Services which are outwith 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.
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 school or sport
• 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 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