Private patient tariff - UHS

Private Patient Tariff 2017 / 2018

Issue No. 2

Contents General Notes ................................................................................................................................... 3 Contacts ............................................................................................................................................ 4 Universal Charges ............................................................................................................................ 5 Theatre Charges ............................................................................................................................... 6 Critical Care Charges ....................................................................................................................... 6 Cancer Care ...................................................................................................................................... 7 Radiotherapy ................................................................................................................................... 7 Bone Marrow Tranplants ................................................................................................................. 9 Cardiothoracic Services ................................................................................................................. 10 Neurosciences ................................................................................................................................ 10 General Medicine ............................................................................................................................ 11 Obstetrics & Gynaecology ............................................................................................................. 13 Gynaecology ................................................................................................................................. 13 Gynaecology ................................................................................................................................. 13 Ophthalmology ............................................................................................................................... 14 Major Procedures .......................................................................................................................... 14 Intermediate Procedures ............................................................................................................... 15 Minor Procedures .......................................................................................................................... 15 Other procedures .......................................................................................................................... 15 Diagnostics & Imaging................................................................................................................... 15 Orthopaedics .................................................................................................................................. 16 Paediatrics ...................................................................................................................................... 17 Pathology ........................................................................................................................................ 18 Laboratory Medicine ....................................................................................................................... 19 Medical Physics .............................................................................................................................. 20 Pharmacy ........................................................................................................................................ 20 Radiology ........................................................................................................................................ 21 Clinical radiology ........................................................................................................................... 21 CT scanning .................................................................................................................................. 21 Nuclear Medicine .......................................................................................................................... 23 Terms & Conditions ........................................................................................................................ 24 1.1 General............................................................................................................................... 24 1.2 Insurance Companies ......................................................................................................... 24 1.3 Insured Patients.................................................................................................................. 25 1.4 Self pay patients ................................................................................................................. 25 1.5 Cancellations ...................................................................................................................... 25 1.6 Late Payments.................................................................................................................... 26 1.7 Drugs and Consumable charges ........................................................................................ 26

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General Notes • All charges apply to inpatients, outpatients and day cases. Charges shown assume that consultants’ fees are charged separately unless otherwise indicated. •

Inpatient and day case charges include an accommodation charge and allowance for drugs up to £25 and consumables up to £125 as specified below. An additional charge will be made for any specialist high cost drugs, medical/surgical supplies used, and drugs issued on discharge.

•

For all inpatients, High Cost drugs will be charged in excess of £25 per the individual drug, which excludes drugs that are issued by TTO for the patients discharge, where it will be the patients responsibility to pay in full.

•

All Private patients high cost consumables are those that exceed £125 per item, with the exception of interventional radiology where a separate price list for these high cost consumables applies (see page 26).

•

Charges for Day Cases are based on the complexity of the surgery being performed as documented in this Tariff Document 2017-2018.

•

A charge will be made for the use of all non-urgent private patient transport, this will be invoiced separately and in additional from the treatment price.

•

A comprehensive list of pathology service tests is available upon request.

•

All charges shown are in pounds sterling (£) and are inclusive of VAT.

•

Private International patients will be charged 25% in addition to their invoice to cover medical/professional fees.

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Contacts Name Debbie Roberts Ian Godfray

Division Trust HQ

Department General Enquiries/ Cashiers

Job Title Chief Cashier Deputy Chief Cashiers

Telephone 02381 20 6058

Charlotte McCaskie

Trust HQ

Commercial Enquiries

Private Patient and Contracts Manager

02381 20 6260

Nathan Burnett Ann Clay

Division A

Cancer Care

Private Patient Co-ordinator Business Manager

02381 20 6598 02381 20 5437

Hayley Conway

Division A

Surgery

Private Patient Coordinator

02381 20 6875

Sue Denton/ Elvena Prince

Division A

Critical Care

Private Patient Coordinator Ward Clerk

02381 20 8707 02381 20 6117

Carole Collins

Division B

ED/ CDU

Office Manager

02381 20 6220

Lisa Burt Frost

Division B

AMU

Office Manager

02381 20 8049

Susan Dance Leanne Beck

Division B

Pathology

Contracts and Information Manager Private Patient Coordinator

02381 20 8443 02381 20 8355

Linda Peart

Division B

Ophthalmology


02381 20 6853

Tina Walsh

Division C

Women’s & Children’s


02381 20 5069

Division C

Pharmacy

High Cost Drugs Technicians

023 8120 8637

Division D

Radiology

Office Manager

02381 20 4434

Division D

Cardiothoracic, Neuro & Trauma and Orthopaedic

Private Patient Co-ordinator

02381 20 3211

Angela Macaulay/ Christie Sarah Hall

Jayne

Emma Francis

Universal Charges Outpatient consultation

Day case - non operative

Classification of Treatment

Notes

Consultation appointment

Charge is for the use of the room only. An additional charge will be made for all diagnostic procedures, all drugs and all medical and surgical devices.


