NHS referral to private treatment

*While this scenario focuses on a physiotherapist, it could also apply to a range of healthcare professionals employed by the NHS.  The suggestions offered are examples, and not an exhaustive list of all possible actions or solutions.


Simon is a physiotherapist employed by the NHS. He treated Rosie in an NHS neuro-rehabilitation unit for six weeks following a stroke.


Rosie improved significantly during her time at the unit and her family were keen for Simon to continue treating her in a private capacity once she was discharged.

What the physiotherapist did

Simon was mindful of his professional obligations to his current employer, the wider NHS, and the people in his care, and so discussed his plans to undertake private treatment with his line manager, who raised no concerns.

Simon discussed the realistic prognosis for Rosie with her and her family to ensure they were aware of the likely outcomes of ongoing private physiotherapy treatment. He also discussed the fee he intended to charge, providing them with a breakdown so they understood fully the payments they would be making.
Simon also hired a room at a private physiotherapy practice for Rosie’s physiotherapy sessions, to ensure that she felt comfortable with treatment and that professional boundaries were maintained. He also outlined the key NHS policies he would adhere to when undertaking private sessions.

Simon thought about whether or not there was a conflict of interest in him providing private care to a patient he had previously treated through his employment with the NHS. He thought about how he might ensure any fees he charged were appropriate and that the patient and their family wasn’t coerced in to paying high fees because they wanted continuity of care.  He also reflected on how he might approach providing private care in a way which retained professional boundaries.

What the physiotherapist had to consider

  • Joint statement from the Chief Executives of statutory regulators of healthcare professionals
  • General Chiropractic Council, The Code, 2016
  • General Dental Council, The standards for the dental team, 2013
  • The 7 principles of public life (‘Nolan principles’ May 1995) – apply to anyone who works in health, education, social and care services and give guidance on transparency and declaring any interests.