Non-NHS Work

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, producing medical reports for insurance companies, to whom it may concern letters. The Government’s contract with GPs covers medical services to NHS patients but not non-NHS work. 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, lightning, etc. – in the same way as any small business.

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
  • 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 GPs 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 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, they 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 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 they 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. Most GPs have a very heavy workload and paperwork takes up an increasing amount of their time. Our GPs do non-NHS work out of NHS time at evenings or weekends so that NHS patient care does not suffer.

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.

If you are a new patient we may not have your medical records so the doctor must wait for these before completing the form.

What will I be charged?

It is recommended that GPs tell patients in advance if they will be charged, and what the fee will be. It is up to individual doctors 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 before requesting your GP to complete them.
  • 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. Usually non-NHS work will take 2 weeks.

Request a Letter from Your GP

“I need a letter from my GP”

Our doctors are frequently asked to provide private or ‘To Whom it May Concern’ letters or reports for third parties. The standard fee for this is £30, which is payable in advance. More complicated letters or reports may attract a higher fee.

“Why do I have to pay?”

The preparation of these letters or reports is not covered by the NHS. The doctor must complete them during their own time and as such there is a fee payable. All letters require the doctor to take time to review a patient’s medical records to ensure that the information provided is correct, then the doctor has to dictate the letter, and finally a medical secretary has to type and print it.

“How long will it take?”

Private letters do not take priority over NHS work and hence may take some time to prepare. Please allow at least two weeks.

“But I need it today/tomorrow/next week/sooner than that!”

In genuinely urgent cases, we will do our best to meet your deadline; however, we cannot promise this. If you cannot wait, we will refund your fee if the letter has not yet been written.

“The doctor has to write these exact words…”

We are very sorry, but we usually cannot accept requests for the doctor to write the letter in a specific way. The doctor will write what he or she knows is supported by your medical record, and his or her opinion on what that should be is final. Please use the form linked below to request your letter, but note that our doctors reserve the right to refuse your request or provide alternative wording.

Please note: if you insist on the doctor changing your letter to suit what you think it should say, or if you want to dictate the contents, we will withdraw our offer to write the letter and refund your fee. Please remember that the doctor is not obliged to write a letter for you at all, as this is not an NHS requirement.

“I want the doctor to write me a job reference.”

These kinds of requests are not appropriate and we will not be able to write a letter for you.

Examples of suitable requests:

·  Fitness to travel, or cancellation of holidays

·  Confirmation of medication or a medical condition

·  Letters for school, universities, employers or courts, etc.

·  Letters to the Council/housing requirements

Example of requests we cannot fulfil:

·  Confirmation of address or other proof of residence or ID (We have no means of verifying this

·  Countersigning passport applications (A GP is no longer required on the form)

·  Letters stating something that is not supported by your medical record

If you understand and agree to the above terms and still want the GP to write a Private Letter, please put this request in writing and hand into a member of our reception team or via our website under administration E-consult.

We look forward to hearing from you.

 

Kind regards

Secretaries at Summercroft Surgery