These Terms and Conditions set out the basis on which Streamline and your Consultant provide their respective services to you. The agreement is made between you and Streamline and your Consultant.
1. Your Contract with Streamline
1.1 These Terms together with the Procedure Consent Form, Clinic Letter (“Treatment Letter”) and Invoice form your contract with Streamline (“Contract”). By completing our Terms and Conditions declaration, you agree to be bound by the Terms of the Contract.
1.2 The Terms of the Contract shall apply throughout the course of, and during the time you receive Care from Streamline. Please ensure you read these Terms, the Procedure Consent Form and any Treatment Letter carefully.
1.3 If there is any conflict between these Terms, the Procedure Consent Form or Treatment Letter, these Terms will take precedence.
1.4 Streamline may change these Terms at any time. However, changes to these Terms will only apply to any new episode of Care or Treatment that you receive. To clarify, if you have already commenced a Treatment Package, then the relevant Terms for that Treatment apply.
1.5 All Consultants are self-employed and make their own clinical decisions at all times. The patient warrants that having read and understood these Terms and Conditions that no cause of action in negligence and/or breach of contract will accrue against Streamline for any treatment carried out by the Consultant. The patient further warrants that they have read and understood the patient information and fully understands the range of possible outcomes of the proposed Care. For the avoidance of doubt Streamline is not vicariously or in any other way whatsoever liable for the negligent acts and omissions and/or breaches of contract and/or statutory duty by the self-employed Consultant, such liability remains at all times with the Consultant.
1.6 All Treating Hospitals work in partnership with Streamline and hold the necessary regulatory requirements to provide your Care and Treatment, acting as sole agents. The patient warrants that having read and understood these Terms and Conditions that no cause of action in negligence and/or breach of contract will accrue against Streamline for any treatment carried out at the Treating Hospital. For the avoidance of doubt Streamline is not vicariously or in any other way whatsoever liable for the negligent acts and omissions and/or breaches of contract and/or statutory duty by the sole agent Treating Hospital, such liability remains at all time with the Treating Hospital.
1.7 Streamline will make every effort to provide the Care and Treatment Package set out in your Treatment Letter and procedure booklet. However, Streamline reserve the right to refuse, cancel or reschedule any treatment, including procedures for any reason.
This may include, but not limited to, delays or cancellations as a result of an event outside Streamline’s control, for operational or technical reasons or because your Consultant does not think it is in your best interests for you to proceed.
In very rare circumstances during your procedure, your surgeon may discover a complication which, in their clinical opinion, is unsafe to proceed with.
Where we do need to abort your planned procedure, we will refund any monies less associated charges for the care and treatment received to this point.
1.8 If you are not ordinarily a resident in the UK, you will be liable to pay charges if you require NHS treatment in the UK, whether related to your Care or Treatment Package with Streamline or not. By signing and agreeing to these Terms you confirm that you have leave to enter the UK and that you meet all relevant immigration criteria. You also confirm that you have made adequate arrangements to pay for your Treatment Package. Streamline or your Treating Hospital may contact the Home Office or UK Border Agency (as relevant) to the extent necessary to clarify any information regarding your leave to enter or remain in the UK in relation to your Care.
2. Fixed Treatment Package and Cancellations
2.1 Paragraph 2 will apply if you are paying for your own Care, or are funded by your insurer, that we have offered you in a Fixed Treatment Package.
2.2 You will have been sent a Treatment Letter including a quotation that will outline your Package Price and how you pay.
2.3 The Fixed Treatment Package price is valid for one (1) month from the date issued to you.
2.4 We reserve the right to amend your Fixed Treatment Package price if any of the following are required:
- Change of location (Treating Hospital).
- Additional tests and investigations.
- Medical conditions identified after your initial consultation.
- Requirement for additional or specialist Care such as high-dependency unit (HDU).
- A Body Mass Index (BMI) of 50 or above.
2.5 The Treatment Letter and quotation will set out the cost of your Care and details of your payments schedule:
- A minimum deposit of £500 to be paid in full on receipt of your invoice. Failure to pay this on receipt will result in postponement of the commencement of your Care.
