Non-NHS Work

The National Health Service provides most health care to most people free of charge, but there are exceptions. Some services provided are not covered under our contract with the NHS and therefore attract charges. 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. The NHS pays the doctor for specific NHS work, but not for non NHS. The fee has to cover the doctors costs.

The fees charged are based on the British Medical Association (BMA) suggested scales and our Patient Services team will be happy to advise you about them along with appointment availability.

Examples where a patient can be charged include the following:

  • Insurance claim forms
  • Prescriptions for taking medication abroad
  • Private sick notes
  • Letters to third parties
  • Vaccination certificates
  • Certain travel vaccinations
  • Private medical insurance reports
  • Holiday cancellation forms
  • Referral for private care form
  • In certain instances fitness to work forms

Examples where another company can be charged include the following:

  • Medical reports for an insurance company
  • Some reports for DSS/Benefit agency
  • Examinations for local authority employees

Where NHS and Private Care Meet

Patients are increasingly using private health providers. This is often a response to the increasingly long NHS waiting lists and these patients often feel that they are ‘helping’ the NHS by seeking private diagnosis and treatment. Unfortunately, many of these patients don’t realise that the interface between the NHS and private practice is complex.

Private providers may not be regulated in the same way as the NHS, and they may not follow NHS guidelines on diagnosis and management.

From the Thames Valley Commissioning Guidance:

  • There is no obligation for the GP to prescribe treatment recommended by a private practitioner if it is contrary to local agreement or outside normal clinical practice.
  • The NHS will not normally fund treatment recommended by a private practitioner if they are not usually commissioned in an area.
  • Even if the patient can demonstrate they have benefited from private treatment this does not provide grounds for continuing the treatment on the NHS – clinical need should be assessed in the same way that we would assess an NHS patient in our area.
  • Retrospective funding is not possible.
  • There should be as clear as possible separation between NHS and private care.
  • In one individual private consultation the patient must pay for all aspects within that consultation – any drugs prescribed or interventions.
  • For ongoing care, the NHS GP can continue to prescribe if it would be normally provided on the NHS for that condition – we as GP’s are then taking on full responsibility for this. If the drug is not normally provided by primary care, we can enter into a ‘shared care agreement’ with ongoing monitoring by the private consultant if this is clearly set out and meant for GP shared care (for example gender services)

Frequently Asked Questions

What is covered by the NHS and what is not?

The government’s contract with GPs 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 GPs 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

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 GPs have a very heavy workload – the majority of GPs work 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.