If you’re considering booking an appointment with a private dermatologist, it’s natural to wonder how things will unfold if your skin condition turns out to need more than just a diagnosis and a prescription. For example, what happens if you require a surgical procedure such as a mole excision, skin biopsy, or treatment for a skin cancer diagnosis? Will your private dermatologist carry out the surgery themselves, or will they refer you back to the NHS? And if so, how does that process work? Will it delay your treatment or disrupt your continuity of care?
These are valid concerns especially for patients weighing up the benefits of going private versus waiting for an NHS referral. While private consultations can be quicker and more flexible, many skin surgeries and follow-up treatments are still handled through NHS hospitals, depending on the complexity of the case, the cost of the procedure, and the facilities required.
The good news is that private dermatologists often work closely with NHS services and can ensure that any necessary referral is handled efficiently and professionally. In fact, many private consultants also hold NHS posts, which allows for a smooth transition between the two systems when needed. In such cases, your dermatologist will help coordinate your care, provide supporting medical records, and often advise you on what to expect at each stage.
In this article, we’ll explore exactly how private dermatologists collaborate with the NHS when further intervention is required. We’ll look at the typical scenarios where a referral back to the NHS might happen, what patients can expect in terms of timing and communication, and how follow-up care is usually arranged to ensure nothing gets missed. Whether you’re dealing with a worrying mole, a skin lump that needs removing, or a chronic condition requiring long-term treatment, understanding how private and public healthcare systems can work together will help you make the right decision for your care.
When Will a Private Dermatologist Refer Me to the NHS?
Private dermatologists are highly trained professionals who often work across both private clinics and NHS hospitals. They’re equipped to diagnose and manage a wide range of skin conditions from acne and eczema to more serious concerns like melanoma or basal cell carcinoma. Many issues can be treated entirely within the private sector. However, there are situations where a referral to the NHS is the most appropriate and cost-effective route for the patient, especially when it comes to more complex or resource-intensive treatments.
Here are the most common scenarios where a private dermatologist may recommend an NHS referral:
- Need for Specialist Surgery
Certain skin conditions particularly some types of skin cancer may require specialist surgical techniques such as Mohs micrographic surgery. This procedure is highly effective for treating basal cell and squamous cell carcinomas, especially when they occur in sensitive areas like the face. Because Mohs surgery requires a dedicated laboratory and surgical team, it is typically performed in hospital settings, often under the NHS. Your private dermatologist may refer you to an NHS facility where these resources are available and where the cost of such specialised treatment can be covered. - Excision of Larger Tumours or Complex Lesions
If you have a larger skin tumour or a lesion that is situated in a difficult area such as close to nerves or on the eyelid the excision might require general anaesthesia, surgical reconstruction, or coordination with other medical specialists. While some smaller excisions can be safely done in a private clinic under local anaesthetic, more complex procedures are often better managed in an NHS hospital setting. In such cases, your dermatologist will explain the reasoning behind the referral and help facilitate the process. - Requirement for Inpatient or Multidisciplinary Care
Some skin conditions aren’t just skin-deep. For example, autoimmune blistering diseases, severe psoriasis, or cutaneous lymphomas may require not just dermatological input, but also care from immunologists, oncologists, or other hospital-based specialists. If your condition demands inpatient care or multidisciplinary management, you may be referred to an NHS hospital where a broader team and facilities are available. The NHS can also provide access to certain biologic treatments or therapies that might not be readily accessible or affordable in the private sector. - Cost and Accessibility Considerations
Sometimes, even if a treatment is available privately, your dermatologist may suggest accessing it through the NHS if it’s in your best interest financially. For example, if you need a course of phototherapy or long-term medication monitoring, the cumulative costs in the private sector could be high. NHS referral in these cases ensures you still receive high-quality care while minimising the financial burden. - Second Opinions and Specialist Investigations
In rare or unusual cases where the diagnosis isn’t straightforward, or if your dermatologist suspects a complex underlying systemic condition, they may refer you to an NHS tertiary centre for further investigation. These centres often house specialists with expertise in rare diseases and have access to advanced diagnostic tools, such as patch testing suites or immunofluorescence labs.
How Does Continuity of Care Work Between Private and NHS?
A common concern among patients moving between private and NHS healthcare is whether the handover will be smooth and whether they’ll receive consistent, joined-up care throughout their treatment. Fortunately, when you’re under the care of a qualified private dermatologist, transitions to the NHS are typically well-managed, clear, and thoughtfully coordinated to ensure no disruption to your treatment plan.
