Non – NHS fees

Non – NHS Fees Explained

Why are fees charged?

The contract the practice has covers medical services to NHS patients. In recent years more and more organisations have been requesting Doctors to complete a wide range of non-NHS work and certification. This is often done to cover costs and apportion responsibility should an unexpected event occur.

This work is not funded by the government, so GP’s have to charge a fee to cover their time and other administrative expenses.

Surely the doctor is being paid any way?

It is important to understand that many GP’s are not employed by the NHS. They are self-employed and they have to cover costs of everything from the limited NHS Funds provided – staff wages, buildings, heating, lighting etc – in the same way any small business has to.

Do GP’s have to do non-NHS work for their patients?

GP’s do not have to carry out non-NHS work in the same way any business or contractor does not have to carry out work that you ask for. Many GP’s will however attempt to assist their patients with this work where it is in their area of knowledge, understanding and expertise.

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.
  • reports for health clubs to certify that patients are fit to exercise.
  • pre-employment medicals, as requested by employers.

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.

I’m doing a sport event, charity event or extreme activity and I need a fit to undertake certificate?

This is a very contentious area and recently there have been cases for litigation and blame against Doctors. Many event organisers are now requiring applicants to have a Doctor certificate to say they are fit to undertake an event to safeguard their own insurance policies and personal liability.

It is extremely difficult for a GP to certify you are “Fit to” undertake without a thorough medical examination and carrying out extensive tests. They will also be required to read your complete records to ensure there is no medical history that could implicate or cause reason for you to not be “fit”. The average patient record is 40 -100 pages of reading. Some of these will be on computer but for many, elements will be still on paper records which will need to be read. The average patient record takes 15 – 30 minutes to be read! Also, at the end of the doctor reading your record the opinion may be that you are perhaps not fit to undertake in their opinion. Please be aware that there will still be a fee for this and if further investigations or work involved this will increase cost.

Please be aware that even though you may be doing an event for charity the charity still charges you an administrative fee for undertaking the event. Therefore we will also still need to charge you for any documentation required. We also personally support many charities.

Why does it sometimes take my GP a long time to complete my form/letter?

Time spent completing forms and preparing reports takes the GP away from the medical care of patients which will always have top priority. GP have an ever increasing workload of forms/letters/reports and certificates which must be prioritised against offering appointments and other urgent administrations like referrals and results. We aim to complete non-NHS work within two weeks of receipts but this is in no way guaranteed and may be closer to 3 weeks at times. Copy records may take up to 4 weeks to complete.

I only need the GP’s signature – what’s the problem?

When a GP signs a certificate, letter or report it is a condition of legality and of remaining on the medical register (which allows them to practice as a doctor), that they only sign what they know to be factually true. In order to complete even the simplest of forms, the doctor needs to read the entire medical record. They also  need to have medical indemnity insurance which for a Full time GP is approximately £10,000 – £12,000 per annum and is paid by them.

What can I do to help?

Not all documents need a signature by a doctor, for example passport applications. You can ask another person in a position of trust to sign such documents free of charge.

If you have several forms requiring completion, present them all at once and ask your GP if he or she is prepared to complete them at the same time to speed up the process.

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.

  Description of Non-NHS Request / Work: All fees are minimum fees and are dependent on the actual work involved once documentation has been received by practice (payment by cash or cheque we do not accept card payment – cheques payable to Church Avenue Medical Group)Fee Payable: (From 05/05/2019)
 Copy Records – Subject Access Request –No charge
30 days to provide – Subject to https://ico.org.uk/for-organisations/guide-to-freedom-of-information/refusing-a-request/
 Adoption – Parents medical report – same as letters / reports misc level 3 (if not set by company)£78.00
 Army Medical Report – same as letters / reports misc level 3£78.00
 Court of Protection Order Assessment£90.00
 Driving – Elderly Drivers Medical£110.00
 Driving – LGV/PSV/HGV Medical£115
 Driving – Racing Driver Medical£160
 Driving – Seat Belt Exemption report only£30
 Driving – Seat Belt Exemption certificate and Medical ( 20 minute appointment also required)£110
 DS 1500 Dept. of Work and Pensions£17.00
 DVLA Report£40.00
 DWP DLA Factual Report£33.50
 Extra Information Request (follow up)£28.00
 Firearms Licence (Fee paid by patient)£49.00
 Fitness to Travel Certificate / letter£28.00
 Forms – small  ( Bus pass / Travel meds / Council Tax etc)£30.00
 Forms – medium  (Housing Report / Claim forms / Holiday Cancellation / Ofsted / University etc)£44.00
 Firearms Licensing£49.00
 Fostering Medical£76.24
 HIV test – private£46.00
 Holiday Cancellation Certificate (report)£44.00
 Insurance Forms (medium) – PATIENTS request (Claim forms / Holiday canc.)£44.00
 Insurance Forms (medium) –      COMPANY request /level 3 letters£72.00
–                                                  Subsequent form£28.00
 Letters miscellaneous – Level 1  eg simple statements of fact EG.(TWIMC / OFSTED / UNIVERSITY)£30.00
 Letters miscellaneous – Level 2  eg professional opinion required inc housing, Holiday cancellation, Fit to undertake£45.00
 Letters/reports miscellaneous – Level 3  eg more complicated/lengthy letters/reports (Army, adoption, Seafarers, sports   medicals etc)£75.00 min
 Letters/reports miscellaneous – Level 4  eg more complicated/lengthy letters/reports for Insurance Companies and  Solicitors  –£20 per 5 minutes with a minimum fee of £100£120.00 min
 M.A.R (Medical Attendants Report)£110.00
 M.A.R (Medical Attendants Report) Extra report£28.00
 M.A.R (Medical Attendants Report) with Medical Exam£178.00
 OFSTED Childminding – Check and sign only£28.00
 Private Prescription£20.00
 Seafarers Medical£72.00
 Sick Note – private/certificate of attendance/school sickness certificate£28.00
 Sickness/accident report/ certificate – without exam£72.00
                                                         – With examination£178.00
 Solicitors reports – £20 per 5 minutes with a minimum fee of £100£110.00
 Sports Medical£72.00
 Taxi Medical£110.00
 Travel documents with medication£28.00

In reviewing and setting its fees, the Practice has consulted BMA guidance www.bma.org.uk/advice/employment/fees/fee-finder  and benchmarked with national and local averages to ensure fees are appropriate.    

For further information on GP fees, please see BMA advice www.bma.org.uk/advice/employment/fees/why-gps-charge-fees