Non-NHS Services & Fees

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The NHS provides most healthcare 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 providing copies of health records or producing medical reports for insurance companies.

What is covered by the NHS and what is not?

The government’s contract with GP’s 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 GP’s 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 GP’s can charge their patients:

• Certain travel vaccinations
• Private medical insurance reports
• Holiday cancellation forms
• Referral for private care forms
• Letters requested by or on behalf of, the patient
• In certain instances fitness to work forms

Examples of non-NHS services for which GP’s can charge other institutions are:

• 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/her patients. Most GP’s have a very heavy workload - the majority of GP’s work up to 60 hours a week and paperwork takes up an increasing amount of their time. 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 record. Carelessness or an inaccurate report can have serious consequences for the doctor, with the General Medical Council or even the Police.

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 GP’s have a very heavy workload- the majority of GP’s work up to 60 hours a week 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 record.

Carelessness or an inaccurate report can have serious consequences for the doctor, with the General Medical Council or even the Police.

Surely the doctor is being paid anyway?

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. The NHS covers these costs for NHS work, but for non-NHS work, the fees charged by GPs contribute towards their costs.

How are charges decided?

The British Medical Association recommends that GPs tell patients in advance if they will be charged. It is up to the individual practice to decide how much to charge.

Private fees for non NHS work

For more information about charges, visit the British Medical Association website