Non NHS Services – Chargeable

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 can take 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. NHS medical care of patients always takes priority during our working day so any private letters or forms can take up to four weeks to complete and return to you.  We cannot guarantee they will be completed earlier.

I only need the Doctor’s signature – what is the problem?

When a doctor signs a certificate or completes a report they need to ensure that this statement is based on all of the medical records and this can involve reading through significant amounts of computer and paper records.

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. 
 

Fitness to letters (GP Surgery Policy on Private Work Involving Vicarious Liability)

Purpose:

This policy outlines the types of private work that our GP surgery will not undertake, particularly where there is a risk of vicarious liability. The primary objective is to ensure the safety and well-being of both our patients and the healthcare professionals, while maintaining the highest standards of clinical care within the scope of our NHS services.

Scope: This policy applies to all patients registered at our GP surgery and covers private work requests that may expose the practice or its clinicians to vicarious liability.

Fitness letters: Our GP surgery is committed to providing high-quality care within the scope of NHS services. However, we do not undertake private work that may involve specialist assessments or activities which present a significant risk of vicarious liability. These include, but are not limited to, the following:

Fitness to fly assessments

Clearance for high-risk sports (e.g., mountaineering, skydiving, paragliding)

Certification for participation in sporting events (e.g., marathons, triathlons)

Diving medicals (beyond DVLA Statements of fact) or fitness to dive

Medical certifications for extreme sports or adventure travel

Rationale:

These types of private work often require specialist knowledge and expertise that fall outside the general practice remit. Moreover, issuing certifications for such activities may expose the GP surgery to potential legal risks, including vicarious liability, if an adverse event occurs.

Our GPs are trained to provide general medical services and support within the NHS framework. Specialist assessments should be undertaken by professionals with specific expertise in those fields, and we encourage patients to seek advice from appropriately qualified clinicians or agencies for such requests.

Alternative Options: For private work not covered under this policy, patients are advised to seek independent medical assessments from specialists in the relevant field. These might include:

Occupational health specialists

Sports physicians

Aviation or diving medical examiners

Travel medicine clinics