Notes

Hourly rate - capped at four (4) hours

Accommodation charges

Includes use of bed for observation, drug monitoring, transfusion, infusion etc.


Notes

Shared accommodation

Charge per day or part thereof Charge per day or part thereof and subject to availability Charge per day or part thereof and subject to availability

Single room

Single room - en suite

Amenity bed Clinical support services

Tariff 75

Tariff 108

Tariff 343 379

414

101


Notes

Physiotherapy Dietetics Occupational therapy Sports injury clinic

per 15 minutes session per 15 minutes session per 15 minutes session per 15 minutes session

Tariff 45 45 45 45

Theatre Charges Theatre and catheter room Day case and Inpatients Includes local anaesthetic Includes local anaesthetic


Max Time (minutes)

Tariff

Minor Intermediate

Up to 30 Up to 60

Theatre and catheter room Day case and Inpatients Includes General Anaesthetic


Max Time (minutes)

Tariff

Minor Intermediate Major Major Plus Complex Major – 1 Complex Major – 2 Complex Major – 3 Complex Major – 4/5

Up to 30 Up to 60 Up to 90 Up to 120 Up to 150 Up to 180 Up to 210 Up to 240

642 1,262 1,881 2,502 3,119 3,667 4,360 4,965

334 987

Any Minor or Intermediate procedure that lasts longer than the specified time will incur an additional charge of £300 per 30 minutes in theatre or part thereof. Any Major or Complex procedure that lasts longer than the specified time will incur an additional charge of £680 per 30 minutes in theatre or part thereof. The charges above do include: • General and local Anaesthetic The charges above do not include: • High cost consumables (over £125, including Trust handling fee) which will be charged separately • Cardiac consumables/ pacemakers/ implantable devices, these will be charged separately. • The Surgeon and Consultant Anaesthetist Fees, which will be billed separately.

Critical Care Charges Critical care


(per day or part thereof)

Non ventilated High Care Ventilated High Care Intensive Care – Cardiac Intensive Care – Neuro Intensive Care - Other specialties Haemofiltration therapy Plasmapheresis therapy

E&OE

Notes

Tariff 1,163 1,676 2,758 2,758 2,758 1,289 1,586

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Cancer Care Chemotherapy (per treatment session)

Hours Up to 2hrs 2 - 4hrs 4 - 6hrs 6 - 8hrs Rate per Hour (over 8 hours)

Chemotherapy


(per treatment session)

Scalp cooling Stem cell - white blood set Stem cell - auto PBSC Stem cell - red blood set Stem cell - plasma exchange Plasma exchange

Other charges


Notes

Tariff 278 377 468 561 164

Notes

Tariff 138 724 724 643 708

2-3 likely to be required 2-3 likely to be required 2-3 likely to be required 2-3 likely to be required Patient to require every 3 - 4 weeks.

536

Notes

Tariff

Blood test Chemotherapy treatment cost Per hour (excludes drugs)

40 105

Where a chemotherapy patient is an inpatient, and receives chemotherapy treatment from their bed, the standard bed day rate will apply and no chair cost will be made.

Radiotherapy Classification of Treatment

Fractions included

Tariff

Prostate by VMAT

37 21,228

Breast package 1

25 27,361

Breast package 2

15 20,520

Breast Boost Head and Neck with shell and IMRT Prostate by VMAT + Day case Single Brachytherapy HDR Treatment HDR vault insertions as OP for endometrium patients

5 5,472 33 20,985 15 21,060 4 19,473

Cervix followed by 2 HDR full insertions as a daycase Endometrium followed by 2 HDR vault insertions as an outpatient