Here’s how continuity of care usually works between private dermatologists and the NHS:
Seamless Referrals with Detailed Clinical Handover
When your private dermatologist refers you to the NHS, they don’t simply hand you a referral letter and send you on your way. Instead, they typically prepare a comprehensive medical handover, including:
- A summary of your condition and diagnosis
- Detailed notes on your symptoms and clinical findings
- Results from any blood tests, biopsies, or scans already performed
- A record of any medications or treatments already trialled
This information is securely shared with the NHS team, allowing them to take over your care without repeating unnecessary investigations or delaying treatment. This not only saves time but also reduces stress and ensures that care remains consistent.
Ongoing Communication Between Healthcare Providers
In many cases, the private dermatologist stays involved even after your referral has been made. This might involve:
- Direct communication with NHS consultants to discuss your case
- Responding to NHS queries or updates on your treatment
- Offering second-opinion consultations if additional guidance is needed later
This collaborative relationship ensures your care is not fragmented, but instead supported by input from both sectors when necessary.
Post-Surgery and Aftercare Support
If you’re referred to the NHS for surgery such as the removal of a skin cancer or a complex lesion it doesn’t necessarily mean your relationship with your private dermatologist ends there. In fact, many patients return to their private dermatologist for:
- Post-surgical wound care
- Scar assessment and management
- Skin maintenance and long-term follow-up
- Cosmetic improvements, such as reducing post-operative pigmentation or texture issues
This shared-care approach is especially helpful when the NHS has managed the acute phase of treatment, but you wish to continue certain aspects of follow-up or cosmetic care with the same specialist you trust.
Patient-Centred Coordination
The overall goal of continuity between private and NHS care is to ensure the patient experience remains seamless and supportive. Whether you’re undergoing a biopsy, surgery, or starting new medications, you can expect:
- Minimal delays between phases of treatment
- Clear communication at every stage
- Reassurance that all clinicians involved are aligned on your needs and progress
In essence, it’s not about which sector is providing your care at any given moment it’s about making sure you receive the right treatment, from the right people, at the right time, with no gaps in service or knowledge.
What Can I Expect in Terms of Waiting Times for NHS Surgery?
One of the major advantages of seeing a private dermatologist is the speed at which you can access care. Appointments are typically available within days, and diagnostic tests or treatments can be arranged quickly without needing to wait for NHS scheduling. However, when it comes to surgery especially complex or highly specialised procedures your private dermatologist may recommend an NHS referral, where waiting times can vary.
NHS Waiting Times: What Factors Influence Them?
If you’re referred to the NHS for surgery, it’s important to understand that waiting times can differ considerably depending on several factors:
- The nature and urgency of your condition
- The type of surgery required (e.g. simple excision vs. Mohs micrographic surgery)
- Your local NHS Trust’s capacity and resources
- Seasonal demands or regional backlogs in care
For instance, Mohs surgery, which is a highly precise technique used to treat certain skin cancers, may not be available in every NHS facility. It requires a specially trained surgeon and on-site pathology support. As a result, patients may be placed on a waiting list at a regional centre of excellence, which can lead to longer delays compared to standard procedures.
Less complex skin surgeries, such as the removal of benign lesions or small skin cancers under local anaesthetic, may be scheduled more quickly often within several weeks to a few months.
Comparing Private vs NHS Timeframes
While private clinics can often offer faster access to initial appointments, test results, and minor treatments, not all surgeries are practical or available in the private sector. Some surgical procedures require:
- Specialist surgical teams with multidisciplinary support
- General anaesthesia or day-case hospitalisation
- Histopathological analysis by NHS laboratories
- A sterile hospital environment with backup facilities
In these cases, even private dermatologists may recommend NHS referral as the safest and most appropriate option despite longer waiting times. The trade-off is that you benefit from the extensive infrastructure and resources of the NHS, even if it takes a little longer to access.
How Your Private Dermatologist Supports the Process
If your private dermatologist determines that surgery is required, they’ll do more than just hand you a referral slip. You can expect them to:
- Explain the likely NHS waiting time based on your condition and location
- Provide interim management such as wound care, symptom relief, or monitoring while you wait
- Follow up after your NHS surgery, especially if further treatment or scar care is needed
- Stay available for private consultation if you have concerns during the wait
In many cases, they may also refer you directly to a named NHS consultant or unit with whom they already work, which can help streamline the process and reduce delays.
Can You Still Choose to Go Private for Surgery?
