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Non NHS fees

Costs of other services not offered by the NHS

Why do GPs sometimes charge fees?

The NHS provides health care 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, for example, medical reports for insurance companies.

It is important to understand that GPs are self-employed and offer their services to the NHS, 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.

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

  • Accident/sickness insurance certificates.
  • Certain travel vaccinations
  • Private medical insurance reports.

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

  • Medical reports for an insurance company.
  • Some reports for the DSS/Benefits Agency.
  • Examinations of local authority employees
  • Reports regarding joining the Army.

Where do fees comes from?

The British Medical Association (BMA) suggests fees for non-NHS work which is not covered under a GP’s NHS contract, to help GPs set their own professional fees. However, these fees are guidelines only, not recommendations, and a doctor is not obliged to charge the rates suggested.

Why can it take a long time to get a form completed?

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 NHS workload and this paperwork is done at times set aside for it.

I only need the doctor’s signature – why do I need to wait?

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.

What is going to be the charge?

The BMA recommends that GPs tell patients in advance if they will be charged, and how much. It is up to the individual doctor to decide how much to charge, but the BMA produces lists of suggested fees which many doctors use.

How can I keep costs down?

  • Not all documents need 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.
  • If you have several forms requiring completion, present them all at once and ask your GP if he or she is prepared to complete them all at once as a ‘job lot’ at a reduced price.
  • Plan in advance. Do not expect your GP to process forms overnight. You should expect the form(s) to take up to 4 weeks to be processed.

Check the current costs of non NHS services.

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