25 40,475

Gynecological no HDR

28 17,435

E&OE

25 24,058

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Radical Lungs package 1

30 18,681


20 12,453


33 20,548

Radical Lymphoma

15 9,538

Radical Lymphoma

10 6,482

Superficial treatment package 1

10 9,058

Superficial treatment package 2

5 4,529

Prophylactic Cranial Irradiation

10 6,359

Prostate LDR Seeds Brachytherapy (BT212) HIPEC IOERT

1 13,574 n/a POA n/a POA

Classification of Treatment Palliative treatment package 1 Simple Complex e.g. with shell Palliative treatment package 2 Simple Complex e.g. with shell Palliative treatment package 3 Simple Complex e.g. with shell

Fractions Included

Mould room charges

Notes

Classification of Treatment Full shell Head shell Prone shell Orfit shell Electron shell Conformal wax Compensator

E&OE

Tariff 10 10

5,738 6,359

5 5

2,868 3,179

1 1

1,367 2,164

Tariff 401 319 733 131 437 171 479

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Bone Marrow Tranplants Peripheral blood stem cell transplant


Tariff

Full intensity, sibling allogeneic PBSCT

115,210

Full intensity, sibling allogeneic BMT

107,718

Full intensity, VUD allogeneic PBSCT

100,025

Full intensity, VUD allogeneic BMT Reduced intensity, sibling allogeneic PBSCT

96,663 101,857

Reduced intensity, sibling allogeneic BMT

97,864

Reduced intensity, VUD allogeneic PBSCT

89,141

Reduced intensity, VUD Allogeneic BMT

90,001

Autologous PBSCT

51,833

Autologous BMT without TBI

52,125

Autologous BMT with TBI conditioning

58,573

PBSC harvest only

16,061

Bone marrow harvest only

12,038

Sibling donor lymphocyte infusion

5,406

Volunteer unrelated donor lymphocyte infusion

4,188

Harvests for Volunteer Unrelated Donors are charged separately. The charges made will vary significantly depending on the country supplying the donation. These prices are based on a standard procedure with expected drug and blood products. Any additional drugs, blood products or procedures will be charged separately. All prices include outpatient appointment costs and hospital stay costs.

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Cardiothoracic Services Cardiothoracic diagnostics


Notes

24 hour BP monitor Flow rate U/S study T.O.E

Cardiac investigations

Tariff 52 103 424


Notes

ECG Stress test Echocardiogram with doppler Tilt table test Automatic function test Cardiomemo 24 hr heart monitor (fit & analysis) 24 hr heart monitor (analyse only) 24 hr blood pressure monitor 7 day event recorder Pacemaker check ICD check

Excludes Consultant Fees Excludes Consultant Fees Excludes Consultant Fees Excludes Consultant Fees Excludes Consultant Fees Excludes Consultant Fees Excludes Consultant Fees Excludes Consultant Fees Excludes Consultant Fees Excludes Consultant Fees Excludes Consultant Fees Excludes Consultant Fees

Tariff 69 224 289 242 101 56 137 64 116 222 67 70

Neurosciences Neurosciences

Classification of Treatment E.M.G E.E.G – routine E.E.G – ambulatory E.E.G. infected patient Evoked potentials Nerve Conduction Studies (NCS) Visual fields Intra operative Spinal/ Brainstem Monitoring Videotelemetry

Notes

Per hour

First 24 hour period or part thereof Each subsequent 24 hour period or part thereof All other procedure charges will be based on the theatre and day case rates specified in the Universal Charges section.

E&OE

Tariff 133 163 437 180 173 117 69 151 1,704 1,482

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General Medicine General Medicine

Classification of Treatment High resolution oesophageal manometry 24 hour impedance testing 24 hour pH testing Combined High resolution oesophageal manometry and 24 hour pH Combined High resolution oesophageal manometry and 24 hour impedance High resolution anorectal manometry (physiology) Endoanal ultrasound Nerve conduction studies (EMG/pudendal nerve) Sacral nerve neuromodulation Follow-up Anorectal biofeedback Hydrogen/methane breath testing Sigmoidoscopy Anorectal Physiology Gastroscopy Bronchoscopy Colonoscopy Liver biopsy (excluding Pathology & Radiology procedures) Fibroscan (Hepatology) ERCP Sphincterotomy Stone removal (Lithotripsy) Naso biliary drainage EUS (endoscopic ultrasound) Cardio-pulmonary exercise test Endobronchial Ultrasound (EBUS)

