Services which are outside of the NHS Contract
The National Health Service provides most healthcare to the majority of people free of charge, but there are exceptions. GPs are self-employed and are contracted to provide NHS general medical services for their patients.
Sometimes, GP’s are asked to provide additional services which fall outside their contract and in these circumstances, they are entitled to make a reasonable charge for providing them.
| Service | Practice charge (20 working days) |
| Straightforward ‘To Whom It May Concern’ Letter | £25.00 |
| Private Sick Note (Incapacity Certificate) for employer (except those required for SSP purposes) | £35.00 |
| Accident Insurance Certificate Sickness Insurance Certificate | £35.00 |
| Freedom from infection Certificate Vaccination Certificate | £35.00 |
| Validation of Private Medical Insurance (PMI) Claim Form (e.g. support a claim, or completion of a pre-treatment form) BUPA/PPP Certification | £45.00 |
| Health club brief written report to certify that a patient is fit for exercise | £45.00 |
| School fees Insurance Certificate Holiday Insurance Certificate/Cancellation Form | £45.00 |
| Driving Licence Fitness to Travel Certificate (Extract from records see pro forma charge below) | £45.00 |
| Private Prescription | £30.00 |
| Extract from Medical Records (e.g. Insurance Claim Form) | £67.00 |
| Report of incapacity to work Firearms Medical Report on Pro forma Fitness to Travel Pro Forma | £89.50 |
| Completion of childminder health form | £91.00 |
| *Fitness for Sport Pro Forma | N/A |
| Written report, providing a detailed opinion and statement on the condition of the patient (Up to 30 minutes) | ||
| Accident Insurance Written Report Sickness Insurance Written Report Employer’s detailed report and opinion without examination Fitness for education (University/College/Teacher/Nurses/Dentist) Pharmaceutical trials Written Report (Suitability of patient to take part as non-patient volunteer) Private Medical Insurance Written Report (Prospective subscriber to a PMI Scheme) HGV/ PCV/ Taxi Medical Examination (Form to be handed in prior to appointment, and 30 Minute appointment to be booked) Elderly Driver Fitness medical Sports Medical Seatbelt exemption | £130.00 includes a £30 non refundable deposit when booking if a medical examination is required. Patients needs to see an optician for an eye check before booking. | |
| Solicitors Report Profoma Dictated report | £90.00 £300 per hr | |
| Lighter Life | £40.00 | |
| Comprehensive clinical examination including report, certificate, forms | ||
| Pre-Employment Medical Examination | £175.50 includes a £50 non-refundable deposit when booking. | |
| Private Medical Consultation (per 15 mins) | £75.00 | |
| Private X-Ray | £25 payable to the practice plus costs charged by the hospital invoiced directly to applicant | |
| Private Blood Tests | £35 plus costs for each test paid directly to the Path Lab at Stepping Hill Hospital | |
| Private ECG | £65.00 | |
| Medical records copying fees (Under Part 3 of DPA2018, Manifestly Unfounded/ excessive) | ||
| Health records held on computer | £10.00 | |
| Health records held in part on computer and in part manually | £50.00 | |
| Health records held manually | £50.00 | |
| Collaborative arrangements – (Organisation requesting pays) | ||
| Forms M, B – Obstetric neonatal reports | £35.00 | |
| Form AG2 – update report, parent/carer | £35.00 | |
| Form AH – Health Assessment report | £80.00 | |
| Initial Health Assessment (IHA) Looked after child | £80.00 | |
| Forms C,D,YP or AME Full medical examination of child | £95.00 |
Your questions answered
Isn’t the NHS supposed to be free?
The National Health Service provides most healthcare to the majority people free of charge, but there are exceptions: for example, medical reports for insurance companies.
Surely the Doctor is being paid anyway?
It is important to understand that 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 covers these costs for NHS work, but for non-NHS work the fee has to cover the Doctor’s costs.
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 to do non-medical work 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 GPs can charge their NHS patients are:
- accident/sickness insurance certificates
- certain travel vaccinations
- private medical insurance reports
- statements of fact relating to general health e.g. for children’s dance classes
- Letters requested by, or on behalf of, the patient
- Holiday cancellation claim forms
- Referral for private care forms
Examples of non-NHS services for which GPs can charge other institutions are:
- medical reports for an insurance company
- some reports for the DSS/Benefits Agency
- examinations of occupational health
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 – the majority work up to 70 hours a week – and paperwork takes up an increasing amount of their time, so many GPs find they have to take some paperwork home at night and weekends.
Why does my doctor seem reluctant or say no to this request?
Your doctor is inundated with work. They have to balance their time with treating the sick, keeping their practice afloat and making sure they are doing all of this safely and within their professional duties as a doctor. With certain exceptions written within their contract, doctors do not have to carry out non-NHS work. However, many choose to for the benefit of you and other families they treat. Where a doctor chooses to undertake the work, we advise them to inform and agree a fee in advance of undertaking work.
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 or even the Police.
What can I do to help?
- Not all documents need a signature by a doctor and can be done by other professionals. Please check the form and accompanying guidance as you may get a quicker response that way.
- If you have several forms requiring completion, present them all at once and ask your doctor 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.
- Don’t book an appointment with your doctor to complete forms without checking with your doctor’s administrative staff as to whether you need to or not.
- All non-NHS work if accepted by the GP can take up to 56 working days from receipt to process.
Examples of Non-NHS Services include the following:
- Medicals for pre-employment, sports and driving requirements (HGV, PSV etc.)
- Insurance Claim Forms
- Prescriptions for taking medication abroad
- Private Sick Notes
- Vaccination Certificates
The fees charged are based on the British Medical Association (BMA) suggested scales and Practice Reception Staff will be happy to advise you about them along with appointment availability.