Charging Patients

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.

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 GPs can charge their own NHS patients 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

Examples of non-NHS services for which GPs can charge other institutions are:

  • life assurance and income protection reports for insurance companies
  • reports for the Department for Work and Pensions (DWP) in connection with
  • disability living allowance and attendance allowance
  • medical reports for local authorities in connection with adoption and fostering

Is it true that the BMA sets fees for non-NHS work?

The BMA suggest fees that GPs may charge their patients for non-NHS work (i.e. work not covered under their contract with the NHS) in order to help GPs set their own professional fees.
However, the fees suggested are intended for guidance only; they are not recommendations and a doctor is not obliged to charge the rates the BMA suggest.

How do I find out more about fees?

The BMA’s website has a section about fees which covers common queries such as completing cremation forms, providing medical reports such as sick notes and reports for insurance companies.

What type of report work doesn’t have to be done by a GP?

There is some medical examination and report work that can be done by any doctor, not only a patient’s GP.
For this work there are no set or recommended fees which means doctors may set their own fees. The BMA offer guidelines only.
Find out more about work which doesn’t have to be done by a patient’s GP by clicking on this link