If the anticipated NHS waiting time feels too long and you’re concerned about delays affecting your condition or peace of mind, your private dermatologist may be able to help you explore private surgery options. However, it’s important to remember that not all procedures are available privately, and costs can vary significantly based on the complexity of the surgery and hospital fees.
Follow-Up After Surgery: Private Care and NHS Support
After your surgery whether performed through the NHS or privately follow-up care is a crucial part of your recovery journey. Many patients opt to continue working with their private dermatologist post-operatively to ensure continuity, convenience, and a more personalised level of support. At the same time, the NHS may also provide structured follow-up appointments, particularly after more complex procedures.
Here’s how follow-up care typically works across both private and NHS services:
Post-Operative Consultations in Private Dermatology
Once your surgery is complete, your private dermatologist can offer a range of follow-up services to support your recovery. These may include:
- Routine post-op check-ups to assess wound healing and ensure there are no complications such as infection or delayed healing
- Scar assessment and management, including recommendations for silicone gels, laser therapy, or other cosmetic interventions to reduce visible scarring
- Emotional support and reassurance, especially if you’ve undergone surgery for skin cancer or other high-impact diagnoses
- Advice on sun protection and skincare routines to prevent recurrence or promote healthy skin during healing
Private follow-up appointments are usually easy to schedule and can offer a more relaxed, patient-focused environment. You’re also more likely to see the same dermatologist at each visit, which contributes to a sense of consistency and trust.
NHS Post-Surgical Monitoring and Support
Depending on the type and complexity of the surgery, the NHS may also provide its own structured follow-up pathway. This can include:
- Wound checks and dressing changes at a nurse-led clinic
- Post-operative reviews with your NHS surgeon to discuss pathology results, surgical margins, and any need for further treatment
- Regular skin surveillance if you’ve had a skin cancer removed this might involve annual or biannual full-skin checks
- Referral to other NHS services, such as oncology or physiotherapy, if needed based on your condition
In cases where you’ve had Mohs surgery or other intricate procedures, the NHS will typically offer a short series of post-op appointments before discharging you back to your GP or private dermatologist.
Combining NHS and Private Follow-Up for Comprehensive Care
Many patients find that combining NHS post-surgical reviews with private dermatological aftercare offers the best of both worlds. This blended approach allows you to benefit from:
- The clinical excellence and surgical expertise of the NHS
- The personalised attention and convenience of private care
- Greater flexibility in scheduling, especially for cosmetic concerns or non-urgent issues
- Continued care from a dermatologist who knows your skin history intimately
Your private dermatologist may also liaise with NHS colleagues to ensure you’re getting the right support on both sides. If any new concerns arise during follow-up, they can quickly step in to investigate or refer you further if needed.
Final Thought: Getting the Best of Both Worlds
If your skin condition requires surgery, a private dermatologist will guide you through the referral process and ensure that you receive the best possible care. Whether it’s a Mohs surgery, excision, or another procedure, the seamless integration between private and NHS care means you won’t miss out on timely treatment.
You can get in touch with us to book a consultation with one of our expert dermatologists in London, whether you’re seeking advice, treatment, or surgery referrals, we’re here to help you.
References
- Nelson, P.A., Barker, Z., Griffiths, C.E., Cordingley, L. & Chew‑Graham, C.A., 2013. ‘On the surface’: a qualitative study of GPs’ and patients’ perspectives on psoriasis. BMC Family Practice, 14(1), p.158. Available at: https://bmcfampract.biomedcentral.com/articles/10.1186/1471-2296-14-158
- Nicholson, P., Lallas, A., Peris, K., Thomas, L., Rallan, D., 2020. Impact of COVID‑19 on Mohs micrographic surgery. Journal of the European Academy of Dermatology and Venereology, 34(11), e665–e667.
Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7361858/ - Bittner, G.C., Brown-Joel, Z., Kovarik, C.L., 2021. Mohs micrographic surgery: a review of indications. International Journal of Dermatology, 60(5), pp.543–552. doi:10.1111/ijd.15326 Available at: https://doi.org/10.1111/ijd.15326
- Shearman, H., Yap, S.M., Zhao, A.J., Passby, L., 2023. A United Kingdom‑wide study to describe resource consumption and waste management practices in skin surgery including Mohs micrographic surgery. Clinical and Experimental Dermatology, 48(S1).
Available at: https://www.researchgate.net/publication/370815832 - British Society for Dermatological Surgery (BSDS), 2020. Mohs Service Guidance and Standards. Available at: https://cdn.bad.org.uk/uploads/2021/12/29200202/Mohs-Service-Guidance-and-Standards-2020.pdf