Why GPs sometimes charge fees
Isn’t the doctor being paid anyway by NHS England?
It is important to understand that many 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. NHS England pays GPs for NHS work, but for non-NHS work. The fees charged by GPs contribute towards covering their additional costs.
What is covered by the NHS and what is not?
The Government’s contract with GPs covers medical services to NHS patients, including the provision of ongoing medical treatment. In recent years, however, more and more organisations have been 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 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 the practice can charge their own NHS patients:
- accident or sickness certificates for insurance purposes
- school fee and holiday insurance certificates
- reports for health clubs to certify that patients are fit to exercise
- Examination and reports for renewal of HGV/PSV licences
- Some holiday vaccinations are not available on the NHS and will be charged
Examples of non-NHS services for which the practice can charge other institutions:
- 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
Does the practice 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, for example for insurance purposes, they are not required to do such non-NHS work.
Is it true that the BMA sets fees for non-NHS work?
The BMA suggests fees that practices may charge their patients for non-NHS work (i.e. work not covered under their contract with the NHS) in order to help GPs set their own professional fees. However, the fees suggested by them are intended for guidance only; they are not recommendations and a doctor is not obliged to charge the rates we suggest.
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. Sometimes, the GP who has seen you more than others in the Practice and therefore is best qualified to complete your form, may be away when you bring your form in. This is why it is necessary to allow for up to 2 weeks before a form may be completed.
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 (the doctors’ regulatory body) or even the Police.
What will I be charged?
The BMA recommends that GPs tell patients in advance if they will be charged, and what the fee will be. Ask Reception to check for you what a fee will be.
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.
- 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 at the same time to speed up the process.
- Do not expect your GP to process forms overnight. Urgent requests may mean that a doctor has to make special arrangements to process the form quickly, and this may cost more.
We understand you might need to get some forms signed by your doctor for various things like HGV licence application, insurance reports, claim forms etc. We are able to do these for you but please ensure that you inform the receptionist clearly what it is you want, as they will be able to advise you better on how to get forms completed. Some forms require you to be seen by a doctor / nurse and sometimes certain tests are needed as well.
We use iGPR Technologies Limited (iGPR) to assist us with responding to report requests relating to your patient data, such as subject access requests that you submit to us (or that someone acting on your behalf submits to us) and report requests that insurers submit to us under the Access to Medical Records Act 1988 in relation to a life insurance policy that you hold or that you are applying for. iGPR manages the reporting process for us by reviewing and responding to requests in accordance with our instructions and all applicable laws, including UK data protection laws.
For more information about how your data is processed by iGPR, please visit https://www.igpr.co.uk/managed-service-dpia/
Please continue to submit your requests for medical reports to Elmwood and we will arrange completion by either one of our clinicians or iGPR.
Please make sure you allow adequate time for the forms to be completed as some of them take time in view of looking into your past records or needing more time to complete the forms. Also when coming in to see a doctor / nurse please ensure you have already filled in the sections which need to be filled by yourself.
You might need to pay for completion of some forms / reports as they are outside the domain of NHS Work. Charges vary depending on the type of forms and time needed to complete these. We follow the rates set or advised nationally by the British Medical Association (BMA).
Craig Coulson, Chartered Physiotherapist MCSP, HCPC Registered
Elmwood Physiotherapy offers treatment for all musculoskeletal conditions. If you are not sure whether Physiotherapy is for you then please contact Craig via phone or email to book a free 30 minute consultation.
Elmwood Chiropody & Podiatry Clinic
Donna Hall & Associates BSc (Hons) Podiatary, MChS, HCPC Registered