This policy explains how NHS Essex manages situations where people receive both NHS care and private healthcare.
It explains what the NHS can fund, what patients may choose to pay for privately and how decisions are made when people move between private and NHS-funded care.
The policy helps NHS Essex make fair and consistent decisions and use NHS resources responsibly.
For more information, read the full defining the boundaries between NHS and private healthcare policy by downloading the accessible Word document below.
Who the policy applies to
This policy applies to:
- patients whose NHS care is commissioned by NHS Essex
- NHS healthcare providers
- GP practices
- community pharmacies
- dental practices
- optometry services
- primary care networks and other commissioned services
Why this policy is important
The defining the boundaries between NHS and private healthcare policy helps NHS Essex to:
- ensure fair access to NHS-funded healthcare
- make decisions consistently
- use NHS resources responsibly
- support patient choice
- avoid unfair advantages based on a person’s ability to pay
- make sure NHS funding is used appropriately
The NHS provides care based on clinical need, not a person’s ability to pay. This principle is central to the policy.
NHS care and private healthcare
Many people receive all of their treatment through the NHS. However, some people choose to pay privately for part of their care.
The policy explains how NHS care and private healthcare can work alongside each other while remaining separate.
People can choose private healthcare. However, NHS organisations cannot use NHS funding to pay for private treatment. NHS resources must be used for NHS-funded care.
Prescriptions after private treatment
Sometimes a patient receives treatment from a private healthcare provider and then asks their NHS clinician to prescribe medication.
The policy explains when NHS prescribing may be appropriate and when it may not be possible.
NHS clinicians can only prescribe medicines when they are clinically appropriate and meet local NHS prescribing guidance.
Shared care arrangements
Some medicines need regular monitoring and support from healthcare professionals.
In some cases, NHS clinicians and specialist providers work together through a shared care arrangement.
These arrangements help patients receive safe and effective treatment. They also make sure everyone understands their responsibilities.
Moving from private treatment to NHS-funded care
Some patients start treatment privately and later ask the NHS to continue funding their care.
The policy explains how NHS Essex considers these requests.
NHS Essex bases funding decisions on clinical evidence, patient need and local NHS policies. If you choose private treatment, this does not automatically mean the NHS will fund that treatment later.
Fair and consistent decision-making
NHS Essex aims to make decisions fairly and consistently for all patients.
When making decisions about NHS-funded care, NHS Essex considers:
- clinical need
- patient safety
- clinical evidence
- NHS policies
- value for money
This approach helps ensure NHS resources are used fairly and responsibly.
Equality and accessibility
NHS Essex is committed to making services accessible to everyone.
NHS Essex will provide reasonable adjustments where needed. For example, patients may be able to access translation services, interpreters, British Sign Language support or other communication support.
Policy review
This policy was approved on 1 April 2026 and is due for review in April 2028.
For more information, read the full defining the boundaries between NHS and private healthcare policy by downloading the accessible Word document below.