Patient Terms and Conditions

Please ensure that you read these Terms and Conditions carefully.

1. Your Contract with St John and St Elizabeth Hospital

1.1. These Terms together with the Registration Form and, if applicable, the Treatment Letter or Admission Letter (which will include the expected costs) form your Contract (referred to interchangeably as “Contract” or “Terms”) with St John and St Elizabeth Hospital (“the Hospital” “we” or “us”) for your treatment at the Hospital (“Contract”). By signing the Registration Form, you agree to be bound by the terms of the Contract.

1.2. Capitalised words in bold have specific meanings as defined in the Schedule.

1.3. The terms of the Contract shall apply throughout the course of and during the time you receive Care from St John and St Elizabeth Hospital. Please ensure you read these Terms, the Registration Form, and any applicable Treatment or Admission Letters carefully.

1.4. This contract is between you and St John & St Elizabeth Hospital. No other person shall have any rights to enforce any of its terms and you may not transfer your rights under this Contract to any other person.

1.5. If there is any conflict between these Terms, the Treatment or Admission Letters or Registration Form, these Terms will take precedence. If there is any conflict between the Contract and any marketing materials published by or on behalf of St John and St Elizabeth Hospital, the Contract will take precedence.

1.6. St John and St Elizabeth Hospital may change these Terms at any time. However, changes to these Terms will only apply to any new Episode of Care (sometimes called “Pathway”) or Treatment Plan that you receive. If you have already begun Care or a Treatment Plan, then the old Terms will apply and you will be asked to agree to any new Terms before they come into effect in relation to your Care or Treatment Plan.

1.7. St John and St Elizabeth Hospital will make every effort to provide the Care as set out in your Treatment Letter. However, St John and St Elizabeth Hospital reserves the right to refuse your admission or to cancel or change the date of your admission for any reason, including, but not limited to, delays or cancellations as a result of an event outside St John and St Elizabeth Hospital’s control, for operational or technical reasons or because your Consultant does not think it is in your best interests for you to proceed with the Care including, for example, for medical reasons. This is detailed in the clauses below. Where this happens or where we refuse admission we will try to give as much notice as possible to you and will liaise with you to arrange an acceptable alternative date to carry out your Care or Treatment Plan.

1.8. Should you require a copy of St John and St Elizabeth Hospital Standard Rates, a copy of this will be provided to you in electronic format within 7 working days of a written request by you to selfpay@hje.org.uk

1.9. Please be aware that the Consultants involved in your Care are independent practitioners and are not employees of St John and St Elizabeth Hospital. The Contract between you and St John and St Elizabeth Hospital for your Care is different from, and separate to, the contract that you have with your Consultant (which may or may not be written). Please pay particular attention to the sections in these Terms about Consultants (Section 7).

2. Self-Pay Patients

2.1. If your care is not paid for by an insurer or confirmed third party (e.g. an Embassy), you agree that you will pay for any procedures, treatments and associated care as a ‘Self-Pay’ patient. In accordance with these Terms, you will be charged at the Hospital’s Standard Rates and your Admission Letter (if relevant and in so far as possible) will set out costs you can expect to pay.

Price Quotations and Payments

2.2. St John & St Elizabeth Hospital prices its treatments and procedures in one of three ways. These are described in 2.2.1 – 2.2.3 below.

2.2.1. Standard/Treatment Procedure Price Quotation with Hospital Fee Guarantee: for a common ‘standard’ treatment or procedure, following initial consultation and any required diagnostics, the Hospital fee will be guaranteed at the price quoted, valid for three months from date issued, but is subject to pre-assessment, as set out in 2.4, 2.5 and 2.6.

2.2.2. Bespoke Quotation with Hospital Fee Guarantee: if after assessment from your consultant you require a non-standard treatment or procedure, a tailored quotation will be prepared – the ‘bespoke quotation’. On this bespoke quote, the Hospital fee will be guaranteed at the price quoted, valid for three months from date issued, but is subject to pre-assessment as set out in 2.4, 2.5 and 2.6.

2.2.3. Fully-Inclusive Package: Occasionally, the Hospital may run promotional offers, available for specific time periods, in which all associated costs of a treatment or procedure are packaged together to include all elements at a stated price i.e. the surgeon and anaesthetists’ fees included etc. These packages will only be valid for the period of time stated and are subject to pre-assessment, as set out in 2.4, 2.5 and 2.6.

