Non-NHS services

While most NHS services are free, there are exceptions where GPs may charge fees. Some services, like medical reports or insurance forms, aren’t covered by the NHS. Since GPs are self-employed, they must cover their costs for non-NHS work, such as administrative fees.

This page will explain why fees are sometimes charged, what services fall outside NHS coverage, and how you can help streamline the process when requesting these services.

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.

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 pay for both the doctor’s time and his administrative and staff and support 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:

· accident/sickness insurance certificates
· certain travel vaccinations
· private medical insurance reports
· signing forms confirming a patient’s identify

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 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.

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 will I be charged?

We will tell you what the expected cost will be, and reception staff will always ask for payment in advance.

What can I do to help?

Not all documents need signature by a doctor, for example passport applications (which is a service we do not offer). You can ask another person in a position of trust to sign such documents free of charge.

If you have several forms requiring completion, present them all at once and ask the receptionist to ask your GP if he or she is prepared to complete them all at once as a ‘job lot’ at a reduced price.
Do not waste GP appointments which could be used by sick patients by booking them solely for the completion of forms.

Do not expect your GP to process forms overnight – allow as much time as possible, and expect to wait a minimum of 1 week up to a maximum of 4 weeks. Dealing with urgent requests may mean that a doctor has to make special arrangements to process the form quickly, and this will cost more.