Services which are outwith the NHS Contract
The National Health Service provides most healthcare to the majority of people free of charge, but there are exceptions. GPs are self-employed and are contracted to provide NHS general medical services for their patients.
Sometimes, GPs are asked to provide additional services which fall outside their contract and in these circumstances, they are entitled to make a reasonable charge for providing them.
Further explanation of charging for Medical & Completion of : Medical Reports, Letters and Statements
We are requested to complete a significant number and vast array of reports/certificates for our 8,400 patients. These include reports to enable patients to claim on their Private Health Insurance, or for purposes such as housing, mortgages, employment, travel, fitness to perform, Jury service, membership cancellations etc. We have a contract with the NHS to provide medical services for our patients. This contract does not include the completion of forms or letters in support of the above stated claims. Our doctors undertake a great deal of responsibility in respect of the information they provide in medical certificates and reports. Furthermore, the Practice incurs a cost of over £50k per year on medical indemnity, in this respect. As mentioned above, this is not funded by the NHS and so we, therefore, have no other alternative but to charge patients for the time and responsibility undertaken by our doctors and any administration costs in this respect.
Costs for producing medical reports/letters, which require a physical examination of the patient are much higher than those requiring information from medical records. It is therefore important, in the first instance, to identify whether or not the Authority requesting a medical report/letter requires the doctor to carry out a physical examination of the patient or are happy to receive a report based on medical records of the patient kept by the practice.
We do draw our patients’ attention to the fees we charge for Private services. Our fee structure is based on British Medical Association guidelines and local practices’ policies on fees for private services. This is displayed on our notice board and is referred to in our practice leaflet. I should also point out that Insurance companies usually state in their forms to their clients that the client’s GP can charge for the completion of the respective form.
There may, in the past, have been inconsistencies in our fee structure and in some instances your fees may have been waived. The practice has now decided to adhere strictly to a defined and consistent fee structure and apologises if you have received a different charge in the past for the same report.
Your questions answered
Isn’t the NHS supposed to be free?
The National Health Service provides most healthcare to the majority people free of charge, but there are exceptions: 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 cover the Doctor’s costs.
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 to do non-medical work 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
- statements of fact relating to general health e.g. for children’s dance classes
- Letters requested by, or on behalf of, the patient
- Holiday cancellation claim forms
- Referral for private care forms
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 occupational health
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 can I do to help?
- If you have several forms requiring completion, present them all at once.
- Do not expect your GP to process forms overnight
Examples of Non-NHS Services include the following:
- Medicals for pre-employment, sports and driving requirements (HGV, PSV etc.)
- Insurance Claim Forms
- Prescriptions for taking medication abroad
- Private Sick Notes
- Vaccination Certificates
The fees charged are based on the British Medical Association (BMA) suggested scales and Practice Reception Staff will be happy to advise you about them along with appointment availability.