2.3. In all cases except 2.2.3, your quotation price only states the Hospital Fee; your Consultants’ costs will not be included unless St John & St Elizabeth Hospital have been requested to collect their fees on their behalf – this will be stated on the quotation. Otherwise, the Consultant fee and any other associated cost will be advised separately. You will need to settle these costs directly with your Consultant and will be invoiced separately by the Consultant.

2.4. We will provide the Care to you as set out in a Treatment or Admission Letter, which details the care and treatment you will receive from us as a Self-Pay patient – as one of the three types listed above in clause 2.2. The Admission Letter will set out the calculated and guaranteed Hospital Fee and any appointment or admission dates. The Admission Letter will also include (if appropriate) whether your Consultant and, if required, the anaesthetist will send you a separate invoice to collect his or her fees from you directly or if we are collecting on their behalf.

If you have any queries regarding the Consultant or anaesthetist fees please contact them directly.

2.5. Following receipt of your Admission Letter and prior to your admission date, you will be asked to complete a pre-assessment check, where we will confirm you are medically fit for the planned procedure. This is managed through a system called ‘LifeBox’ which takes you through a detailed questionnaire about your health and medical history, and you will also be given details about your admission. A phone call with a nurse may also be required, to discuss the answers you supplied via LifeBox. Sometimes, it may also be necessary for pre-assessment to include a visit to the hospital for an appointment with a nurse in-person.

2.6. If, following the pre-assessment, it is considered that for clinical or medical reasons it is not appropriate to proceed with your Treatment either at all or for the price quoted in the Admissions Letter, or because further tests or assessments need to be carried out, we will discuss this with you, and if we are still able to offer the Treatment but at a later date (due to the tests or assessments required) or at a different price. In this instance, we will send you a revised Admission Letter with a new date for Treatment or price. If we are not able to continue the Treatment at all, we will tell you the reason(s) why.

2.7. The Hospital Fee quoted for your Self-Pay procedure is subject to the results of your pre-assessment review. The Hospital Fee is confirmed once you sign the Registration Form on admission to the Hospital for your procedure. Once confirmed, however, it will not change. We calculate the prices based on:

(a) your Consultant’s medical advice,

(b) required post-operative care before discharge,

(d) the complexity of your Care and Treatment.

2.8. If there are any costs incurred for matters outside those required for the procedure, prices will be charged at the Hospital’s Standard Rates. These will be outlined with a calculation and explanation as to why the costs were required for your care.

2.9. Any medical treatment not related or connected with the care and treatment identified at your pre-assessment, which requires a separate Pathway of care, or is not clinically required, whether or not carried out at the Hospital, even if you are not discharged from the Hospital, is not included in any price quoted.

2.10. Any specific inclusions and exclusions pertaining to your treatment or procedure will be outlined in your quotation treatment letter.

Treatments without a prior quotation

This section is most relevant for Outpatient services. It will also apply if you are paying for ‘unplanned’ procedures, or a non-standard procedure via a Bespoke Quotation

(as outlined in 2.2.2).

2.11. If your treatment, procedure or care is not paid for by an insurer, or is not part of a Self-Pay Quotation (2.2.1 or 2.2.2), you will be charged at the Hospital’s Standard Rates. As noted in clauses 2.3 above and 7.3 below, unless otherwise indicated, your Consultant and anaesthetist will invoice you separately for the treatment he or she provides.

2.12. Many outpatient treatments /procedures or diagnostics will need payment on the day you attend. Expected costs are available upon request at the desk and outlined on the Procedure Sheet you will be given at outpatient registration. You will be advised of the final cost of the treatment or Care you received by letter following which you will be billed accordingly.

2.13. Histology fees could be subject to change depending on complexity of the sample and diagnosis. These may incur additional costs separate to your original quoted cost.

2.14. We will give you an estimate of costs for your care before it begins. Please note that it is not always possible to give an exact estimate for the care you receive and the total cost may depend on a number of factors, including any other conditions you may have. We will always try to provide an accurate estimate and updates if the cost of your care is likely to exceed original guidance, as soon as possible. You are responsible for the payment of all care you receive at the hospital, including any sundry items.

2.15. If you are admitted to the hospital, you will need to pay the expected fee in full at least 48 hours before you are admitted and settle further charges to your account within seven days (7) following receipt of our invoice. Your Admission Letter will set out what payment is required in relation to your care. You can pay the invoice online, by post or over the phone. Details of our payment methods are given on our website: https://hje.org.uk/how-to-pay-for-your-treatment/

2.16. If your Consultants’ fees are not included in your invoice, you will need to settle these directly with your Consultant.