Notes Excludes Consultant Fees

Tariff 400

Excludes Consultant Fees

400

Excludes Consultant Fees Includes Consultant Fees

400 1000

Includes Consultant Fees

1000


605

Excludes Consultant Fees Excludes Consultant Fees

264 310


267

Excludes Consultant Fees Excludes Consultant Fees Excludes Consultant Fees Excludes Consultant Fees Excludes Consultant Fees Excludes Consultant Fees Excludes Consultant Fees Excludes Consultant Fees

605 200 788 202 788 788 788 896

Excludes Consultant Fees Excludes Consultant Fees Excludes Consultant Fees Excludes Consultant Fees Excludes Consultant Fees Excludes Consultant Fees Excludes Consultant Fees Excludes Consultant Fees

314 1,199 1,199 1,199 896 690 341 3,996

Respiratory


Notes

Tariff

Pulmonary Function Tests

Aeroallergens

100

Food Allergens Consultation appointment Spirometry Spirometry with Ventolin Spirometry with Ipratopium Spirometry (Ventolin/Ipratopium) Bronchial Challenge Transfer factor Flight assessment (Fit to Fly) Helium-Rebreathing (lung volumes)

125 75 56 80 110 110 260 63 122 62

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Plethysmography Six minute walk Muscle testing Oscillatory Nitric Oxide Measurement Aero Allergens Food Allergens Areo/Food Allergens Combination Cardio Pulmonary exercise testing (CPET) FENO Histamine Challenge BDR Ipratopium BDR Salbutamol Capilliary Blood Gas Other tests available upon request Dermatology


Photo dynamic therapy

Single area (per session) Multiple lesions (per session)

PUVA (photo chemotherapy) Light therapy

First session (including MED test)

113 54 76 57 63 101 124 150 506 50 111 116 111 78 POA Notes

Tariff

Excludes Consultant Fee Excludes Consultant Fee

448 601

First Session

2 hour session

122.35

Additional sessions

30min session

50

Excludes Consultant Fee

131


31 POA

Includes Consultant Fee

487


168 316


335


987

Additional sessions Iontophoresis treatment Patch Test

Patch test - 3 sessions Photo patch test (including outpatient consultant fee)

Skin surgery

Nurse Led Consultation

E&OE

Minor procedures including simple excision, shave excision, curettage including local anaesthetic (30 min) Intermediate procedures including up 3 excisions, larger excisions for skin cancer trunk/ limbs, multiple mole removal (60 min) Day case procedures incl. skin flaps, skin graft, excisions for skin cancer on the face Per session

70

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All prices for treatments and packages include room costs, all procedures, anaesthetic (if required) and consumables. Prices exclude Consultant and Histopathology fees unless stated otherwise. Any other Dermatology procedures prices are available upon request.

Obstetrics & Gynaecology Classification of Treatment

Notes Tariff

Gynaecology

Minor procedure cervix / uterus Minor procedure cervix (uterus collagen injection)

Minor procedure uterus / adnexae

Hysteroscopy

Colposcopy Classification of Treatment

Excludes Consultant Fee, High costs drugs will be charged separately. Excludes Consultant Fee, High costs drugs will be charged separately. Excludes Consultant Fee, High costs drugs will be charged separately. Excludes Consultant Fee, High costs drugs will be charged separately. Excludes Consultant Fee, High costs drugs will be charged separately..

338

338

701

701

701

Notes Tariff

Gynaecology Ultrasound Foetal medicine outpatient ultrasound assessment Delivery - normal including 1 night stay


134 134

Excludes Consultant Fee 1,480

Any necessary surgical procedures will be charged in accordance with the theatre categories stated in the Universal Charges section.

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Ophthalmology All Major and Minor procedures include the use of ophthalmology theatres, all procedures exclude surgeon and anaesthetic fees. Major Procedures Cornea Iris & Anterior Chamber

Classification of Treatment lamella graft (keratoplasty) to cornea

Tariff £’s 2555

Combined Phacoemulsification, implant and trabeculectomy Surgical Trabeculectomy

1922 1922

Correction of ptosis of eyelid (simple, including tarsomullerectomy)

1922

Muscles

Surgical correction of squint – horizontal 1 muscle Surgical correction of squint – horizontal 2 muscle

