Services which are outside of the NHS Contract
The NHS provides most healthcare to the majority of patients free of charge, but there are exceptions. GPs are self employed and are contracted to provide NHS general medical services for their patients.
Sometimes GPs are asked to provide additional services which fall outside their contract and in these circumstances, they are entitled to make a reasonable charge for providing them.
This agreement between the practice and patient lists the fees to be charged for private work. All fees are payable in advance by the patient.
| Service | Fee |
|---|---|
| Access to view records – paper and computerised | Free |
| Adoption and fostering medical | £100.00 |
| Adoption and fostering – health declaration | £40.00 |
| Blue badge scheme report/examination | £20.00 |
| Bus pass form / disabled persons travel pass | £25.00 |
| Copies of records – per sheet (*from 25.5.18) | Free |
| Coroner’s report (extract from records) | £40.00 |
| Cremation report | £40.00 |
| Disability living allowance | £25.00 |
| DNA series 2 report | £40.00 |
| Driver/ employment medicals with examination (taxi and HGV) | £90.00 |
| Elderly fitness to drive | £58.00 |
| Fire arms / shotgun cert/licence | £35.00 |
| Fitness for special activity (e.g. parachute jump) | £30.00 |
| Fitness to travel certificate | £30.00 |
| Fitness to fly in pregnancy | £30.00 |
| Forms basic (and no more work than a basic letter) | £30.00 |
| Forms – complicated – see medical reports | |
| Gym certificate | £30.00 |
| Health declaration – see letters | |
| Health insurance claim form | £30.00 |
| Holiday insurance cancellation | £30.00 + £10 each additional form |
| Housing report (full examination) | £39.00 |
| Immunisation certificate | £30.00 |
| Insurance reports | |
| Insurance – extract from record | £40.00 |
| Insurance – full examination and report | £100.00 |
| Insurance – report and opinion (no examination) | £87.50 |
| Insurance – report on pro-forma | £87.50 |
| Letters | |
| Letter TWIMC/ simple letter including private fit note, careers break, Camp America, letter to fly, prospective employee but if it becomes more complex see below | £30.00 |
| Letter complex | £40.00 |
| Medical reports | |
| Medical report – extract from records | £55.00 |
| Medical report – short certificate | £30.00 |
| Medical report (with full examination) | £150.00 |
| Medical report (without examination) | £87.50 |
| Medical report on pro-forma | £87.50 |
| Ofsted – childminder – with examination | £85.00 |
| Ofsted – childminder – without examination | £65.00 |
| Ofsted – other professionals – without examination | £65.00 |
| Assessment of capacity | |
| Personal independent payment (PIP) | £33.50 |
| Power of attorney (GP visits patient) | £150.00 |
| Power of attorney (Patient attends surgery) | £120.00 |
Your questions answered
Isn’t the NHS supposed to be free?
The National Health Service provides most healthcare to the majority people free of charge, but there are exceptions: for example, medical reports for insurance companies.
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.
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 to do non-medical work 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.
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
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, so many GPs find they have to take some paperwork home at night and weekends.
Why does my doctor seem reluctant or say no to this request?
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 agree a fee in advance of undertaking work.
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 or even the police.
What can I do to help?
- 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.
- All non-NHS work if accepted by the GP can take up to 56 working days from receipt to process.
Examples of Non-NHS Services include the following:
- Medicals for pre-employment, sports and driving requirements (HGV, PSV etc.)
- Insurance claim forms
- Prescriptions for taking medication abroad
- Private sick notes
- Vaccination certificates
The fees charged are based on the British Medical Association (BMA) suggested scales and practice reception staff will be happy to advise you about them along with appointment availability.