Non-NHS Services

Not all services are free on the NHS. There is a range of non-NHS services for which GPs can charge a fee which is based on the time and effort involved.

Why do GPs charge fees?

The NHS provides most health care to most people free of charge, but there are exceptions e.g. prescription charges. There are a number of other services for which fees are charged. Sometimes the charge is made to cover cost of treatment e.g. travel vaccinations, dental treatment. In other cases the service is not covered by the NHS e.g. medical reports for insurance companies, claims on private health insurance and other letters and forms which require the doctor to review the patients medical records. The Private work list is exhaustive.

GPs are not employed directly by the NHS and are self-employed and have to cover costs e.g. staff, building, heating, lighting etc. in the way as any small business.

The NHS pays the GP for specific NHS work, but not for non-NHS work. Time spent completing forms and preparing reports takes the GP away from the medical care of his/her patients. Non-NHS work must be undertaken outside of NHS contracted 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 will need to check the medical records.

From the 25 May 2018, in most cases, patients can request access to their medical records (Subject Access Request – SAR) free of charge, including when a patient authorises access by a third party such as a solicitor. A reasonable fee can be charged if the request is manifestly unfounded or excessive. If the request is for a medical report (rather than a SAR) then this falls under the Access to Medical Reports Act (AMRA) and will be handled in the usual way. The General Data Protection Regulation (GDPR) does not change the AMRA.

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

• Accident or sickness certificates for insurance purposes
• Certain travel vaccinations
• Certificates for school
• Holiday insurance and cancellation forms
• Referral or private care forms
• Letters requested by, on behalf of, the patient

You may contact the surgery to enquire about fees that are currently charged. There are certain items of Private work that the Surgery will not agree to do