1922 1922

Vitreous

Vitreous biopsy/ pars plana vitrectomy Pars plana vitrectomy Pars plana vitrectomy with internal tamponade, scleral buckling and retinpexy Pars plana vitrectomy with internal tampondae, scleral buckling and retinopexy, including dissection of excision of epiretinal membrane/macular surgery Combined pars plana vitrectromy

1922 2555

Eyebrow & Lid

Eyebrow & Lid

Cataract Choice Cataract Surgery

2555

3189 3189

Correction of ptosis of eyelid - simple, including tarsomullerectomy Correction of ptosis of eyelid - complex Correction of ptosis of eyelid with autologous fascia lata Bilateral upper lid and lower lid blepharoplasty GA Lid reconstruction

2555 2555 2555 1969 2619

Inclusive Package price Consultant Choice

1,600 1,900

To note any procedures not mentioned above are available on request.

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Intermediate Procedures Lens

Classification of Treatment Phaoemulsification of lens with implant – unilateral

Eyebrow & Lid

Blepharoplasty (Bilateral) Correction of lower lid ectropion without graft/ flap Correction of lower lid ectropion with graft/ flap Correction of entropion - lower lid Correction of entropion - upper lid, including graft/ flap

Minor Procedures Eyebrow & Lid

Classification of Treatment Excision of lesion of eyelid Correction of entropion

Tariff 997 997 997 997 997 997 Tariff 337 337

To note any procedures not mentioned above are available on request. Minor and intermediate charges do not include the cost of a general anaesthetic which will be charged separately if required. This will be charged at £334 for all minor and intermediate procedures.

Other procedures Treatment room procedures

Classification of Treatment Intravitreal triamcinalone injection Intravitreal antibiotic injection

337 337

Macula Degeneration

Intravitreal Injection (excl drug)

337

Miscellaneous

YAG Laser Capsulotomy - Unilateral YAG Laser Capsulotomy - bilateral Argon Laser

337 337 314

Diagnostics & Imaging


Imaging

Fundus Flourescein angiography (FFA) Fundus photography Optical Coherance Tomography (OCT) Indocyanine Green Angiography (ICG) Combined Flourescein/IGS Heidelberg Retinal Tomography (HRT) Endothelial cell count Corneal Topography Anterior segment photography Corneal Pachymetry Stereo Disc Photos

E&OE

Tariff

Tariff

255 73 73 255 275 73 82 73 73 73 73

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Treatment room procedures Miscellaneous

Pachymetry 73 73 73 73 73 73 73 73 73 402

Biometry Pre-op Assessment Orthoptic Assessment Ocuscan Ultrasound (B scan ) Refraction Low vision assessment Contact lens fitting Visual Evoked Response (VEP) and Pattern Electro-Retinogram (PERG) VEP, PERG and Electro-Retinogram (ERG) VEP, PERG, ERG and Electro-Ocular Gram (EOG) Electrodiagnostic tests for a Child 100 Hue test 24 Hour phasing 12 Hour phasing Visual Fields Colour Photography Punctual Plugs Radio Surgery Botulinum Toxin Glaucoma Screening Visudyne Therapy

355 466 566 402 73 73 73 73 73 176 289 289 161 2123

Orthopaedics Orthopaedics Classification of Treatment Plaster of paris

Other procedures available upon request

E&OE

Tariff

Xiapex Clinic Dynocast/Bay Cast:

1,569

Below Elbow Above Elbow Below Knee Above Knee Jacket/Hip Cast

102 169 210 347 1,029 POA

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Paediatrics Orthopaedics

Classification of Treatment Tongue Tie

Notes Package Price – includes consultant fee Major release of muscle Includes high cost consumables, (excluding hamstring - cost per excludes consultant and case basis) anaesthetist fees Pelvic osteotomy Includes high cost consumables, excludes consultant and anaesthetist fees Open reduction - complex Includes high cost consumables, excludes consultant and anaesthetist fees Spica to Broomsticks Includes high cost consumables, excludes consultant and anaesthetist fees Broomsticks to splints Includes high cost consumables, excludes consultant and anaesthetist fees Adductor release and arthogram Includes high cost consumables, excludes consultant and anaesthetist fees Femoral osteotomy Includes high cost consumables, excludes consultant and anaesthetist fees Guided growth Includes high cost consumables, excludes consultant and anaesthetist fees Removal of hip spica and pins Includes high cost consumables, (after pelvic osteotomy) excludes consultant and anaesthetist fees Open reduction and femoral Includes high cost consumables, osteotomy combined excludes consultant and anaesthetist fees

Tariff 164 2,802

11,210

11,210

1,681

1,681

2,129

11,210

5,605

2,556

16,814

All other paediatric orthopaedic cases will be charged on a cost per case basis.

