Beyond the Consultation: How Private Prescriptions and Shared Care Work in 2026

Most people arrive at a private consultation with a clear picture of the appointment itself: the waiting room, the history, the examination, the letter that follows. What is discussed far less often is the quiet practical step in between — the moment a consultant decides a medicine is needed, and that prescription has to be priced, dispensed and, quite often, repeated for many months.

That gap in expectations causes more anxiety than it should. Nothing about it is unusual, and almost all of it can be planned for. What follows is a plain account of how private prescribing works in the UK, where the costs sit, and when it is sensible to involve your GP.

A private prescription is not an NHS prescription

When an NHS GP prescribes, the prescription is issued on an NHS form — usually an electronic FP10 — and the patient pays the standard NHS prescription charge, or nothing at all if they are exempt. A private prescription is different in kind, not merely in price. It is issued on the consultant's own private stationery, or increasingly as a private electronic prescription, and it carries no NHS subsidy whatsoever.

You pay the full cost of the medicine, together with the pharmacy's dispensing fee. This is why the same box of tablets that costs a few pounds on an NHS prescription can cost thirty or forty pounds privately. It is not a mark-up applied by your consultant; it is simply the removal of public subsidy.

It also follows that a private prescription cannot be taken to a pharmacy and dispensed at NHS rates, and an NHS prescription cannot be used to obtain a medicine privately prescribed. The two systems run in parallel.

What you are actually paying for

A private pharmacy bill normally has two or three components. First, the cost of the medicine itself, which the pharmacy buys from a wholesaler or, for less common products, directly from the manufacturer. Second, a dispensing fee, which is the pharmacy's charge for the professional work of checking, labelling and supplying. Third, in some cases, a small mark-up on the medicine's cost price.

Specialist items — unlicensed preparations, imported medicines, or products that must be made up individually — attract additional charges, sometimes considerable ones. If you are prescribed something in this category, it is entirely reasonable to ask for a written estimate before the pharmacy proceeds.

The same medicine, a very different price

Dispensing fees are set by each pharmacy, not centrally, so they vary widely. A hospital outpatient pharmacy is convenient and often efficient, but it is not always the cheapest. Supermarket and online pharmacies frequently quote lower fees, while independent pharmacies may be able to order unusual items more quickly.

You are entitled to ask for the private prescription to be returned to you so that you can compare prices before committing. For a one-off course of antibiotics the difference is trivial; for a medicine taken monthly for a year, it can be several hundred pounds.

Repeat supplies: agree the plan before you leave

This is the single most common source of avoidable stress. Before you leave the consulting room, establish three things: how long the consultant intends you to take the medicine, who will issue repeat supplies, and when the next review will take place.

Many consultants will provide a private prescription covering three or six months, with a review in between. Others prefer to issue monthly until a dose is stable. Ask for the generic name of the medicine as well as the brand — it makes price comparison far easier — and ask whether the prescription can be dispensed in instalments so that you are not paying for six months of tablets in one go.

If you travel, or if a bank holiday is approaching, mention it. Some medicines need to be ordered in, and controlled drugs carry stricter rules on quantity and validity.

Can my GP take over the prescribing?

Sometimes, yes. This is what is meant by shared care: an arrangement in which a specialist initiates or recommends a medicine and the GP continues to prescribe it on the NHS, usually with an agreed monitoring plan.

It is important to be clear that a GP is never obliged to take on a private prescription. Prescribing is a professional decision, and a GP may decline if the medicine is not on the local formulary, if the monitoring arrangements are unclear, or if the drug is classified in local guidance as one that should remain with the specialist. Where a GP does agree, it is normally because the consultant has written to them with the diagnosis, the rationale, the intended duration and the blood tests or observations required.

If shared care is your hope, raise it early — at the first consultation, not after the third private repeat. Ask your consultant whether the medicine is one that GPs in your area commonly continue, and ask them to write to your GP promptly. A short, well-documented letter is far more likely to produce a helpful reply than a request made in passing months later.

Insurance, receipts and the small print

Most private medical insurance policies in the UK cover inpatient and day-case treatment and exclude, or tightly cap, outpatient medicines. It is worth checking your policy wording before assuming a prescription will be reimbursed. Keep itemised receipts for every private dispensing; some policies allow these to be claimed against an outpatient allowance.

NHS prepayment certificates do not apply to private prescriptions, and neither do NHS exemptions. If you expect to pay privately for medicines over a long period, ask your pharmacy whether a repeat dispensing arrangement or a monthly account would reduce the dispensing fees.

Questions worth asking before you leave

• What is this medicine called generically, and what is it for?
• How long do you expect me to take it?
• Who will issue the next supply, and when?
• Is it available on the NHS, and would you be willing to write to my GP about shared care?
• Are there monitoring tests, and who will arrange them?
• What should I do if I develop side effects before my review?
• Roughly what should I expect the first supply to cost?
• Are there any restrictions — for example on travel or on driving — I should know about?

When to speak to your GP

Your GP remains the right first point of contact for side effects, interactions with medicines they already prescribe, and any monitoring blood tests that would ordinarily be arranged in primary care. If the private cost of a medicine is a genuine obstacle, say so — to your consultant and to your GP. There may be a therapeutically equivalent option available on the NHS, and clinicians would far rather discuss that than have a patient quietly stop treatment.

None of this needs to feel daunting. A well-run private provider will explain the prescribing and cost pathway at the outset, in writing. If that information is not offered, ask for it — and treat a clear answer as one small measure of the quality of the service you are buying.