The Scottish government and National Health Service experts are preparing a compromise over co-payments — the issue of whether patients should be allowed to pay privately for extra drugs without losing their right to NHS care.

Under proposals being considered in England, patients who pay to top-up their care with drugs not funded by the NHS would be transferred to hospitals’ private wings or have the extra medicines administered at home to avoid upsetting sufferers making do with basic treatments.

In Scotland, ministers have ordered a review of the current guidance, which they admit is unclear, with a view to allowing some patients to receive both private and NHS care.

Currently, health boards in Scotland operate different policies, with co-payments banned by some and allowed by others, despite guidelines stating that no patient can receive both private and NHS care for the same condition.

The lack of clarity was criticised by the public petitions committee earlier this year, prompting the Scottish government to review its policy.

The UK government was put under further pressure to allow top-ups after the Scottish government indicated last week that patients should be allowed the right to co-pay. “There may be a case for simultaneous care in the NHS and the private sector where there are clear clinical accountability and governance arrangements in place,” it said.

Jean Turner, chief executive of the Scotland Patients Association, welcomed the moves. “If you look at the legislation in Scotland, it is really ambiguous at the moment,” she said.

“People should not be excluded from the NHS. It is completely unfair and against the principles of the NHS.”

Nick Clegg, the leader of the Liberal Democrats at Westminster, is expected to announce his support for allowing co-payments in a speech at Reform, the think tank, on Tuesday. He would be the first leader of a big party to endorse the scheme.

Times Recommends

• Catalogue of failings ‘leaves others at risk’
• Tourists told to stay away amid Venice floods
• Google generation has no need for rote learning