Services which are not included in 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, GPs 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.

Standard Process

1. Patient or representative will contact reception or administration team to request a non-NHS service below
2. If it is a standard request listed below- the reception/administration team will take the appropriate fee and allocate to GP or member of the healthcare team
3. There will then be a 4 week turnaround for these letters to be done, sometimes this can be done earlier, in exceptional circumstances and sometimes there may be a higher fee.
4. Please be aware that the 4 week turnaround/ “clock” does not start until the fee is paid.
5. If the request is not standard and not a listed item above then we would initially decline the request and you would need to seek the form or letter elsewhere. You can however ask this to be reviewed by a GP but standard waiting times do not apply above and it is not guaranteed this would be accepted. We cannot then be held liable for any delay to your form or letter being completed if you choose not to contact another service.
6. If the report can only be done after a medical examination, this will be dependent on appointment availability and may not be done within 4 weeks of request.
7. If a letter is initially accepted but is later found to be something that we do not do in practice, we will let you know at the earliest opportunity and refund the fee.
8. If the letter or report has been done then the fee will not be refunded if a patient or representative later change their mind.

Housing letters

We do not complete any requests of letters for housing.This pertains to all general practitioners.

School Sick Notes or School Toilet Passes

On no occasion will notes be provided by the doctors for school including toilet passes or sick notes. If the school has safeguarding concerns about a child, they can contact the Surgery directly through the usual channels.

Current Charges for Non-NHS Services

All Fees are Payable in Advance
Letter written at patient request This is at the discretion of the clinician, it is typically a fact based letter from the clinical record.	£30
Letter for Holiday Cancellation	£30
Fitness to Travel	£30
General Forms e.g TWIMC, immigration, bank, university letters, proof vaccination record (up to 1 side of A4)	£30

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.

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?

• If you have several forms requiring completion, present them all at once.
• Do not expect your GP to process forms overnight

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. 
 

Examples of Non-NHS Services that do not have a fee: 

Jury service exemption letter