- The outstanding balance to be paid in full and in clear funds at least twenty (20) days prior to your admission or treatment date. Failure to pay the above in full will result in your planned Procedure and Care being cancelled and your full deposit retained.
2.6 If you decide not to go ahead with your Treatment Package, you should inform Streamline in writing or by telephone as soon as possible. If you cancel for any reason less than twenty (20) days in advance of your Procedure and Care date, your deposit will be non-refundable.
2.7 If your Treatment Package has already commenced, you will be required to pay for any Care, pre-operative assessment tests and all incurred administration costs for the treatment you have received up until the point of cancellation.
2.8 If you have already settled your invoice in full for your Treatment Package, Streamline will refund your payment, less any monies outlined in 2.7 above.
Please note: we will only pay any refund to the cardholder or person who made the original payment. We do not pay cash refunds.
2.9 Unless your Treatment Letter states otherwise, your Fixed Treatment Package includes:
- Pre-operative assessment to determine your fitness for surgery (this must take place at the Treating Hospital
- (Gastric Balloon Only) Anti-Emetic drugs as prescribed by your Consultant prior to your procedure.
- All Consultant fees, while you are in Hospital.
- Operating theatre and/or treatment room charges.
- Your accommodation in the Hospital including your meals as defined in paragraph 12 (length of stay).
- Your nursing care, while you are in Hospital to the point of discharge.
- If required, high dependency and/or intensive care fees up to two (2) nights.
- Tests, drugs and dressings you may need during your stay in Hospital.
- Take-home drugs dispensed by the Hospital for up to fourteen (14) days.
- Imaging, physiotherapy, pathology required during your stay in Hospital.
- (Gastric Balloon and Gastric Band only) Prosthesis.
Aftercare appointments set out in your Treatment Letter with your specialist clinical team, including dieticians, nursing and Consultant.
- (Gastric Bands Only) All band fills and adjustments as clinically prescribed during your aftercare period as outlined in your Treatment Letter.
- (Gastric Bands Only) Within the first six months of your procedure, the associated costs of re-siting a band or the reposition of a port (on the advice of your Consultant).
2.10 What is not included in your Fixed Treatment Package (unless otherwise stated in your Treatment Letter):
- Your initial consultation and any tests carried out during the investigation stage.
- Diagnostic tests or assessments that fall outside your pre-operative assessment with your Treating Hospital.
- Treatment or investigations of any medical problems before surgery, which may become apparent as a result of your pre-operative assessment.
- Care not listed in your Treatment Letter to be excluded from the Fixed Treatment Package.
- Any treatment received at other hospitals or clinics, including any NHS care or treatment, unless your care or treatment is being provided as part of your planned care pathway.
- Extended nights stay at the Treating Hospital after your Consultant has declared you ready to be discharged.
- Any medication prescribed after you have been discharged from the Hospital.
- Sundry Items and other miscellaneous expenses, including, but not limited to, telephone, alcoholic beverages, transport (to and from the hospital) and your guests’ expenses such as food and accommodation.
- On-going tests including pathology (regular blood tests).
- (Weight Loss Surgery Only) Vitamin supplements and/or injections.
- (Gastric Bands Only) Any revision surgery (excluding band slippages or port re-sitting in the first six months) is not considered a complication.
- (Gastric Bands Only) Any band adjustments performed outside your care plan including from another provider without the acknowledgement and advice of your consultant.
2.11Streamline acts as an agent in the collection of fees for and on behalf of the Consultant and Treating Hospital. The Consultant and/or Treating Hospital may, where agreed in advance with the Patient, invoice the Patient directly. In these instances, the final Fixed Package Payment Fee may differ from the quotation.
