NHS vs PP

I don't know if this helps but both my older brother and myself are "living with prostate cancer" as the phrase goes. I was treated at the Clatterbridge Cancer Centre on the Wirral under the NHS and my brother was treated at the Christie in Manchester under his private medical insurance. In terms of the guidance we both received I would say it was identical. At Clatterbridge I saw the surgeon who explained what he could do for me and then he left the room and the oncologist came in to explain her options (Hormone Therapy to start with radiotherapy being the main treatment). This pretty much mirrors what my brother received at the Christie.

Now, when it came to the treatment itself, my brother's was slightly different. He had high dose brachytherapy and this was carried out by the main consultant. In subsequent visits, he always saw the consultant. In my case I would often see one of the oncologists working to the lead consultant. My brother's treatment required an overnight stay and this was, being private, in his own room with a TV and decent food. My treatment didn't require an overnight stay being External Beam Radiotherapy delivered over 20 sessions.

At Clatterbridge they also do private patients. In the case of External Beam Radiotherapy there is a separate facility which is a bit more luxurious and there seems to be greater flexibility in terms of timing your treatment. This could be valuable to some people.

So, here in the North West, I don't think there is any difference in the quality of the advice you receive and neither should there be. The main differences are as I outlined above.

Under NHS rules for mixing NHS and private procedures, clinicians are never permitted to suggest private procedures during an NHS consultation, unless you have previously asked them to do so, in which case they must do as you request and let you know if they know of any appropriate procedure which is only available privately.

I guess what you've seen is a formal way to make a request that they let you know about appropriate private procedures.

There was no such formal process where I was treated, but I let the MDT know on a couple of occasions that I wanted to also consider both diagnostic procedures and treatments which were only available privately, and I offered to have a PSMA PET scan done privately if it would help them with the diagnosis. (They offered me a full body MRI scan on the NHS instead which they said was better, so I went for that.) As it happened, there were no better private-only treatments, but they did then let me know I could have my treatments privately or on the NHS. Private meant I could chose when and where and have a private room, but the treatment was identical. I like being with other patients, so I stuck with the NHS.

I saw one of the top prostate cancer urologists in Britain privately in London (£250 for a twenty minute consultation) who offered me a prostatectomy at a London clinic for £19,950.

I said ‘As you are an NHS consultant, can you put me on your NHS list?’

‘Sure, no problem’.

And so it was that I had my surgery by the same consultant and his pet robot Da Vinci, at his NHS hospital in Guldford (I live in Coventry), which was only marred by a weird Catweazle-type character in the bed opposite, who kept his curtains drawn all the time and had his telly on, full-blast, at 3am.

In my experience of private hospitals, the wine list there is better than the NHS where it is non-existent, and I found the food at Guilford surprisingly palatable. Not that you feel like eating much anyway, post-op. The medical care is just as good in both.

A potential bonus of private is if you go to a top hospital e.g., The Royal London, they conduct biopsy during surgery, called Neurosafe, so it gives the surgeon more idea of what is cancer and what is safe to leave alone. Not sure if any NHS hospitals offer this currently, although there have been trials which were successful.

Private or NHS, go for a well-reputed, high-volume surgeon where you are less likely to suffer incontinence and erectile dysfunction afterwards. My surgeon said he wouldn’t send any family or friend to a surgeon who does less than 100 prostatectomies a year.

Intriguingly, he said if he had to have the op., he’d go to some klinik in Germany! Forgot where he said.

Best of luck,

Cheers, John.

Edited by member 24 Dec 2019 at 16:16  | Reason: Not specified

I had mine done privately, mainly for the guarantee that the specific surgeon would definitely do it in the specified time.

Even if listed for the specific surgeon, this can be guaranteed in NHS setting. However, I feel the MDT etc is more robust in NHS setting and the after care wasn't brilliant either with a very junior being a RMO and bank nurses to look after. This was in London.

The wait should not be an issue, any cancer would be dealt within weeks although cancellation can occur if emergencies come up.

Consultant appointments can be slower than you want and I recall considering private treatment.  

I only met a consultant once during my diagnosis and he passed me to a surgeon.   Then I met the surgeon once and have never seen him since, except when I saw him pop out of his office at a clinic.

I was able to speak to Macmillan nurses whenever I wanted to.   But in general my treatment dates were more important to me than who I met.

I got my scan results but it took another 17 days to meet the consultant which I wasn't happy about.  He gave me as long as I wanted which was 25 minutes.  Although it was mainly him telling me the options even though I knew I wanted the op.

He referred me to the surgeon who saw me 11 days later.  He offered me an op 4 weeks later, but then gave me a date 10 days later which was almost faster than the system.

The only reason to go private for me was time.  The private hospitals near us are small and located near the big NHS hospital which to me sums up where you might end up if anything happens.