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Pathology Classification of Treatment

Notes

Referred stained slides or blocks-this covers administration costs and report production only.

Excluding medical fees

Tariff

Cellular Pathology 45

Where technical work is carried out on wax blocks or unstained slides supplied with or produced from a referred case the following additional charges will apply Special stains Immunohistochemical Tests first 2 (excluding ER & PR) Additional immunohistochemical test – ER Additional immunohistochemical test – PR Immunofluorescence Electron microscopy Renal biopsy Liver biopsy - routine case Liver biopsy - complex case Radical prostatectomy Bone marrow trephine

Including controls

43

43

Per case Per case Full examination including electron microscopy No immunostaining Including immunostaining Includes large blocks with levels Includes levels and special stains

Acetyl Cholinesterase HER2 IHC SISH HER2 plus SISH EMU

Histopathology (excludes medical fees)

E&OE

105 311 629 188 309 238 200 137 120 167 268 268


Notes

Basic routine case

Up to 2 standard blocks with H&Es and levels With H&Es and levels Each with H&Es and levels Per case, initial report

Each additional standard block Large blocks Frozen sections

26 98

Tariff 84 22 45 91

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Classification of Treatment Neuropathology (excludes medical fees)

Muscle biopsy

620

Nerve biopsy Eye (globe) CSF

353 166 103

Classification of Treatment Non-Gynae Cytology (includes medical fees but price will be broken down within the invoice)

Tariff

Notes

Cervical smear

84

Body fluids Sputum Brushings Electron Microscopy (includes medical fees)

Classification of Treatment Electron Microscopy from fixed tissue including processing, sectioning and photography X-ray analysis including processing, sectioning and Analysis Report sent to pathologist concerned Brushings Out of Hours Testing per test

Tariff

155 155 155 Notes

Tariff 365

436

Between 17:00-08:00hrs Monday – Thursday Friday 17:00 – Monday 08:00hrs including Public Holidays

121242.50 157 44

Laboratory Medicine Clinical pathology


Notes

(includes medical fees, price will be broken down within the invoice)

Various tests, for example:

Biochemistry ‘Full Profile’

37

Individual tests from £15.60 each please call lab on 023 81 20 6435 for further details Renal profile Liver profile Bone profile Blood gases INR Phlebotomy

E&OE

Tariff

24 24 24 37 13 36 19 of 26

Haematology & blood transfusion


Notes

(includes medical fees, price will be broken down within the invoice)

Various tests for example:

Full blood count (FBC)

24

Cross match per unit (excluding cost of blood) Coagulation screen APTR HEP

67

Immunology


Tariff

18 18 13 Tariff

Various tests available; prices upon request Classification of Treatment Microbiology Venesection


Tariff

Phlebotomy

36

All Pathology tests requiring 'out of hours' service will levy an additional fee per test.

40

Medical Physics Medical Physics


Notes

Sub-Arachnoid haemorrhage monitoring Microvascular assessment Vascular ultrasound Bone densitometry Displacement measurement Displacement measurement

Per assessment

Dupple or transcranial Neuro otological Neuro only

Tariff 19 151 224 75 300 194

Pharmacy Pharmacy

Classification of Treatment Drugs for TOP UP and Co-Payment Patients;

Tariff POA

See 1.7 of the Terms and Conditions for other associated charges

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Radiology This includes interventional radiology procedures and nuclear medicine. All prices under the Radiology section exclude High costs drugs (over £125 per item), General Anaesthetic, Consultant and Consultant Anaesthetist fees unless specified otherwise: Group Classification

Notes

Group A Group B Group C Group D Group E Group F

Tariff 47 130 238 427 681 1,095

These charges will apply in the absence of a specific tariff. Classification of Treatment

Notes

Tariff

Clinical radiology PACS Storage Plain X Ray Group A Ultrasound Group B Drainage Biopsy

POA 47 130 867 867

Price excludes Consultant & Consultant Anaesthetist charge. Classification of Treatment

Notes

Tariff

CT scanning CT scan 1 area (+/- contrast) CT Scan 2 areas (+/- contrast) CT scan 3 areas (+/- contrast) CT scan brain (+/- contrast)