Cancellation

2.17. If you decide not to go ahead with your procedure or any other services as part of Self-Pay Quoted treatment, you may contact us at any time to cancel. You will be required to pay for any costs incurred by you or the Hospital up until the point of cancellation. This will be charged at the Hospital’s Standard Rates. We reserve the right to charge a cancellation fee in accordance with clause 2.20 if you cancel your treatment within 48 hours of a scheduled appointment or admission date – this does not apply if you are deemed medically unwell within the 48 hours before treatment or procedure.

2.18. We will refund any advance payment made by you or on your behalf, less any amount that you owe to St John & St Elizabeth Hospital and/or a Consultant, for Services that we have not yet provided to you and we reserve the right to charge a cancellation fee as described in clause 2.20.

2.19. If your Consultant cancels your treatment because they consider it is not in your best interests for medical reasons, and you have already paid , we will refund your payment.

2.20. We reserve the right to charge a cancellation fee if you cancel any appointment with St John & St Elizabeth Hospital within 48 hours of your scheduled appointment or admission date. If a cancellation fee applies, the amount of the fee will be the greater of £250, or the cost of the care that you have received up to the point of cancellation and any other reasonable costs that the Hospital has incurred.

2.21. If you do not pay for the Care as required, we may not provide any remaining services to you with immediate effect until you have paid any outstanding amounts.

2.22. We will make every effort to provide the Care on the date that we have set out in your Admission Letter. However, we reserve the right to refuse your admission or to cancel or change the date of your admission.

2.23. There may be delays or cancellations for any reason, such as because of an event outside our reasonable control, for safety, operational or technical reasons or because your consultant does not think it is in your best interest for medical reasons. Where this happens or where we refuse admission, we will try to give as much notice to you as possible. Where possible, as appropriate, we will always try to rearrange any appointment or admission dates with you.

2.24. Where we are required to cancel the appointment or refuse admission, any advance payment you have made for Care that has not been provided will be refunded to you. We will refund these amounts by cheque or electronic transfer only to the cardholder or person who made the original payment.

2.25. Please note we do not accept any payments or make refunds in cash.

2.26. We may cancel any appointment or admission date or any care or treatment at any time if we do not receive payment in cleared funds at least 48 hours in advance.

3. Insured Patients

3.1. This clause 3 will apply to you if your Care is covered by private medical insurance.

3.2. Prior to booking your first consultation you will be responsible for checking with your insurer that your insurer’s policy covers the Care contemplated by you; we cannot obtain any such confirmation on your behalf.

3.3. While you are at St John & St Elizabeth Hospital, if you want to check with your insurer whether any aspect of your care is covered by your insurance policy, we will give you access to a telephone so you can contact your insurer. You may be required to obtain confirmation of cover from your insurer for various aspects of your treatment throughout your pathway. At this point, your insurer will inform you if you need to pay a shortfall for any aspect of your treatment.

3.4. Following confirmation with your insurers, you will be required to include the policy details on the hospital’s Registration Form.

3.5. Whilst you ultimately remain responsible for the full payment of your Care, where you have private medical insurance:

(a) we will, where possible, process the insurance claim for your care with your insurer, provided you have given us and your insurer all the information we and your insurer need to do so, including but not limited to your policy and pre-authorisation numbers. If this information is incomplete or inaccurate, we may not be able to process your claim and you will need to pay for your care, as set out in (c) below;

(b) where we process your insurance claim and your insurer pays us direct, the rate agreed between St John & St Elizabeth Hospital and your insurer (rather than the Hospital’s Standard Rates) will apply to your Care;

(c) if your insurer fails to settle our invoices (or any part of them) within 45 days of the date of issue we will assume that the outstanding amount will not be paid by your insurer and we may invoice you directly; and

(d) if we invoice you for your care or an element of it, you agree to pay us the amount invoiced within the time limits set out therein. If you do not think that we have invoiced you correctly, please let us know as soon as possible so we can investigate this further.

3.6. You are responsible for any shortfalls from your insurance company and agree to pay upon receipt of our invoice. The Hospital will not be responsible for any shortfall in cover. We recommend you confirm your policy limits with your insurer before you undertake your treatment.

3.7. Your insurer may require access to your medical records in order to validate and approve your treatment. Access also might be required to allow your insurer to audit St John & St Elizabeth Hospital’s performance of the contract between us and your insurer. Any audit undertaken by your insurer will be for the purpose of validating the accuracy of St John & St Elizabeth Hospital’s charges and assessing and assuring the quality of services provided by us.

