Private urologist vs NHS: what differs and what doesn’t

Published 22 October 2026

Choosing between a private urologist and the NHS is rarely a choice between better and worse doctors. All three of our specialists also practise at Guy’s & St Thomas’, and the same regulators oversee both sectors; what changes privately is access, who you see, time, and where and when you are seen. This page sets out those differences, including when the NHS is the right route.

What is the difference between a private and an NHS urologist?

In most cases the difference is the route, not the specialist. A urologist’s training, GMC registration and professional duties are the same whoever pays. At The Andrology Centre, all three of our specialists also practise at Guy’s & St Thomas’, named by Newsweek in 2025 as the number one urology service in Europe.

What changes is the system around the consultation, and who pays. NHS services are free of charge, apart from certain limited exceptions; a private appointment is paid for by you or your insurer. The two are not mutually exclusive: you can use both at different stages of the same problem.

How do private and NHS urology compare?

The main differences are speed of access, choice of an individual specialist, appointment length and cost. The NHS column covers rules across NHS services in England; the private column covers our clinic, which may differ elsewhere.

Scroll the table sideways to see every column

What stays the same if you go private?

Paying buys a different route into care; it does not buy different medicine.

The specialists

You see Mr Maj Shabbir, Consultant Urological Surgeon and a past National Chair for Andrology at BAUS; Ms Raveen Kaur Sandher, Consultant Urological Surgeon; or Ms Elsie Mensah, Urology Specialist. Their GMC numbers are published on our consultants page and can be checked against the GMC register.

The regulation

The Care Quality Commission (CQC) is the independent regulator of health and adult social care in England. It registers care providers and monitors, inspects and rates services, and it inspects independent hospitals as well as NHS trusts.

The evidence

Paying does not change which test answers a clinical question or which treatment works. A raised PSA or blood in the urine is investigated on the same evidence either way. We will tell you plainly when a test or treatment is unlikely to help.

What changes when you see a urologist privately?

Five things change in practice: how you get an appointment, who you see, time, follow-up, and where and when.

Speed of access

If you are paying for yourself, you can contact us directly to book, without joining an NHS waiting list. If you are insured, the main step is obtaining a GP referral and an authorisation code.

Speed matters most for problems not urgent enough for a fast-track NHS referral but disruptive enough that a long wait is hard: a slowing stream, getting up at night, recurrent infections, or a fertility question when time is already a factor. It matters less where the NHS already has a fast pathway, as for suspected cancer.

Choice of a named consultant

Privately, you choose the individual. On the NHS, when your GP refers you, in most cases you have the legal right to choose the hospital, and you can choose a clinical team led by a consultant; the choice is of the team rather than of each doctor within it.

That choice can include many private hospitals that provide services to the NHS, if it costs the NHS no more than a standard NHS hospital: NHS-funded care, not paying privately.

Choosing the individual matters most in a subspecialty: Mr Shabbir and Ms Sandher work in andrology, male infertility and reconstruction, Ms Mensah in bladder cancer, BPH and prostate diagnostics. If you are unsure which you need, see andrologist vs urologist.

Time in the appointment

Appointment lengths are published in advance. A first consultation in person is booked for up to 40 minutes, a first consultation by video or telephone for up to 30 minutes, and a follow-up for up to 20 minutes. NHS clinic slot lengths are set by each hospital.

Follow-up

Privately, follow-up appointments are booked with a named specialist, and you can ask when booking to see the same person each time. That matters for problems watched over months, such as a PSA being monitored. NHS care comes from a consultant-led team.

Where and when

We see patients at HCA at The Shard (SE1 9BS) and HCA at Guy’s Hospital (SE1 9RT), both near London Bridge station, and HCA at Canary Wharf (E14 5NR). See private urology at Guy’s Hospital.

How long are NHS urology waiting times?

It depends on the hospital and changes over time, so the useful answer is where to look. The NHS publishes waiting times for individual hospitals on its My Planned Care website, so you can compare hospitals before choosing where to be referred.

Behind those figures sit some fixed rules. The NHS Constitution gives you the right to be seen within maximum waiting times, and for non-urgent, consultant-led treatment the maximum is 18 weeks. The clock starts when the hospital receives your referral letter, or when you book your first appointment through the NHS e-Referral Service, and stops when treatment begins, when a clinician decides none is needed, or when you decide not to be treated.

If you are likely to wait longer than the maximum, you have the legal right to ask to be seen by a different provider. The hospital or your integrated care board must then look into it and offer a range of suitable alternative hospitals or clinics that would be able to see you sooner.

The 18 weeks is a maximum that gives you rights, not a forecast of your own wait; your hospital’s published figures are the better guide.

When is the NHS the right route?