MR scanning

Gadolinium

E&OE


Includes consultant fee Includes consultant fee Includes consultant fee Includes consultant fee

Notes

471 622 889 490

Tariff

1 Area

Includes consultant fee

453

2 Related areas 2 Unrelated areas 3 Related areas 3 Unrelated areas Cardiac scan Cardiac scan under stress

Includes consultant fee Includes consultant fee Includes consultant fee Includes consultant fee Includes consultant fee Includes consultant fee

629 895 899 1,487 1,309 1,765 150

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Interventional Radiology – Prices exclude Consultant or Consultant Anaesthetist charges.

Paediatric

Minor Intermediate Major

Tariff 379 566 1,028

Fixed price treatments

Classification of Treatment Discogram Joint injection Nephrostogram Longline PICC - single lumen PICC - double lumen Chest drain Liver bx Balloon dilatation

362 214 252 431 727 776 612 537 1,133

Basic package price - with some additional consumables to be charged on a case by case basis

Nephrostomy Ureteric stent Gastrostomy Transjug liver bx Ureteric stent change Tace IVC filter IVC filter retrieval TIPSS RFA RFA cryo Atherectomy AAA Colonic stent PCNL Renal artery stenting

977 665 685 1,811 665 1,085 2,542 1,360 1,299 2,439 2,623 2,314 3,363 868 3,684 1,355

The lead consultant may be able to give advice on an approximate total cost in advance of the procedure being undertaken, this is because the volumes change on a case by case basis. Cost per case

TIPSS venogram PTC Angiogram Angioplasty Fibroid embolisation Embolisation Complex embolisation Biliary stent SIRT

POA POA POA POA POA POA POA POA POA

For all embolisation treatments the quantity of embolic agent is unknown until the procedure is underway. Additional consumables will therefore vary from case to case and are not predictable. Prices for all other procedures will be undertaken on a cost per case basis

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Classification of Treatment Nuclear Medicine Bone

Notes

Bone Whole Body with SPECT CT DXA Scan

Tariff 435

Bone mineral density scan for osteoporosis

75

Brain

Brain perfusion imaging SPECT Brain dopaminergic system imaging

Cardiac

MPS Tf stress gated MPS Tf rest gated Cardiac ventriculography rest (MUGA)

515 515 515

Renal

Renal DMSA Renogram with diuretic GFR estimation 3 samples

434 538

Thyroid Scan (Pertechnetate) Iodine 123 (Whole Body + SPECT CT) Thyroid I131 thyrotoxicosis therapy Parathyroid scan SPECT CT

309

Liquid gastric emptying study Lung Perfusion Scan (VQ) Lymphoscintigram Radionuclide SeHCAT bile study White Cell Fab Leukoscan SPECT MIBG iodine 123 SPECT CT Octreotide scan SPECT CT Urea breath test

595 540 661 929 1,297 2,365 2,491 272 1,192 464 525 435 272

Thyroid

Other

Phosphorus 32 therapy Blood Volume Lacrimal Scintidacrocystogram Meckels Scan Iodine 131 no drink Iodine 131 (Whole Body + SPECT CT) Sentinel Lymph node SPECT CT

E&OE

577 1,016

434

509 672 652

435 544

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Terms & Conditions 1.1

General

1.1.1 Please read these terms and conditions below carefully prior to agreeing to undertake treatment as they set out the terms upon which you will be provided with treatment and replace any previous terms and conditions which you may have received. 1.1.2 The tariff applies to private patient admissions from 1 April 2017 to 31 March 2018. 1.1.3 The prices included within this tariff are in the main hospital charges for private patients and do not include the costs of Consultants and Consultant Anaesthetists who will agree charges and bill you directly unless specified otherwise. 1.1.4 All patients are required to sign an ‘Undertaking to Pay’ agreement before an outpatient, day case or inpatient appointment or treatment can proceed. This applies to self paying and overseas patients as well as those with insurance and will cover any unforeseen costs. 1.1.5 No variations to this tariff will be made unless specifically agreed to in writing by the Trust authorised representative. 1.1.6 Patients should ensure that they understand which Universal Charges will be charged in addition to specified treatment costs prior to undergoing treatment as well as the expected costs for high cost consumables and drugs which will be charged. 1.1.7

The Trust is unable to accept responsibility for any personal property lost, stolen or damaged during a Hospital stay or visit and therefore advises that property brought into the Hospital is done so at the owner’s risk.

