A few days ago, someone started a conversation with me stating: “I know doctor, that you are against private referrals, but...”. I was a bit taken aback, as I do not think I have ever expressed much of an opinion on this matter. Personally I value the NHS a lot, but I know well there are (many) flaws to it. And sometimes the NHS is simply not convenient. So private referrals clearly have their place.
As a GP I do retain some responsibility for my referrals, if only to ensure that I am not sending my patients knowingly to quacks, charlatans or crooks. In order to be on the safe side I will only refer to consultants and professionals who also work in the NHS and preferably to people I know and trust. If someone is conscientious in their NHS practice it is a lot safer to assume that their private practice is at least equal to that.
If you do ask for a private referral, I will usually write my letter to the consultant and give it to you to pass on. We tend not to organise private appointments: You are seen at the time of your and your doctor's convenience.
Insurances ask occasionally for confirmation of referral. The forms for this are of course not NHS work and will attract a (small) fee.
Finally, very occasionally someone will have “jumped the gun” and organised themselves a private consultation prior to speaking with me. I will if at all possible normalise this by following it up with a proper referral, but obviously can only do so, if I myself consider it medically justifiable and the person referred to someone I feel able to trust. This is of course of particular importance if someone wants to utilize an insurance for such treatment. It is therefore always better, particularly if you need “GP approval” for eventual insurance claims to discuss the matter aforehand with me.