3. Our obligations to each other
3.1 Streamline have, before issuing a contract to a Consultant permitting them to practice, confirmed that the Consultant is registered with the General Medical Council and have seen a copy of the Consultant’s private practice medical indemnity insurance certificate that was current at the date of issuing the contract permitting them to practice such procedures. Streamline does not obtain whole copies of the policy nor does it make any warranties in respect of the content of the same, save as set out above. Streamline continues to check the Consultant’s General Medical Council registration status every six (6) months and the private practice indemnity insurance annually. Streamline only suggests a Consultant to a Patient from a list of independent self-employed Consultants who hold contracts with Streamline to carry out the procedure that the Patient is considering. The Patient always maintains the right to request another Consultant with a Streamline Contract, under these Terms and Conditions. Streamline accepts no responsibility for matters which are within the professional responsibility of the Consultant including the consenting of the patient. All Consultants are independent contractors and are not employed by Streamline. Streamline will satisfy itself, as far as is reasonability practical, that the Consultant is insured against claims for professional negligence. The relevant practitioner is solely responsible for maintaining their insurance as appropriate and in line with the recommendations of the GMC or relevant registered body. The Patient accepts that Streamline are unable to notify a Consultant’s insurers of any potential claim or that the Consultant maintains their Insurance once they are no longer working with Streamline. In signing these Terms and Conditions the Patient expressly agrees that they accept UK insurance and Defence Union Cover is acceptable.
3.2 The Patient agrees to provide the Consultant and clinical employees, sub-contractors or persons otherwise engaged by Streamline with a health history that is honest, accurate, reliable and complete. The Patients understands that withholding any medical information could be detrimental to their health and safety and may result in cancellation of their Care with no refund. The Patient agrees that if any change occurs with their medical history or status that they will inform Streamline and their Consultant without delay and will keep Streamline and the Consultant informed. Failure to provide this very important medical history will be treated by Streamline as a material breach of contact by the Patient.
3.3 The Patient agrees to disclose before treatment if they smoke, take any drugs or medication (legal or otherwise) use an e-cigarette, nicotine patches or any similar device and to disclose their true alcohol consumption and is responsible to stop their use/consumption in accordance with the Consultant’s instructions. Cancellation due to non-compliance with this clause on the day of admission will require the patient to pay a £1,500, rebooking fee in addition to the quoted procedure price.
3.4 The Patient acknowledges that the Patient Support Co-Ordinator is not a Consultant or in anyway medically qualified. Any advice the Patient Support Co-Ordinator may give is purely of a general non-medical nature. If the Patient has any medical queries then these should be addressed to the Consultant or other suitably medically qualified person.
3.5 The Patient accepts that Streamline and the Consultant’s total liability for any breach of contract is limited to the Care costs, save for death or personal injury, fraud or fraudulent misrepresentation or any other act or omission where liability may not be limited or excluded under any applicable law.
4. What happens if my stay is shorter than expected?
4.1 If your stay in hospital is shorter than the anticipated length of stay as highlighted in paragraph 12, you will not be entitled to receive a refund of any portion of your Fixed Treatment Package.
5. What happens if I suffer complications?
5.1 While the Treating Hospital and your Consultant will do their best to ensure a satisfactory outcome, no clinical procedure is entirely risk-free and the results of any particular treatment cannot be guaranteed.
5.2 Your Fixed Treatment Package includes the cost of treating any clinical complication at your Treating Hospital only for a thirty (30) day period from the date of your procedure or treatment. Complications will only be treated where they arise directly out of the Care you have received and are identified within thirty (30) days of your procedure, and you have followed the advice of your Consultant and/or clinical care team.
5.3 Where your Consultant believes it is in the best interests for your health, we reserve the right to transfer or refer your onward care to your most appropriate local NHS service.
5.4 If you have not followed the advice of your Consultant and/or any other medical professional involved in your Care or the complication is not directly related to your Care, this will be excluded from your thirty (30) complication cover at your treating hospital.
5.5 Any additional costs associated outside your complication cover will be invoiced and must be paid within seven (7) days of the date of the invoice. Failing this Streamline reserves the right to debit the cost from your credit or debit card in accordance with paragraph 11.4
5.6 Any patients who experience complications within the thirty (30) day complication cover maybe required to return to their Treating Hospital for onward Care. Streamline will not cover the cost of care within another independent/private hospital unless approved by Streamline prior to the commencement of any such Treatment or Care.
6. What happens if I decided to stay in hospital longer?
6.1 If, you choose to extend your hospital stay beyond the date your Consultant has recommended discharge, your Fixed Treatment Package will be no longer apply and you will need to pay the treating hospital directly for any costs incurred.
