Non-NHS Work

Medicals and Chargeable Services

Why do GPs charge fees?  Your questions answered

Isn’t the NHS supposed to be free?

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 made to cover some of the cost of treatment, for example, dental fees.  In other cases it is because the service is not covered by the NHS, for example, medical reports for insurance companies, claim forms for referral for private care and other letters and forms which require the doctor to review the patient’s medical records.

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 pays the doctor for specific 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.

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

  • Certain travel vaccinations
  • Private medical insurance reports
  • Holiday cancellation claim forms
  • Referral for private care forms
  • Letters requested by, or on behalf of, the patient

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 local authority employees

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/her patients.  Most GPs have a very heavy workload 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.  Therefore, in order to complete even the simplest of forms, the doctor needs 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.  At Crown Dale Medical Centre we are unable to sign passport application forms.

What will I be charged?

The BMA recommends that GPs tell patients in advance if they will be charged, and how much.  It is up to the individual practice to decide how much to charge, but the BMA produces lists of suggested fees for the Doctors to use as a guideline.

What can I do to help?

Not all documents need a signature by a doctor.  For example, you could ask another person in a position of trust, who may be willing to sign a passport application free of charge.  (Teacher, Accountant, etc.)

If you have several forms requiring completion, present them all at once and ask the receptionist if the price can be reduced by bringing them as a ‘job lot’.

You can complete the form to the best of your ability in pencil, so the doctor just has to quickly verify your entries against the information we hold.

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.