Why do GP’s charge fees? Your questions answered
The NHS 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 isn’t covered by the NHS, for example, medical reports for insurance companies, claims on private health insurance and other letters and forms which require the doctor to review the patient’s medical records.
It is important to understand that GP’s are not employed by the NHS, they are self-employed, and they have to cover their costs which include staff, buildings, heating, lighting etc. in the same way as any business. The NHS pays the doctor for specific NHS work, but for non NHS the fee has to cover the doctor’s costs.
What is covered by the NHS and what is not?
The government’s contract with GP’s covers medical services to NHS patients. In recent years, more and more organisations have been involving doctors in a whole range of non-medical work. Sometimes the only reason that GP’s are asked is because they are in a position of trust in the community, or because an insurance company or employer wants to be sure that information provided is true and accurate.
Examples of non-NHS services for which GP’s can charge their patients
- Certain travel vaccinations
- Private prescriptions
- Private medical insurance reports
- Holiday cancellation forms
- Letters requested by or on behalf of, the patient
- Private sick notes
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/her patients. Most GP’s have a very heavy workload, the majority of GP’s work can add up to 60 hours a week and paperwork takes up an increasing amount of their time. In addition non-NHS work must be undertaken outside of NHS contracted time.
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. Therefore in order to complete even the simplest of forms, the doctor needs to check the patient’s entire record. Carelessness or an inaccurate report can have serious consequences for the doctor, with the General Medical Council or even the Police.
How are charges decided?
The British Medical Association (BMA) recommends that GPs tell patients in advance if they will be charged. It is up to the individual practice to decide how much to charge. GPs are able to set their own fees to ensure that their costs in delivering the services are covered. Time spent completing private reports and undertaking private medical examinations are generally done outside of normal working hours as an extra commitment to a GPs workload.
Kings Medical Practice endeavours to follow a fair charging policy and we regularly review our fees in line with the national average.
Changes November 2020
There are a number of areas we have traditionally not charged fees for providing non NHS services. Due to increasing NHS demands and strain on resources we are no longer able to continue to provide these for free. Therefore, from November 1st 2020 we will be charging a fee for providing private prescriptions and for certain travel vaccinations and certification of vaccination.
We should not provide private scripts to our NHS patients to obtain medication cheaper. This represents defrauding the NHS.
Please note private referrals that generate a prescription request would necessitate a private prescription fee. If you are given a private prescription at your appointment we would not be able to change this to a NHS script.
We are unable to issue a private prescription for an item that is not commissioned within our CCG.
| Description | Fee |
|---|---|
| Private sick note | £40.00 |
| Private prescription | £20.00 |
| Health Club – patient fit to exercise | £63.00 |
| OFSTED Childminders | £91.00 |
| Certificates of fact | £19.00 |
| Character reference | £30.00 |
| General letters/ housing/ school | £40.00 |
| Travel cancellation form | £63.00 |
| Private medical insurance claim form/ school fees insurance claim | £47.00 |
| Simple insurance form (1-2 pages) | £25.00 |
| Income protection targeted report | £50.00 |
| Life insurance targeted report | £66.00 |
| Non-targeted insurance form (life assurance, critical illness, GPR, etc) | £104.00 |
| Supplementory reports | £27.00 |
| Fitness to bear firearms | £90.00 |
| Adoption Medical Form AH | £78.00 |
| Adoption Update Request Form | £48.00 |
| Private medical examination | £127.00 |
| Mental capacity examination and certificate | £169.00 |
| HGV, PSV, Taxi (we do not do the eye test section) | £133.00 |
| Private/ paternity blood tests | £45.00 |
| Fitness to travel (fee relative to complexity) | £29.00–£69.00 |
| Medical reports (up to 20min) | £90.00 |
| Medical reports (up to 30min) | £145.00 |
| Private travel vaccination certificate for HepB | £21.00 |
| Non-NHS Travel vaccinations (Rabies, TB, MenACWY, Japanese Encephalitis, Tick-borne Encephalitis) | £55.00 |
Accessing Medical Records
There are two options for you to view your GP medical records:
- We recommend patients to sign-up for either the NHS App or SystmOnline where you can view and print your GP medical records.
- You can request, in writing for the attention of Nicola Hetherington or Michael Land, a copy of your medical records (free of charge). Please bare in mind the cost and time it takes to produce copies of medical records compared with the online option above.
If you wish to have access to other people’s records we will need:
- Wherever practicable, written consent from the person whose records you want. We will check with the individual whether the request is legitimate and the reason why you are requesting them instead of themselves.
- Where you have parental responsbility for a child under the age of 16 and does not have the capacity to provide consent for themselves. Please note, we cannot provide online access to children’s medical records as capacity to consent changes over time for each child individually.
- Where you have a lasting power of attorney for welfare or a court of protection order for welfare for an individual who lacks capacity to provide consent for themselves and the request for the records is legitimate.