3.8. You will be responsible for ensuring that you keep St John and St Elizabeth Hospital and/or your insurer up to date with any changes to your Treatment or procedure pathway or your personal details. Please note that some insurers use care guidelines that may not match the professional medical opinion of the Consultants, nursing staff and other medical professionals providing your Care. In some cases, this can mean that your insurer may not pay for certain parts of the Care you receive, and you will be required to pay for that part of your Care. You will need to check any such guidelines with your insurer directly.

3.9. Please note that your insurance policy may not cover the cost of Sundry items or other items such as specialist equipment, like crutches or wrist braces, or certain medications, or it may only cover part of such costs. You will be required to pay for any such items not reimbursed by your insurer. As polices vary so much St John and St Elizabeth Hospital cannot advise on what an individual’s policy does or should cover.

3.10. If you pay for your treatment and subsequently seek reimbursement from your insurer, and if no other rate has been expressly agreed between you and St John & St Elizabeth Hospital and your insurer, the Hospital’s standard rates will apply to your Care.

4. International Patients

4.1. If you are a patient who is not ordinarily a resident in the UK, you will be liable to pay charges if you require NHS treatment whilst in the UK, whether related to your care at St John & St Elizabeth Hospital or not. By signing a Registration Form and agreeing to these Terms you confirm that you have leave to enter the UK and that you meet all relevant immigration criteria.

4.2. You also confirm that you have made adequate arrangements to pay for your care. St John & St Elizabeth Hospital may contact the Home Office or UK Border Agency (as relevant) to the extent necessary to clarify any information regarding your visa to enter or remain in the UK in connection with your care.

5. Cosmetic Surgery

A Reflection and cooling off period

5.1. St John and St Elizabeth Hospital recommends, in accordance with “Guidance for Doctors who offer cosmetic intervention” GMC 2016[1] and the Royal College of Surgeons of England’s “Professional Standards for Cosmetic Surgery”[2] that patients have an adequate time for reflection to decide whether or not to proceed with cosmetic treatment or surgery.

5.2. All cosmetic surgery patients at St John and St Elizabeth Hospital are required to take a period of 14 days reflection and cooling off after your first consultation with your Consultant before proceeding to your second consultation.

5.3. If during your 14 days reflection and cooling off period you decide not to proceed with your cosmetic surgery, clauses 2.17-2.20 will not apply.

VAT

5.4. For cosmetic only procedures (where there is no medical or medically related purpose for the procedure), patients will incur an extra charge of the standard VAT rate in relation to their procedure price, as part of their Fixed Price. The details documented during your consultations with your Consultant will be used to determine whether there is a medical justification for the procedure.

6. Complications

6.1. Any quoted Self-Pay treatment, procedure or care, covers any medical or surgical complications directly related to your treatment or surgery for three (3) months following your discharge from the Hospital provided that:

(a) such post-operative care and complications are treated at the Hospital;

and

(b) you have followed the advice of your consultant and other healthcare professional involved in your Care or treatment at the Hospital.

(c) The decision as to whether a complication is related to the procedure rests with your Consultant or healthcare professional.

7. Consultants

7.1. While at St John & St Elizabeth Hospital, you will be under the care of the Consultant you have been referred to, who may also involve other consultants in your care, if appropriate. St John & St Elizabeth Hospital staff, including nurses, will provide your Care under your Consultant’s instructions.

7.2. Consultants involved in your Care are independent practitioners. Accordingly, St John & St Elizabeth Hospital will not be liable for any act or omission of a Consultant; the Consultant will be responsible for the care he or she gives you.

7.3. Your Consultant, who may be a physician, surgeon, or anaesthetist, is an independent medical practitioner and not employed by us, and, unless we advise you otherwise, will charge you separately for his or her services, including for the initial consultation, unless as part of a promotional fully inclusive Package (see 2.2.3). In those circumstances, the Hospital is then acting as the Consultants’ agent only in collecting those fees: however, they always remain an independent medical practitioner.

7.4. We are not responsible for the acts and omissions of Consultants, anaesthetists, or other independent medical practitioners (or the company, partnership or other entity that employs or engages the Consultants, anaesthetists, or other independent medical practitioners) and your Consultant and their secretarial staff also do not have authority from us or the Hospital to quote for hospital charges. Any hospital prices mentioned by them are subject to written confirmation by the Hospital.

