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 Practices covers medical services to NHS patients but not non-NHS work. It is important to understand that Practices are businesses and we have to cover our 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 us in a whole range of non-medical work. Sometimes the only reason that we are asked is because we 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 Practices 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 Practices 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 Practices have to do non-NHS work for their patients?
With certain limited exceptions, for example a Practice confirming that one of their patients is not fit for jury service, Practices do not have to carry out non-NHS work on behalf of their patients. Whilst we will always attempt to assist our patients with the completion of forms, we 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 (i.e. work not covered under their contract with the NHS) in order to help us set our own professional fees. However, the fees suggested by them are intended for guidance only; they are not recommendations and we are 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 us away from the medical care of our patients. Most Practices have a very heavy workload and paperwork takes up an increasing amount of our time.
I only need the doctor’s signature – what is the problem?
When a clinician 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 clinician 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 we must wait for these before completing the form.
What will I be charged?
It is recommended that we tell patients in advance if you will be charged, and what the fee will be. It is up to individual practices to decide how much they will charge. The surgery has a list of fees based on these suggested fees which is available on request.
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. Read the information that comes with these types of forms carefully because we are unable to complete these.
- If you have several forms requiring completion, present them all at once and ask us if we are prepared to complete them at the same time to speed up the process.
- Do not expect us to process forms overnight: urgent requests may mean that a practice has to make special arrangements to process the form quickly, and this may cost more. Usually non-NHS work will take 2 weeks.