Non-NHS services

What is non-NHS work and why is there a fee?

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 because the service is not covered by the NHS, for example, providing copies of health records or producing medical reports for insurance companies, solicitors or employers.  The Government’s contract with GPs covers medical services to NHS patients but not non-NHS work. It is important to understand that many 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.  In recent years, however, 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 ensure that information provided to them is true and accurate.

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

• accident/sickness certificates for insurance purposes
• school fee and holiday insurance certificates
• Letters to whom it may concern regarding health conditions
• Private prescriptions for travel purposes
• Medical evidence for clinical trials

We cannot complete medical assessments for sporting events, occupational health assessments, gym memberships or fitness to fly reports. We would encourage you to seek private consultation with a suitable accredited physician for these assessments.  We do not supply private prescriptions.  We do not offer private travel vaccinations, we do offer the 3 standard NHS vaccinations.

You can make a request for your summary medical records but we are not able to undertake medical assessments.  If you request more than one copy of your medical records with no changes then we will charge you for the second copy as this is duplicate work and deemed excessive.

Evidence for Clinical / Medical Trials 

Many patients choose to take part in clinical trials , this is your personal decision.  The Practice will happily supply a summary of your information for the medical trial but this takes up to 30 days.  It is your responsibility to request this information in good time for your trial.  We will not verify information, stamp or sign it – if anything further is required then a fee will be applied ONLY if the patient’s own GP is willing to provide further evidence, this is fully at the discretion of the individual GP.

We cannot countersign passport application photographs as this must be done by someone who knows you personally and not just professionally. Visit the Gov.uk website for help finding someone suitable.

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

• life assurance and income protection reports for insurance companies
• reports for the Department for Work and Pensions (DWP) in connection with
• disability living allowance and attendance allowance
• medical reports for local authorities in connection with adoption and fostering
• copies of records for solicitors

Do GPs have to do non-NHS work for their patients?

With certain limited exceptions, for example a GP confirming that one of their patients is not fit for jury service, GPs do not have to carry out non-NHS work on behalf of their patients. Whilst GPs will always attempt to assist their patients with the completion of forms, they are not required to do such non-NHS work.

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

The British Medical Association (BMA) suggest fees that GPs may charge their patients for non-NHS work (ie work not covered under their contract with the NHS) in order to help GPs set their own professional fees. However, the fees suggested by them are intended for guidance only; they are not recommendations and a doctor is not obliged to charge the rates they suggest.

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 and paperwork takes up an increasing amount of their time. Our GPs do non-NHS work out of NHS time at evenings or weekends so that NHS patient care does suffer.

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 person’s entire medical record. Carelessness or an inaccurate report can have serious consequences for the doctor with the General Medical Council (the doctors’ regulatory body) or even the Police.  If you are a new patient we may not have your medical records so the doctor must wait for these before completing the form.

What will I be charged?

It is recommended that GPs tell patients in advance if they will be charged, and what the fee will be. It is up to individual doctors to decide how much they will charge. The Practice has a lists of fees based on these suggested fees, all payments must be made in advance.

For to whom it may concern or supporting letters patient cannot request Doctors to type a certain text or wording, these letters are based on the GP clinical judgement and cannot be edited unless there are factual errors.

What can I do to help?

• Read the information that comes with these types of forms carefully before requesting your GP to complete them.  You must request this via our admin team, anything taken into consultations will not be processed.
• Passport photos – please note that these can no longer be verified by your GP or nurse, as they know you in a professional capacity.
• If you have several forms requiring completion, present them all at once and ask the reception team if we are 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 may cost more. Usually non-NHS work will take 2 – 4 weeks.