8. General Terms and Conditions

8.1. While St John & St Elizabeth Hospital and your Consultant will always try to meet your expectations, we cannot guarantee the result of any procedure, Care or treatment, and it is possible that complications with your treatment or procedure can occur. Your Consultant will explain these to you before your treatment.

8.2. The decision as to whether you are fit for discharge rests with your Consultant. Included as part of your Hospital Fee Guarantee will be all the Care directly related to your admission until the Consultant discharges you, regardless of how long or how much is required. If, with the agreement of the Hospital, you decide to stay at the Hospital beyond the date that your Consultant considers it is appropriate for you to be discharged, the Hospital’s Standard Rates will then apply and you will be invoiced separately. If you discharge yourself against the advice of your Consultant no further services will be provided and no refund will be given for quoted Care not received.

8.3. We will need certain information from you that is necessary for us to provide the Care, and this can be asked for by anyone involved in your Care or treatment, including by staff at the Hospital, by your Consultant or other medical professional or as requested in your Admission Letter. If you do not, after being asked by us, provide us with this information, or you provide us with incomplete or incorrect information, we may not be able

to provide you with a full range of services, and that could mean being unable to see you at our Hospital. If we are unable to provide the required Care to you, you do not have to pay for the Care that we have not provided, but this does not affect your obligation to pay for any invoices we have already sent you for any services we have already provided. Any advance payment you have made for Care that has not been provided will be refunded to you.

8.4. We strongly advise that you avoid bringing any valuables or cash to the Hospital. If you do nonetheless bring any valuables or cash, this is at your risk as we do not accept any responsibility for the theft, loss of, or damage to, any of your or your visitors’ cash, valuables or any other property that you or your visitors bring to the Hospital.

If there is a problem with our Services

8.5. If there is any problem with the services provided by the Hospital, please contact us and tell us as soon as reasonably possible, and we will investigate the problem under our complaints procedure and try to repair or fix the problem as soon as we can.

Events outside our control

8.6. We will not be liable or responsible for any failure to perform, or delay in performance of, any of our obligations under these Terms that is caused by an event outside our reasonable control.

8.7. If an event outside our reasonable control takes place that affects the performance of our obligations under these Terms we will contact you as soon as reasonably possible to notify you, and our obligations under these Terms will be suspended and the time for performance of our obligations will be extended for the duration of the event outside our reasonable control.

8.8 You may cancel the contract if an event outside our reasonable control takes place and you no longer wish us to provide the Care. Please see your cancellation rights under clauses 2.17 to 2.26.

Changes to these Terms

8.9. We may change these Terms at any time, however, any changes to the Terms will only apply to any new care or treatment that you may receive and will not apply to any care or treatment that you may be part through or currently receiving when the change to these Terms is made.

8.10. If you wish to end any care or treatment before it is completed, you may do so and your cancellation rights are set out in clauses 2.17 to 2.26.

Governing Law and jurisdiction

8.11. These Terms are governed by the laws of England and Wales. You and we both agree to submit to the exclusive jurisdiction of the courts of England and Wales

Severability

8.12. If any provision in these Terms is held by any competent authority to be invalid or unenforceable in whole or in part, the validity of the other provisions (and the remainder of the provision in question) shall be unaffected.

9. Schedule – Definitions

“Admission Letter” means the welcome letter confirming the date of your Care at St John and St Elizabeth Hospital and setting out pre-assessment information and information relating to payment.

“Care” (also referred to as “Treatment Plan”, “Episode of Care” or “Pathway” means all care, treatment, diagnosis, procedures, services (including Sundry Items) and goods provided by the Hospital;

“Consultants” means all consultants, surgeons and anaesthetists involved in your Care (including those doing so on behalf of a company or partnership);

“Contract” has the meaning given to it in clause 1.1

“Hospital” means The Hospital of St John and St Elizabeth, known as ‘St John and St Elizabeth Hospital’ “Hospital Fee” means the payment receivable by the Hospital in respect of your Care.

“Hospital Fee Guarantee” means the price guarantee offered by the Hospital

“Procedure Sheet” means the breakdown of the payment required and type of package under which the Treatment will be provided.

“Registration Form” means the form setting out your personal details and registration with the Hospital

“Standard rates” means the Hospital’s standard rates for Care which are available on request

“Sundry Items” means personal items incidental to your Care, including meals and beverages for your visitors and phone calls, cost of newspapers etc;

“Treatment Letter” means the letter we send or give to you setting out your Care