If you are not insured the cost of these can be considerable. A single blood test can be as much as £90 and 4 may be needed for each monitoring visit. Most UK health insurance plans do not pay for medications. The cost of these can be considerable and most people choose to wait for the NHS if these medications are needed.
- Private clinics do not offer urgent access. Urgent problems are best managed via the NHS.
- All visits to a private clinic will have a fee. Running a private clinic has numerous costs including room rental, admin support, IT support and high insurance premiums. The fee structure will often be in 2 parts with fees to the Doctor and then the fees to the hospital or clinic. Some self-paying patients are surprised by the costs involved and it is important to know the fees in advance
- If you have a complex problem that may require multiple investigations and the involvement of multiple specialists the NHS is almost certainly going provide you with a better service.
So when is it worth booking a private Dermatology appointment and what are the benefits?
1. The waiting time to get a private appointment will generally be shorter than the NHS. Exceptions to this are if you have a suspected serious skin cancer when the NHS will see you within 2 weeks. Also, many NHS Dermatology departments run urgent clinics for severe rashes and will see patients within 48 hours.
2. In a private clinic you will see an experienced Consultant and will have a longer appointment than in the NHS.
3. It is likely that you will get a definite diagnosis quickly and a clear explanation of treatment options. Sometimes you will be told that the NHS clinics are the best place to be for long term treatment. You may also be told that there are not good treatments for your problem. This can particulary be the case for hair thinning in women where there is a lack of evidence based proven treatments. A Dermatologist is more likely to give you a straight answer than a more cosmetically focused clinic that may offer various non-evidenced based products and lotions to try.
4. If you require a procedure the waiting time will generally be much shorter than in the NHS.
5. Increasingly the NHS will not remove benign skin lesions such as skin tags, viral warts or benign cysts. These can be removed in private clinics.
6. Routine mole checks are generally not offered by the NHS. The NHS will see you within 2 weeks if there is any concern about melanoma, squamous cell or rare skin cancers. The waiting time for suspected basal cell skin cancer is often longer.
What will it cost?
A new patient appointment will cost between £150 to £300 depending on the clinic and the duration of the appointment. Follow up appointments will cost between £100 and £200.
The cost of a skin procedure will depend on the complexity and which facilities are needed. A mole removal which can be done in a treatment room will cost between £400- £600 including analysis of the sample. Approximately one third of the fee will be for the Doctor and the rest for the clinic. Whereas, the removal of a facial skin cancer which needs to be done in a main theatre will cost between £1250 and £2000 due to the higher staff numbers and the equipment involved. Complex surgery such as MOHS surgery, needed for some skin cancers, may cost around £5000.