Some services available at Yorkshire Street Medical Centre are not NHS services, and as a result if you need one of these services you can be charged for it.

Below is an explanation of why we make charges for some things.

Isn’t the NHS supposed to be free?

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 made to cover some of the cost of treatment, for example, dental fees; in other cases, it is because the service is not covered by the NHS, for example, providing copies of health records or producing medical reports for insurance companies.

Surely the doctor is being paid anyway?

It is important to understand that many GPs are not employed by the NHS; they are self-employed and have to cover their own costs – staff, buildings, heating, lighting, etc – in the same way as any small business. The NHS covers these costs for NHS work, but non-NHS work there is no payment from the NHS. The fees charged by GPs contribute towards their costs in these cases.

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 GPs can charge their own NHS patients are:

• Accident/sickness certificates for insurance purposes
• Reports for health clubs to certify that patients are fit to exercise
• Pre-employment and HGV medicals, as requested by employers
• Private prescriptions, e.g. for malaria

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

• Life assurance and income protection reports for insurance companies
• Some reports for the Department For Work and Pensions (DWP)
• 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, for example for insurance purposes, they are not required to do such non-NHS work.

Is it true that the British Medical Association (BMA) sets fees for non-NHS work?

The BMA suggests 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 GPs set their own professional fees. However, the fees suggested by the BMA are intended for guidance only; they are not recommendations and a doctor is not obliged to charge the rates suggested.

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 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 will cost more.

What will I be charged?

The BMA recommends that practices tell patients in advance if they will be charged, and what the fee will be. It is up to individual practices to decide how much they will charge, but the BMA produces lists of suggested fees which many practices use.  Please ask reception for the latest private fees.

What report work doesn’t have to be done by my GP?

There is some medical examination and report work that can be done by any doctor, not only a patient’s GP. For this work there are no set or recommended fees.