1.1.8

No clinical treatment is without risk and therefore patients should ensure that they are fully aware of the risks and potential complications arising from treatments prior to undergoing treatments.

1.2

Insurance Companies

1.2.1 The prices listed in the tariff are those which will be billed to insurers by the Trust from 1st April 2017 to 31st March 2018. 1.2.2 A referral of an insured patient to the Trust after 31 March 2017 by the insurer constitutes acceptance of these terms and conditions. 1.2.3 Any signed agreement / contract made between the Trust and the insurer for the provision of Private Patient Treatment to their insured members is made on the basis of this published tariff and any variation to prices contained therein, as agreed in writing. 1.2.4

In the absence of an alternative agreement in writing between the Trust and insurer made by 31 March 2017, the prices contained within this tariff will always apply between 1st April 2017 and 31 March 2018.

1.2.5 The insurer accepts the incorporation of this published tariff and any supporting price schedules referred to in the tariff (i.e. high value drugs costing over £25), into any standard contract for the provision of Private Patient Treatment services by the Trust. The tariff supersedes any listed procedure prices, treatments, procedures, drugs, consumables or other service inclusions or exclusions which may be included in the insurers standard contract. 1.2.6 Where full payment is not made and this has not been agreed in writing between the insurance company and the Trust the Trust reserves the right to collect the shortfall made against these tariff prices by an insurer from the insured patient. The Trust also reserves the right to charge a fee of £25 to the patient, to cover the cost of additional administrative services. E&OE

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1.3

Insured Patients

1.3.1 The Trust is recognised by most UK insurers and charges will be recoverable under standard health insurance policies within the individual subscriber’s agreement. 1.3.2 The medical insurance is a contract between the patient and the insurance company. 1.3.3 It is the responsibility of individual patients to obtain confirmation that any benefits will be sufficient to meet the anticipated cost of the treatment prior to hospital admission. Individuals must ensure that their insurance policy will meet the anticipated cost of the treatment to avoid delays as this confirmation will be required prior to the commencement of treatment. 1.3.4 If subsequent to treatment your insurance company does not recognise your claim then you will be personally responsible for payment. In addition should your insurance company refuse to pay a portion of your bill you will be responsible for payment along with any surcharges for additional costs incurred by the Trust. 1.3.5 Patients should also ensure that exclusions and waiting periods are adhered to prior to arranging for treatment to be undertaken, as defined in their policy (GP referral).

1.4

Self pay patients

1.4.6 Patients will also be charged additional amounts for sundry items such as telephone calls. 1.4.7 If you decide not to complete your treatment plan you will be charged in full up to the date of cancellation of treatment at the rates specified in the private patient tariff. If your consultant decides to amend or cancel your treatment you will be reimbursed for any amounts paid in advance at the rates specified in the private patient tariff. 1.4.8 All outpatients will be required to pay prior to the day of attending the appointment or on the day of the appointment prior to the appointment. Inpatient and day case patients will be required to pay a deposit equivalent to the estimated total cost of treatment 7 days prior to admission. All additional charges incurred above the estimated total cost of treatment must be paid prior to discharge. 1.4.9 Patients are required to inform the Cashiers Office on 02381 206058 of any changes to their contact details.

1.5

Cancellations

1.5.1 The Trust reserves the right to charge for cancellations made by the patient as set out below: Within 7 days of admission/ consultation 50% Between 2 and 7 days of admission / consultation 75% On day of admission/ consultation 100% 1.5.2 The Trust will reimburse the patient who has pre-paid for a treatment or appointment in advance, that has been cancelled by the Trust for reasons deemed unrelated to the patients health.

E&OE

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1.6

Late Payments

1.6.1 The Trust reserves the right to charge interest at 5% above the Bank of England base rate for any overdue amounts.

1.7 Drugs and Consumable charges The standard the trust applies for drugs is BNF plus VAT + 15%. The standard the trust applies for high cost consumables is VAT (if applicable) plus 10%. A dispensing fee of £8.50 will be applied per every oral medication dispensed. An Aseptic fee for chemotherapy drugs will be applied according to the complexity of a product that is made. (The cost of diluents and intravenous fluids is included in the cost of the drug).

E&OE

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Private patient tariff - UHS

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