The NHS is the right route in an emergency, after an urgent referral for suspected cancer, and when cost would stop you finishing the plan.

Emergencies

A private outpatient clinic is not an emergency service. 999 is for life-threatening emergencies; if you are not sure whether you need it, NHS 111 can check your symptoms and tell you what to do. These urological symptoms need emergency or same-day care, not a clinic appointment:

• Sudden, severe pain in a testicle, testicle pain with feeling sick, being sick or tummy pain, or testicle pain that has lasted more than an hour or continues when you are resting: go to A&E immediately or call 999. Do not wait for a clinic appointment. Sudden severe pain can be torsion, where the testicle twists and can be lost if it is not treated quickly (see testicular pain).
• Heavy blood or clots in the urine, or being unable to pass urine at all despite a full, painful bladder: go to A&E, or call 999 if you are very unwell.
• A high temperature or shivering with pain in your side or back, which can mean a kidney infection: ask for an urgent GP appointment or contact NHS 111 the same day, and call 999 or go to A&E if you are confused, drowsy or have difficulty speaking.

Suspected cancer

If your GP refers you urgently because cancer needs to be ruled out, cancer should be confirmed or ruled out within 28 days of the referral, and you should have an appointment with a specialist or tests soon afterwards, often within 2 weeks. If you have been referred on this pathway, keep the appointment; a private opinion can sit alongside it, not replace it. Visible blood in the urine should always be checked, even if it happens only once; see blood in urine.

When cost would stop you finishing the plan

A private consultation starts a plan; it is not the whole of it. If paying for it would leave you unable to afford the tests or treatment that may follow, it is usually better to start on the NHS and consider a second opinion later.

Can you move between private and NHS care?

Yes. Choosing private care does not take away your entitlement to the NHS: 2009 Department of Health guidance states that, where a patient opts to pay for private care, their entitlement to NHS services remains and may not be withdrawn. As with any patient who changes between NHS and private status, they should be at no advantage or disadvantage, and are entitled to NHS services on the same basis of clinical need as anyone else.

The same guidance says it should always be clear whether a treatment is privately or NHS funded, that private care should be carried out at a different time and in a different place from NHS care and kept as clearly separate as possible, and that the patient bears the full cost of any private element.

In practice, the two can be combined in three ways:

• Private diagnosis, NHS treatment. You can be assessed privately and then ask your GP to refer you for treatment on the NHS. With your agreement we write to your GP with our findings; the NHS team will make its own assessment and may repeat a test.
• NHS waiting list, private opinion meanwhile. You can stay on an NHS waiting list and pay for a private consultation while you wait. The guidance confirms patients may pay for private care while continuing to receive NHS care.
• NHS diagnosis, private second opinion. A second opinion can review your results and imaging without taking you out of NHS care.

Whichever you choose, tell both teams and bring recent results, so tests are not duplicated; see our guide to your first urology appointment.

How much does a private urologist in London cost?

A first consultation with us costs £300 to £350 and a follow-up £200 to £250, depending on the specialist and, for a first consultation, on whether you are seen in person or by video or telephone. The full tables are on our fees and insurance page.

The total depends on what the consultation finds. Some patients need only an examination; others need tests such as a scan, flow study or cystoscopy, which are quoted to you in writing before you commit to them. Because your NHS entitlement is unaffected, you can stop at any stage and continue on the NHS.

Can I use health insurance to see a urologist?

Yes, if your policy covers specialist outpatient care. Insurers usually ask for a GP referral and pre-authorisation before you attend, because that is how they agree in advance that the appointment falls within your cover. How to claim, and when a referral is needed, are set out on our fees and insurance page.

Before you book, it is worth asking your insurer:

• Does the policy cover outpatient consultations and tests, not only hospital treatment?
• Is there a limit on outpatient consultations or tests?
• Do tests or scans need authorising separately from the consultation?
• Does the referral need to name a consultant?
• Is the hospital you want included?
• Is there an excess?

Should I see a private urologist?

See a private urologist if it is not an emergency, you are not on an urgent cancer pathway, and the wait, the choice of specialist or the time in the appointment matters enough to you to pay for it. If so, then ask:

1. What is the wait at your local hospital? Check My Planned Care.
2. How much is the problem affecting you? The more it disrupts sleep or work, the more the wait matters.
3. Do you want a particular specialist, more time or a second opinion? These are what the private route adds.
4. Can you fund the likely next steps, or will your insurance cover them?

If the NHS suits you, that is a good outcome. If you would like to see one of our specialists, call +44 7889 318584 (lines open Monday to Friday, 8am to 4pm), email contact@theandrologycentre.co.uk or use our contact page. For the conditions we assess, see general urology and prostate conditions.

Frequently asked questions

References and further reading