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.
How do I request a report or letter?
The Spa Surgery does provides Non NHS services, this work is completed outside of NHS time and we ask that all requests for these services are submitted using our Request Form.
Payment is required when the request is submitted, as unfortunately from time to time patients have asked for a report and then refused to pay once it has been completed by the doctor. This means we now usually ask patients to pay for the report before the doctor completes any work.
The Government’s contract with GPs covers medical services to NHS patients, however, in recent years more and more organisations have been involving doctors in a wide range of non-medical work, such as Insurance forms and reports, employment medicals and Solicitors reports to name a few examples. 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, employer or public body wants to ensure that the information provided to them is true and accurate.
The Spa Surgery provides Non NHS services, this work is completed outside of NHS time and we ask that all requests for these services are submitted using our Request Form. Payment is required when the request is submitted and we require up to 20 working days from receipt of payment to process and complete the work.
What fee should I expect to pay?
We have provided below details of our fees, which are based on BMA suggested fees guidance. Whenever we receive a request for a letter or report the doctor will review the request in order to work out how long they need to complete the report and therefore what fee to charge.
We will always tell the patient what the fee will be before the report is completed, so they can decide whether they want to go ahead.
Payment for Non NHS Services
To make the invoice and payment process as easy as possible for our patients, our preferred payment method is via a secure link within the invoice. The online payment facility is administered by Stripe.com
Please note that we do not accept payment by credit card.
What if I cannot afford to pay a fee?
The practice recognises that many of our patients may have significant financial difficulties and would not wish to increase their financial stress. For this reason the practice offers two levels of support:
- Provide the patient with a summary of their medical record including key diagnosis and current medications as previously recorded and read coded in their medical record. There is no charge for this level of support.
- Provide a specific letter or report to patients for a fee.
Whilst we understand the financial pressures patients may be experiencing, we receive a high volume of these requests and set all of our fees based on the time the GP takes to complete the work, so that we are equitable and fair to all patients and our doctors. We are not able to negotiate our rates or offer reduced prices.
How much notice do you need for reports and letters?
We require up to 20 working days from receipt of payment to process and complete the work. Although many are completed within this time period the current demand on primary care is causing this work to take longer to complete. Where a patient has an urgent request this should be explained to the Care Navigator, however, more clinically urgent work cannot be delayed.
Taxi Medicals
We regret to inform patients that we are still unable to undertake HGV and Taxi medicals. This is due to the current and expected demand for NHS appointments.
There are alternative organisations that are able to provide these services within the Leeds and York areas, these include:
Please note that the practice is providing these details for information purposes ONLY, other organisations are available. The Surgery does not endorse any of the organisations mentioned. It is entirely up to you who you choose to provide these services for you.
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 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 takes the GP away from the medical care of his or her patients. Most GPs have a very heavy workload – the majority work up to 70 hours a week – 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
- 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.