Medicals & Chargeable Services

Information for Patients on Service Charges and Fees at Bridge End Surgery 

Why do GPs charge fees?  Your questions answered   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, medical reports for insurance companies, claim forms for referral for private care and other letters and forms which require the doctor to review the patient's medical records. 

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 pays the doctor for specific NHS work, but for non-NHS work the fee has to cover the doctor's costs. 

What is covered by the NHS and what is not?

The government's contract with GPs covers medical services to NHS patients.  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 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:

• Certain travel vaccinations
• Private medical insurance reports
• Holiday cancellation claim forms
• Referral for private care forms
• Letters requested by, or on behalf of, the patient 

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 local authority employees 

Will a GP always complete non-NHS forms??

No, completion of non-NHS forms is at the discretion of the individual doctor because this work is outside what is being contracted by the NHS and so is optional and there are a number of other private providers of medicals and certificates. 

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/her patients.  Most GPs have a very heavy workload and paperwork takes up an increasing amount of their time. 

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.  Therefore, in order to complete even the simplest of forms, the doctor needs 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.  At Bridge End Surgery we are unable to sign passport application forms.

What will I be charged?

The BMA recommends that GPs tell patients in advance if they will be charged, and how much.  It is up to the individual practice to decide how much to charge, but the BMA produces lists of suggested fees for the Doctors to use as a guideline. 

What notice is needed for completion of reports and letters ?

To allow the practice to plan the GP’s time 4 weeks notice is required although many are completed within this time. Where a patient has an urgent request this should be explained to the receptionist who will note the request however it is not always possible for other more clinically urgent work to be delayed. 

What can I do to help?

Not all documents need a signature by a doctor.  For example, you could ask another person in a position of trust, who may be willing to sign a passport application free of charge.  (Teacher, Accountant, etc) 

If you have several forms requiring completion, present them all at once and ask the receptionist if the price can be reduced by bringing them as a 'job lot'. 

You can complete the form to the best of your ability in pencil, so the doctor just has to quickly verify your entries against the information we hold. 

Do not expect your GP to process forms overnight, urgent requests may mean that a doctor has to make special arrangements to process the form quickly, and this will cost more. 

Why do GP’s charge for the completion of cremation forms?

A deceased person cannot be cremated until the cause of death is definitely known and properly recorded. Before cremation takes place two certificates must be signed, one by the GP and one by another doctor. The completion of these forms is not part of a doctor’s NHS duties and the fees are usually charged to the funeral director who generally passes on the cost to the family.

These fees are agreed with the National Association of Funeral Directors, the National Society of Allied and Independent Funeral Directors and Co-operative Funeralcare. Death Certificates are a separate form and are completed free of charge.

Schedule of Charges: