If your child has a health condition needing medical treatment, it can be a very emotional time. Here we try to make that time slightly easier by answering some common questions and helping you to ask appropriate questions, if you are considering using private healthcare, for peace of mind.

Is private healthcare right for my child?
At what ages are patients considered children in healthcare?
Are there age limits for some treatment?
Are there any procedures that can’t/won’t be carried out on children?
Do I have the right to a second opinion on treatment options if I don’t agree with something?
How can I compare and contrast the consultants who might operate on my child?
What should I look for when choosing a hospital for my child’s treatment?
Will my child’s education suffer if they have hospital treatment?
Can I choose when my child has their treatment?
What happens if something goes wrong?
What are the costs involved in getting private treatment for my child?
Treatment as a family
Will my child be involved in decision making about their healthcare?
Will I be allowed in the operating theatre with my child?
What will be expected of me while my child receives private healthcare?
How do I get private healthcare treatment for my child?
Some key terms you may hear
Acknowledgements
Sources

Is private healthcare right for my child?

There are some conditions or procedures where the long-term outcome may be better by staying in public system and getting treatment on the NHS. For example, cancer care health services can be complex and require ongoing support across multiple systems and providers. Therefore, it may well be more appropriate for your child to have treatment on the NHS which can then refer you into the supporting networks.

This is not necessarily anything to do with the quality of treatment, but more to do with the social support, and ability to be treated nearer to home, than may be possible in the private sector. For example, the NHS has a national network of Paediatric oncology shared care units (POSCU) which provide specialist cancer services for children and young people.

If your child is likely to need ongoing treatment e.g. for cancer treatment as opposed to a one-off knee procedure, you should investigate your options, especially to see if there is an NHS pathway you can access through your local GP or NHS hospital.

Although London is a hub for private hospitals, there are many equally skilled and experienced consultants elsewhere in the country, and reducing travelling may be better for your child. However, not many private hospitals have the facilities to admit and treat babies and children, so you may have to travel.

There is also the cost to consider. There are various ways to fund private healthcare, and you should ensure that any treatment you consider is affordable, not only up front but when considering possible complications and further treatment.

At what ages are patients considered children in healthcare?

For the purposes of healthcare, children are 0 – 17 years old. Once they turn 18, they will be treated as adults.

Some centres may decline to treat Children and Young People (CYPs) over 16 years old for some conditions that are likely to have long-term treatment pathways over several years. This is because this could leave them having to transfer care to another hospital when they turn 18 years old. For a small number of conditions, some specialist children’s hospitals can continue to treat CYP after their 18th birthday. However, this is not common.

Are there age limits for some treatment?

There are certain treatments that need to happen before a child grows too much or reaches puberty and likewise sometimes your child may have a medical intervention, but then need to return once they’ve past puberty or grown more.

Are there any procedures that can’t/won’t be carried out on children?

There is some debate about whether it is appropriate to conduct elective circumcision, but it is generally considered safer for it to happen in a hospital than elsewhere.

There are certain types of neurosurgery that aren’t suitable for children too.

Heart transplants can’t be carried out on children who travel to the UK for treatment due to donor restrictions.

Do I have the right to a second opinion on treatment options if I don’t agree with something?

You have a lot of choice in your child’s healthcare and, whether the treatment is going to take place in the NHS or the private sector, you always have the right to ask for a second opinion.

You can also choose which doctor (consultant) and hospital your child is treated by and at. You don’t have to take the first one offered to you.

How can I compare and contrast the consultants who might operate on my child?

There are many ways to compare and contrast the consultants who might treat your child. There are patient review sites such as Doctifyand iWantGreatCare which provide written reviews from parents and other patients, so that you can get a feel for other patients’ experiences with them.

The consultant profiles on the unbiased and independent PHIN website provide a more data focused approach. They contain patient satisfaction ratings and information on the number of times a consultant has conducted a procedure, as well as how much they charge.

What should I look for when choosing a hospital for my child’s treatment?

There are many reasons why you might choose a particular hospital including location and price, the number of similar procedures (volume) that have been carried out there before and the average time someone stays (length of stay) in hospital following their treatment.

