Chargeable Services

Please review our list of non-NHS work that we offer at our GP surgery, which attract a fee. This includes certificates, forms, medical examinations and various travel vaccinations.

Non NHS Services and fees

What is non-NHS work and why is there a fee?
The National Health Service provides most health care to most people free of charge, but there are exceptions: prescription charges have existed since 1951 and there are a number of other services for which fees are charged.

Sometimes the charge is because the service is not covered by the NHS, for example, producing medical reports for insurance companies, solicitors or employers.

The Government’s contract with GPs covers medical services to NHS patients but not non-NHS work. It is important to understand that many GPs are not employed by the NHS; they are self-employed and they have to cover their costs – staff, buildings, heating, lighting, etc. – in the same way as any small business.

In recent years, however, more and more organisations have been involving doctors in a whole range of non-medical work. Sometimes the only reason that GPs are asked is because they are in a position of trust in the community, or because an insurance company or employer wants to ensure that information provided to them is true and accurate.

Examples of non-NHS services for which GPs can charge their own NHS patients are:

– accident/sickness certificates for insurance purposes

– school fee and holiday insurance certificates

– reports for health clubs to certify that patients are fit to exercise

– private prescriptions for travel purposes

– Letters to employers, universities or schools

– Letters to the Council/housing requirements

 

Examples of non-NHS services for which GPs can charge other institutions are:

– life assurance and income protection reports for insurance companies

– reports for the Department for Work and Pensions (DWP) in connection with

– disability living allowance and attendance allowance

– medical reports for local authorities in connection with adoption and fostering

– copies of records for solicitors

Do GPs have to do non-NHS work for their patients?
With certain limited exceptions, for example a GP confirming that one of their patients is not fit for jury service, GPs do not have to carry out non-NHS work on behalf of their patients. Whilst GPs will always attempt to assist their patients with the completion of forms, they are not required to do such non-NHS work.

Is it true that the BMA sets fees for non-NHS work?
The British Medical Association (BMA) suggest fees that GPs may charge their patients for non-NHS work (ie work not covered under their contract with the NHS) in order to help GPs set their own professional fees. However, the fees suggested by them are intended for guidance only; they are not recommendations and a doctor is not obliged to charge the rates they suggest.

Why does it sometimes take my GP a long time to complete my form?
Time spent completing forms and preparing reports takes the GP away from the medical care of his or her patients. Most GPs have a very heavy workload and paperwork takes up an increasing amount of their time. Our GPs do non-NHS work out of NHS time so that NHS patient care does suffer.

I only need the doctor’s signature – what is the problem?
When a doctor signs a certificate or completes a report, it is a condition of remaining on the Medical Register that they only sign what they know to be true. In order to complete even the simplest of forms, therefore, the doctor might have to check the patient’s ENTIRE medical record. Carelessness or an inaccurate report can have serious consequences for the doctor with the General Medical Council (the doctors’ regulatory body) or even the Police.

If you are a new patient we may not have your medical records so the doctor must wait for these before completing the form.

What will I be charged?
It is recommended that GPs tell patients in advance if they will be charged, and what the fee will be. It is up to individual doctors to decide how much they will charge. The surgery has a lists of fees based on these suggested fees which is available on request.

What can I do to help?
Not all documents need a signature by a doctor, for example passport applications. You can ask another person in a position of trust to sign such documents free of charge. Read the information that comes with these types of forms carefully before requesting your GP to complete them.

If you have several forms requiring completion, present them all at once and ask your GP if he or she is prepared to complete them at the same time to speed up the process.

Do not expect your GP to process forms overnight: urgent requests may mean that a doctor has to make special arrangements to process the form quickly, and this may cost more. Usually non-NHS work will take 2 weeks.

Why does my doctor charge fees?

When your doctor is asked to give medical information about you in the form of a report, letter or certificate, the request kick starts a series of processes.

This takes time and is not always straightforward or simple to complete. Some of the information is not available easily and will mean the doctor has to sort and select the right information for the request.

The doctor also must establish who is funding this work and if it is not part of their NHS work, agree a fee for this.

Many patients see their doctor as the embodiment of the NHS and all that it provides – free care at the point of delivery. However not all work doctors are asked to do is paid for by the NHS and many GPs are self-employed.

This means they must cover their time and costs – staff, buildings, heating, lighting, etc – in the same way as any small business. The NHS only pays for NHS work, any work outside of the NHS must be funded by other means and this is why fees are charged.

Your doctor receives large amounts of request and which is often to do with whether your general health allows you to do something e.g. to work, receive benefits, drive, play sport, attend school, own a house, a firearm or it is for insurance, court or other medico-legal reasons.

All requests will vary in complexity, volume and consistency ranging from signing a certificate which can take minutes, to an in-depth report with an examination that can take hours.

When your doctor signs a certificate or completes a report, it is a condition of remaining on the Medical Register that they only sign what they know to be true.

In order to complete even the simplest of forms, they may have to check your entire medical record (some of which may not be accessible on a computer or on site).

Carelessness or an inaccurate report can have serious consequences for the doctor with the General Medical Council (the doctors’ regulatory body) or even the Police.

Your doctor is inundated with work. They have to balance their time with treating the sick, keeping their practice afloat and making sure they are doing all of this safely and within their professional duties as a doctor.

With certain exceptions written within their contract, doctors do not have to carry out non-NHS work. However, many choose to for the benefit of you and other families they treat.

Where a doctor chooses to undertake the work, we advise them to inform and always agree a fee in advance of undertaking work.

Should their volume of work prove to be greater or more complex than expected, the doctor will contact you to discuss how to proceed.

– Not all documents need a signature by a doctor and can be done by other professionals. Please check the form and accompanying guidance as you may get a quicker response that way.

– If you have several forms requiring completion, present them all at once and ask your doctor if he or she is prepared to complete them at the same time to speed up the process.

– Do not expect your GP to process forms overnight. Urgent requests may mean that a doctor has to make special arrangements to process the form quickly, and this will cost more.

– Don’t book an appointment with your doctor to complete forms without checking with your doctor’s administrative staff as to whether you need to or not.