What is covered by the NHS and what is not?
The Government’s contract with GPs covers medical services to NHS patients, including the provision of ongoing medical treatment.
In recent years, however, more and more organisations have been involving doctors in a whole range of non-medical work, which is not paid for by the Government.
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.
Do GPs have to do non-NHS work for their patients?
With certain exceptions (e.g. 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 try and assist, they are not required to do such non-NHS work and are entitled to be paid for it if they do feel it is appropriate.
Why does it 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. Non-NHS work is not a medical priority and most GPs have a very heavy workload and paperwork takes up an increasing amount of their time, so many GPs find they have to complete some paperwork at night and at weekends.
I only need the doctor’s signature – what’s the problem?
When a doctor signs a certificate or completes a report or letter, 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 doctor’s regulatory body) or even the Police.
Why do I have to pay the fee’s up front?
Due to the increasing amount of reports and letters that are requested but are not collected or paid for a decision was made in 2017 that all non-NHS work needs to be paid for in advance. This is to ensure that doctor’s only undertake work that is necessary and will be collected by the patient.
The length of time you have been registered at the practice is irrelevant as every patient will be required to pay in advance.
By paying in advance am I guaranteed that the doctor will undertake the work?
There is no guarantee that the doctor will be able to complete the work you have requested. If this happens you will be issued with a full refund.
Non-NHS Services Charges
| Accepted methods of payment include: Card or Cash (Payments greater than £30 must be paid on card) | |
| Type of service | Approx Fee |
| Letter | £30.00 |
| Bus Pass | £15.00 |
| Private prescription | £30.00 |
| Private sick note | £30.00 |
| Holiday cancellation form | £40.00 |
| School fees insurance claim form | £40.00 |
| Disabled Student’s Allowance form | £40.00 |
| Insurance certificate | £80.00 |
| Employers report and opinion (report only) | Hourly rate of £260.00 pro-rata |
| Solicitors reports | |
| Research Report (1. for GP to check record 2. For report) | £80.00 Per form |
| Medical Examinations (These are always payable in advance) | |
| Pre-employment medical | £120.00 |
| HGV, PSV, taxi driver examination | £120.00 |
| Adoption Medical (where patient is paying) | £60.00 |
Changes to our Non-NHS Services Offering
Dear Patients,
We are writing to inform you of some important changes in our practice policy, in line with the British Medical Association (BMA) guidance. We have decided to cease issuing certain types of certificates, each of which we will address separately below. Please note that each of these are not part of our GP contract with the government, which means we are not paid to do them.
1. Fitness to Compete in Activities Certificates: According to the BMA, “even if a thorough history, examination and any necessary investigations are carried out, doctors are still not in a position to guarantee that a patient is fit for a particular activity”⁶. As a result, we are unable to sign or provide these certificates. We would recommend you seek a specialist private GP to complete these forms for you.
2. Firearm Licence Certificates: The BMA strongly supports the Government’s overall message, that gun ownership is a privilege and not a right, and that firearms must be in the hands of only those who are deemed safe and responsible. Legal responsibility for monitoring firearms holders rests with the police. We, as a practice, have chosen not to engage in the firearms certification process on grounds of conscientious objection because of ethical beliefs. Therefore, we will no longer be providing these certificates. We do not need to arrange for alternative provision of a report, as per the BMA. Those who need such a certificate need this done by a GMC-registered doctor, and there are a variety of private options for those that need to get this done. One such example is https://www.midlandmed.co.uk/medical-certificates-for-your-firearms-or-shotgun-licence/
3. Freedom from Infection Certificates: These certificates are often requested for travel or employment purposes. Often, further investigations are needed for these certificates, which do not fall under the remit of NHS services. We would recommend you seek a specialist private GP to complete these forms for you.
4. Fitness to Fly Letters. GPs are encouraged by the GMC to “work within the limits of [our] competence”. As we are not specially trained in aviation medicine and not insured for this work, we are unable to state whether patients are Fit to Fly. This often affects our pregnant women. We no longer have access to the pregnancy notes of our pregnant patients and so are not even able to write a statement of fact regarding the pregnancy. As a result we strongly encourage our pregnant patients to obtain such letters from their midwife. We have written to the midwifery team to explain this.
You are able to obtain these at various private sources, including: Medical Certificate (updoc.uk)
If your private doctor requests a copy of your medical history, you can have instant access to your medical record via your NHS app free of charge or you can request a copy of your medical notes via our medical secretaries by requesting an access to medical records form (please note this can take up to one month to process).
We understand that this decision may cause inconvenience to some of our patients. However, our primary responsibility is to ensure the safety and well-being of all our patients. We believe this decision aligns with that responsibility and the BMA guidance.
We appreciate your understanding and cooperation in this matter, and continued trust in our practice. If you have any questions or concerns, please do not hesitate to contact us.
Thank you, The Oaks Medical Centre