When choosing for your child, it is also important that the hospital ward and any other areas your child might go to provide a child-friendly environment, separate from the adult areas. This could involve special smaller MRI scanners, with picture panels to distract/comfort them, as well as supplying headphones and electronic tablets.

Well trained staff, such as specialist phlebotomists (people who take blood) trained in dealing with children and those who can help with needle phobic children (and their families) through distraction techniques and the use of numbing creams are also important.

Many hospitals will also provide a variety of therapy opportunities for their child patients, including play, music and trained therapy animals. These can all:

  • distract your child from a clinical procedure or environment,
  • be used to familiarise them with processes and procedures
  • help remove fear responses and
  • ‘deinstitutionalise’ your child’s experience in hospital.

You should also look for hospitals who provide support for the wider family. This might include encouraging breast feeding, where possible, or providing psychological or mental health advice and support to parents and siblings.

The hospital profiles on the PHIN website can provide more information on the hospitals you are considering.

Will my child’s education suffer if they have hospital treatment?

If your child needs to stay in hospital for a while for treatment and recovery, then the hospital will be required to provide for their education so that they don’t miss out or fall to far behind. How long they need to be in hospital before this starts will depend on your child, their length of stay, stage of schooling and on the healthcare provider themselves and more.

Local authorities have a legal requirement to arrange education for any child of compulsory school age whose illness prevents them from attending school. Ofsted is responsible for inspecting the quality of education provided. These services must be approved by the Care Quality Commission (CQC).

Hospitals must also be able to demonstrate that they comply with all safeguarding requirements, for example being cared for in a space that is not shared with adult patients, to keep your child safe.

You should ask any hospital you are considering about their education services.

Can I choose when my child has their treatment?

For non-urgent cases, it is usually possible to schedule your child’s treatment for when it will have the least impact, such as at the beginning of the school holidays, to maximise recovery times and minimise the impact on schooling and other events.

What happens if something goes wrong?

Unfortunately, there is an element of risk with any surgical procedure. This is equally true for children. You should be aware that many private hospitals do not have intensive care or critical care units (those that do will say so on their PHIN hospital profile).

In the event of something going wrong in surgery in a hospital without emergency facilities then your child will need to be transferred by ambulance to an NHS hospital.

What are the costs involved in getting private treatment for my child?

Every child’s health needs are different, so we can’t tell you how much it will cost for them to be treated privately. However, your consultant should make the costs clear and for more common procedures, this will be an accurate estimate. For more specialist care, the costs are likely to be higher and, if you are not paying for a ‘package of care’ (i.e. fixed fee), then charges may exceed an initial estimate.

Your consultant only charges you for their time (unless their fees are included in what’s known as a package price which is on offer from some hospitals). Make sure you find out how much the hospital will charge too.

If you are using private medical insurance, you should check with your insurer at the beginning of the process to make sure you understand your level of cover and whether there are any limits on your treatment choices.

Treatment as a family

Although your child will be the one receiving medical treatment, going through the process won’t be easy and the healthcare team should support all your family members throughout the process.

Will my child be involved in decision making about their healthcare?

There is case law which says that where appropriate your child should be involved in the choices about their healthcare. The Gillick competency and Fraser guidelines help people who work with children to balance the need to listen to children's wishes with the responsibility to keep them safe.

Engagement with your child and shared decision-making should be age appropriate and your wishes will be taken into account.

Will I be allowed in the operating theatre with my child?

Although you will not be allowed in the operating theatre itself, you will usually be allowed into the preparation area. If your child is very young, then you may even agree to hold them while they are being given an anaesthetic (though this will be discussed with you and is not compulsory).

The goal of the treating team during the pre-operative time is to minimise anxiety and stress in the patient and you can play an important role in this.

What will be expected of me while my child receives private healthcare?

The doctors and nurses who take care of your child are healthcare professionals, and they are not there to act as parents. You maintain parental responsibility for your child and at least one parent/guardian will be expected to stay at the hospital if your child is being treated as an in-patient.  

How do I get private healthcare treatment for my child?

There are different ways to get your child into private healthcare.

Your child can either been seen by a private doctor (consultant) after being referred by a GP, or you can contact a consultant or hospital directly yourself to make arrangements for them to be seen.

