Getting a private second opinion

When a second opinion actually matters

Most appointments don't need one. A second opinion earns its fee when the stakes are high and the path isn't obvious. The classic triggers:

• Before major, irreversible surgery. Joint replacement, spinal surgery, hysterectomy — anything you can't undo. If one surgeon says operate and the evidence is mixed, a second view is cheap insurance against a £12,000–£15,500 operation you didn't need.
• After a serious diagnosis. Cancer staging, degenerative conditions, anything where the treatment plan will dominate the next year of your life. You're checking the plan, not the diagnosis-giver.
• When treatment isn't working. Months of physiotherapy, medication or procedures with no progress is a reasonable moment to ask whether the working diagnosis is right.
• When two options genuinely conflict. Surgery versus conservative management is often a judgement call, and different specialists weigh it differently.

What a second opinion is not: a way to shop for the answer you want. If three specialists agree, the fourth opinion is rarely the breakthrough.

What it costs

A private second opinion is, in billing terms, just a new-patient consultation — typically £150–£300 depending on the specialty and the consultant. If the second consultant wants fresh imaging rather than relying on your existing scans, add the going rate: a private MRI typically runs £300–£500, a CT £350–£800.

If you hold health insurance and the condition is covered, a second opinion is normally claimable like any other consultation — check with your insurer before booking, as some plans want the referral routed through them.

How to arrange one

Three things make a second opinion useful rather than a repeat of the first appointment: the right records, the right referral and the right consultant.

1. Gather your records. Ask your GP practice or hospital for copies of relevant letters, test results and imaging — you have a legal right to them, and the NHS App now shows much of it. Imaging on disc or via image-sharing link matters most; without it the new consultant may re-order scans.
2. Get a referral letter. Most private consultants prefer a GP referral, and insurers usually require one. Tell your GP plainly that you'd like a second opinion — it's a routine request.
3. Choose a genuinely independent consultant. Ideally a different hospital or group from the first opinion, with a subspecialty interest in your exact condition. Ask the consultant's secretary whether they're happy to review existing imaging.
4. Send everything ahead. A consultant who has read your file gives you a considered view; one seeing it cold gives you a first opinion, again.

Insurer second-opinion services

Several UK insurers now build second-opinion services into their policies — typically a remote review of your diagnosis and treatment plan by a senior specialist, arranged by the insurer at no extra cost. Some use international expert networks for complex cases; others route you to a UK consultant. If you're insured, check your policy documents before paying out of pocket — you may already own the service.

Etiquette myths, busted

The biggest barrier to second opinions isn't money — it's the fear of offending a doctor. That fear is misplaced.

• "My consultant will be insulted." Specialists request second opinions from colleagues constantly; it's how complex medicine works. The GMC's guidance explicitly supports your right to one.
• "It'll go on my record that I'm difficult." It goes on your record as a second opinion. Nobody is keeping score.
• "I'll lose my place with the first consultant." You won't. You can return to the original plan, and NHS waiting-list positions aren't affected by a private second opinion.
• "I need my consultant's permission." You need your records and, usually, a GP referral. Permission isn't part of it.

Ask plainly, gather your file, and treat the fee as part of the cost of the decision — not an extra.

Frequently asked questions