Non-NHS services

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.

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.

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

- medical reports for an insurance company
- some reports for the DSS/Benefits Agency
- examinations of local authority employees

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.

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.

We will tell you what the expected cost will be, and reception staff will always ask for payment in advance. In the case of medical reports, we will ask for a £25.00 deposit. However, sometimes medical reports can be much more complex or involved and only the GP will be in a position to assess how much work is needed. In this case it is up to the individual doctor to decide how much to charge, and we will contact you and let you know before they start work on the report. If you decide that you do not wish to have the report completed at this stage, we will refund the deposit and return the uncompleted form to you.

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.