7. What happens if you decided to leave the treating hospital earlier than recommended?
7.1 If you discharge yourself earlier than expected against the advice of your Consultant, no further Care will be provided to you as part of the Fixed Treatment Package and no refund will be given to you.
8. NHS Patients
8.1 Paragraph 8 will apply to you if you are an NHS patient and Streamline is treating you on behalf of the NHS.
8.2 The costs of your Care and Consultant fees are paid by the NHS. However, the NHS is unlikely to pay for personal items incidental to your Care, including Sundry Items.
If the NHS does not cover any Sundry Items, or it only covers part of the cost, you will be responsible for the payment of those costs that are not paid for by the NHS.
8.3 We may ask you for your credit or debit card details prior to any Care and you understand that we will keep these details until such time as all personal costs have been paid in full. We reserve the right to debit the cost of all Sundry Items from your credit or debit card in accordance with paragraph 11.4.
9. Insured Patients
9.1 Paragraph 9 will apply if your Care is covered by private medical insurance. You will remain responsible for the payment of your care, where you have private medical insurance.
9.2 Where possible, we will process the insurance claim for your Care with your insurer. This can only be done if you have provided both your insurer and Streamline with the relevant information needed.
Streamline will not check with your insurer that your policy is valid, and provides appropriate cover. 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 paragraph 11.4.
9.3 Prior to booking your initial consultation it is vital that you check with your insurer that your policy covers you for the Care and Treatment you are contemplating.
9.4 Where we process your insurance claim and your insurer pays us direct, the rate agreed between Streamline and your insurer (rather than any advertised fees) will apply to your Care.
9.5 If you pay for your Care and subsequently seek reimbursement from your insurer, and if no other rate has been expressly agreed between you and Streamline, the Fixed Treatment Rates will apply to your Care.
9.6 If your insurer fails to settle our invoices (or any part of them) within thirty (30) days of issue, we will assume that the outstanding amount will not be paid by your insurer and we will invoice you directly and/or debit the relevant balance from your credit or debit cards in accordance with paragraph 11.4.
9.7 Please note that some insurers use Care guidelines that may not match the professional medical opinion of the Consultant and other medical professionals providing your Care. In some cases, this can mean that insurer may not pay for certain components of the Care you receive, and you will be required to pay for that part of your Care in accordance with paragraph 11.4. In particular, you should note that treatment for complications may in some cases not be covered by insurers and in such cases, you agree to cover the cost of your Care.
9.8 Where we invoice you for your Care or an element of it directly, you agree to pay the amount invoiced within seven (7) days of the date of the invoice. You should contact us immediately if you believe the invoice to be incorrect or invalid.
9.9 In certain circumstances it may be possible for you to combine a planned self-pay procedure with a secondary insured procedure. If your insurer contacts us regarding either the combined procedure or the secondary procedure, we will be obliged to disclose all relevant information. If your insurer agrees to fund the secondary procedure there will be no discount offered from your Fixed Treatment Package.
11. General Terms and Conditions
11.1 Paragraph 11 will apply to all patients.
11.3 Streamline does not accept any responsibility for the theft or loss, or damage to, any of your or your visitors’ property.
11.4 You are responsible for settling the cost of your Care. Streamline may ask for your credit or debit card details prior to your procedure which you agree to provide. We may swipe and store your credit and/or debit card details until the cost of your Care including Sundry Items have been paid in full by your insurer, yourself or the NHS (as applicable). If you have not paid for your Care before leaving the treating hospital, you agree and provide consent for Streamline to debit the outstanding balance from your card(s) upon 7 days of providing an invoice to you.
11.5 We reserve the right to charge a cancellation fee in respect of reasonable costs incurred by Streamline. If you cancel any appointment or procedure seven (7) days or less of your admission or appointment date, we will apply a minimum charge of £250.00.
11.6 Streamline is not responsible for the acts and omissions of any Consultant, Anaesthetist or other Medical Practitioners involved in your Care. These Medical Professionals will hold their own medical negligence insurance or equivalent cover.
11.7.1 If any provision or part-provision of these Terms is or becomes invalid, illegal or unenforceable, it shall be deemed modified to the minimum extent necessary to make it valid, legal and enforceable.
