Non-NHS Work

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 charges exist because the service is not covered by the NHS, for example, providing medical reports for Insurance companies or Employers.

The Government’s contract with NHS General Practice covers medical services to NHS patients but not non-NHS work.

In recent years, more and more organisations have begun 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 or because an organisation wants to ensure the information provided to them is 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
  • Reports for Health clubs to certify that patients are fit to exercise
  • Private prescriptions for travel purposes

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

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 patients for non-NHS work (i.e. work not covered under NHS contract). The fees suggested provide a guide for practices but may be changed if deemed appropriate.

Why does it sometimes take my GP a long time to complete my form?

The time spent completing forms and preparing reports takes GPs away from providing medical care to patients and contributes for the heavy workload in Primary care. The surgery will always prioritise the care of patients. As a result, non-NHS work may take longer to complete. Some reports and correspondence may also be complex and requires information to be gathered from a number of different sources. Other reports may require a medical examination. The factors also influence the time taken to complete reports.

I only need the Doctor’s signature – what’s 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, the Doctor may have to check the patient’s entire medical record. An inaccurate report can have serious consequences for the patient and for the Doctor who may become the subject to an investigation by 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 any forms or reports.

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. The surgery has a list of fees which is available at Reception and on our website.

What can I do to help?

  • Not all documents need a signature by a Doctor, for example Passport applications. You can ask another person in a position of trust to sign such documents free of charge. Please read the information that comes with such forms carefully. Following advice received previously, Doctors at the surgery do not countersign Passport applications.
  • If you have several forms requiring completion, present them to the surgery at the same time for completion.
  • Forms may take up to 4 weeks to complete. Urgent requests may require special arrangements to be made which may add to the cost. Our priority will always be NHS patient care over non-NHS work.