Isn’t the NHS supposed to be free?

The National Health Service provides most health care to most people free of charge, but there are exceptions: prescription charges have existed since 1951 and there are a number of other services for which fees are charged. Sometimes the charge is made to cover some of the cost of treatment, for example, dental fees; in other cases, it is because the service is not covered by the NHS, for example, providing copies of health records or producing medical reports for insurance companies.

Surely the doctor is being paid anyway?

It is important to understand that your GP is not employed by the NHS, but they work for the NHS. They are self-employed and they have to cover their costs – eg secretarial time, buildings, heating, lighting, etc – in the same way as any small business. The NHS covers some of these costs for NHS work, but for non- NHS work, the fees charged by GPs contribute towards their costs.

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. 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.

Examples of non-NHS services for which patients are charged are:

• Accident/sickness certificates for insurance purposes
• School fee and holiday insurance certificates
• Reports for health clubs to certify that patients are fit to exercise
• School non-attendance letters

Do GPs have to do non-NHS work for their patients?

With certain limited exceptions, for example 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 always attempt to assist their patients with the completion of forms, for example for insurance purposes, they are not required to do such non-NHS 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 (the doctors’ regulatory body) or even the Police.

What will I be charged?

Some fees are set by legislation eg requests under the Data Protection Act, whilst others are set using guidelines from the British Medical Association.

View our Non NHS Work Fees.