11.8 Changes in Applicable Law
11.8.1 You acknowledge and accept that Applicable Law may change and prevent Streamline from providing certain Care to you.
If Streamline becomes aware that such a change has occurred and the change has an effect on your Care, we will contact you to inform you of this and its consequences.
11.9 Force Majeure
11.9.1 Streamline will not be liable or responsible for any failure to perform or delay in performance of, any obligations under these Terms that are caused by an event outside Streamline’s reasonable control.
11.10 Assignment of Agreement
11.10.1 Subject to any restrictions or requirements imposed by Applicable Law, Streamline may transfer and assign this Agreement to any person who acquires all or substantially all of the business or assets of Streamline.
11.11 Third Party Rights
11.11.1 A person who is not a party to this Contract shall not have any rights under or in connection with it.
11.12 Governing Law
11.12.1 These Terms are governed by and shall be constructed in accordance with English Law and the courts of England and Wales shall have exclusive jurisdiction.
12. Length of Stay
12.1 We typically cover the following accommodation arrangements within your Fixed Treatment Package Price:
- Investigations – day case only
- Gastric Balloon Procedures – day case only
- Gastric Band Placements – 1 night stay
- Gastric Band Removal – day case only
- Gastric Band Corrections – day case only
- Endoscopic Sleeve – 1 night stay
- Gastric Sleeve – 2 night stay
- Gastric Bypass – 2 night stay
- Hernia Repair – day case only
- Gallbladder Removal – day case only
“Applicable Law” means any and all laws, regulations, guidelines and professional obligations applicable to the provision of Care or the performance of services to you, including the requirements as regards to treatment and procurement.
“Care” means all care, treatment, diagnosis, procedures, services (excluding Sundry Items) and goods provided by us.
“Consultants” means all consultants, surgeons, specialists and anaesthetists involved in your Care (including those doing so on behalf of a company or partnership) and with whom the patient contacts directly for the provision of their Care/Treatment Package.
“Contract” means these Terms along with your Treatment Letter and if applicable, your Consent Form.
“Fixed Treatment Package” means how you will pay for your Care as set out in your Treatment Letter and Quotation.
“Non-surgical” aspects of a procedure means the services provided by Streamline, and it’s employees, sub-contractors or persons otherwise engaged by Streamline (excluding the Consultant) but excludes all the services provided by the Consultant.
“Patient” means any person who has entered into a contract (on these Terms and Conditions) with Streamline and the Consultant for, in the case of Streamline, the provision of the non-surgical aspects of a procedure and in the case of the Consultant, the informed consent for and the provision of the procedure, pre and post procedure consultation, care and care plans and the patient discharge from the Treating Hospital. The outcome of the procedure remains at all times the responsibility of the Consultant with whom the Patient contracts separately in accordance with these Terms and Conditions.
“Private Patients” means all patients that are not NHS patients and includes patients who are covered by medical insurance and patients who are paying for their own Care.
“Patient Support Co-ordinator” a non-medically trained employee of Streamline who assists the Patient to make a choice about their Care and provides a list of Consultants who can carry out their Care. These Terms and Conditions take precedence over any oral representations by the Patient Support Co-ordinator or any other employees, sub-contractor of persons otherwise engaged by Streamline including the Consultant unless they are confirmed in writing by Streamline to the Patient.
“Procedure Consent Form” means the specific consent form relating to your proposed procedure and care.
“Standard Rates” means Streamline’s standard rates for Care, which are available on request.
“Streamline”, Streamline Surgical” and “Streamline Weight Loss Experts” means Streamline Clinics Limited and any subsidiary.
“Sundry Items” means personal items incidental to your Care, including meals and beverages for your visitors, newspapers etc.
“Terms” means these Terms and Conditions.
“Treating Hospital” or “Hospital” means a hospital, clinic or facility where you receive your Care, working in partnership with Streamline as a sole agent.
“Treatment Letter” means the letter we may send to you relating to your Care and Treatment Package.
“Treatment Package” means the treatment or procedure that will be carried out at the Treating Hospital, as set out in your Treatment Letter and for which you have agreed to pay a Fixed Price.
“We” or “us” means Streamline Clinics Limited and any subsidiary.