Whichever way you choose, the private consultant or hospital will want as much detailed information (e.g. their medical history including diagnostics/scans/notes) on your child’s health as possible in advance. This will help them ensure you seen by the right team.

You can find out about the consultants who might operate on your child from various sources. If you don’t know which specialty is needed, then you can contact a general paediatrician. If you take your child to an outpatient department, then they will have a family consultant who can refer you to a general paediatrician. The general paediatrician is good at giving a view on the ‘whole child’ and identifying what help they might need.

Once a consultant has been chosen, they will review your child’s details and medical records to ensure they are the most appropriate person to conduct the procedure.

Although you can choose the consultant who conducts any procedures and leads on treatment plans and decision-making, it is worth remembering that your child’s overall medical care will be carried out by a wider hospital ‘multi-disciplinary’ healthcare team.

Your chosen consultant may hold consultations (meetings where they assess your child and decide on the type of treatment needed) in their own clinic or in more than one hospital. They may also undertake procedures in more than one hospital, so you should look into that too.

Your child’s healthcare journey (known as their clinical pathway) will be supported by the nursing team responsible for their care but your consultant remains responsible for the decision-making.

The ‘gold standard’ of clinical and medical practice is where Consultants work within ‘multi-disciplinary teams’ (MDTs) involving other medical professionals from other Specialties, as well as senior Nursing and Allied Health Professional (AHP) colleagues.

If your child has a complex condition or ‘co-morbidities’ (more than one condition), then you should ask if your child will be reviewed in an MDT.

If you are ready to start comparing consultants and/or hospitals then please go to the search bar at the top of the page or on our homepage.

Some key terms you may hear

  • In-patient, day-case or out-patient - If you your child has an appointment but does not need to stay overnight, they are being treated as an outpatient or a day-case patient. An outpatient may be having an appointment for diagnosis or treatment. A patient who is admitted for a more involved procedure is referred to as a day-case. Inpatient care requires the patient to stay in hospital overnight.
  • Consultant – is a senior doctor who has completed full medical training in a specialised area of medicine and is listed on the General Medical Council’s (GMC’s) specialist register. They have clinical responsibilities and administrative responsibilities in managing specialist, associate specialist and specialty doctors and resident doctors. They usually work in hospitals or community settings. After graduating from medical school, it takes around seven to ten years to become a consultant.
  • Resident doctors – Previously known as ‘Junior doctors’ this type of doctor have changed their title to better reflect their huge range of skills and responsibilities. Nearly 25% of all doctors in the UK are resident doctors.
  • Registrar – A registrar is a doctor who is still in training. This is the stage of training that comes after being a resident doctor, and before a consultant.
  • Surgeon – A specialist in surgery, which is a broad category of invasive medical treatment (operations/procedures) that involves operating on the body.
  • Physician – A physician is a general term for someone who practices medicine, they will usually have a specialist area, for example cardiologists treat heart disease.
  • Paediatrician – A specialists in the medical management of conditions affecting babies, children and young people.
  • Triage – Where a patient is examined to assess their condition, including its urgency, and signposted or moved to the next appropriate step in their care journey.
  • Surgical intervention (surgery) – is an invasive medical intervention, which requires the consultant to cut into the skin. Both interventions can diagnose, evaluate, or treat a medical condition or illness.
  • Medical intervention – procedures that tend to be minimally invasive and do not usually require a cut into the skin.
  • Sepsis – a life-threatening reaction to an infection which happens when your immune system overreacts to an infection and starts to damage your body's own tissues and organs. It can be especially hard to spot in babies and young children. You cannot catch sepsis from another person.
  • Martha’s Rule – is a patient safety initiative to ensure the vitally important concerns of the patient and those who know the patient best are listened to and acted upon.
  • Duty of Candour – Both NHS and private healthcare providers are under the same remit to be as honest (known as the ‘Duty of Candour’) with you as you should be with them.
  • Observations (‘obs’) – routine checks to monitor your body while you recover during your child’s time in hospital. The basic checks include: body temperature, respiratory rate, heart rate, pain score, level of alertness.
  • Referral - when one medical professional recommends another for the next part of your child’s care

Acknowledgements

Our thanks go to the International & Private Care department at Great Ormond Street NHS Hospital for Children for support in developing this guide

Sources

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