Non-NHS Fees

Why do you charge for some work?

The National Health Service provides most health care to most people free of charge, but there are exceptions such as prescription charges. The NHS does not employ GPs; it has a contract with them to provide NHS general medical services for their patients. Sometimes, however, GPs are asked to provide additional services, which fall outside their contract with the NHS, and in these circumstances, they are entitled to make a reasonable charge for providing them. 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., for example medical reports for insurance companies, referral forms for private care and other letters and forms which require the doctor to review the patient's medical records.

Our policies and our fees are aligned with guidance produced by the BMA.

bma.org.uk/practical-support-at-work/pay-fees-allowances/fees

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

• Accident/sickness insurance certificates.
• Certain travel vaccinations.
• Private medical insurance reports.
• Statements of fact relating to general health e.g. for children’s dance classes.
• Letters requested by, or on behalf of, the patient.
• Holiday cancellation claim forms.
• Referral for private care forms.

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

• Medical reports for an insurance company.
• Some reports for the DSS/Benefits Agency.
• Examinations of occupational health.
• Requests from solicitors for patient records.

Appointments

Depending on the work requested, you may be required to attend an appointment or discuss the paperwork via a telephone consultation with the doctor. Due to the range and nature of the requests we receive, we may only be able to advise of this once we are in receipt of the form. Please allow sufficient time when making requests.

Exemptions, waiving and reducing fees

We often have requests to waive or reduce fees. We are sympathetic to our patients, particularly if their circumstances make them vulnerable. However, we have to be fair and open, and mindful that, if we do not charge fees, we are effectively putting more pressure on our day to day NHS practice. Unfortunately, in order to be fair to all patients, there are no exceptions to the charges.

Services we do not provide

There are some services that we have taken the decision not to provide. These are:

• Passport signatures.
• Fit notes (sick notes) for the first seven calendar days of a patient’s sickness absence. This includes letters to schools within the first seven days of a patient’s sickness. Patients can self-certify for this period, for more information please visit; www.gov.uk/taking-sick-leave

Frequently Asked Questions

Why have your fees risen?

At the start of 2022 we reviewed the fees we charge for private work and increased a small number of them to reflect the higher costs we now face.

Surely the doctor is being paid anyway?

It is important to understand that 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. The NHS covers these costs for NHS work, but for non-NHS work the fee has to cover the doctor's costs.

What is covered by the NHS and what is not?

The Government's contract with GPs covers medical services to NHS patients. In recent years, 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 be sure that information provided is true and accurate.

Is it true that the BMA sets fees for non-NHS work?

The BMA suggests fees for non-NHS work which is not covered under a GP’s NHS contract. However, these fees are guidelines only, not recommendations, and a doctor is not obliged to charge the rates suggested.

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 - the majority work up to 70 hours a week - and paperwork takes up an increasing amount of their time.

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 will likely 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 or even the Police.

Non-NHS Work – Fee Guide 2022