Non NHS Private Fees

Why do GPs sometimes charge fees? Your questions answered in our FAQ.

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.

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.

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.

Can you give examples of non-NHS services for which GPs can charge their NHS patients:

  • accident/sickness insurance certificates
  • certain travel vaccinations
  • private medical insurance reports

Can you give examples of non-NHS services for which GPs can charge other institutions:

  • medical reports for an insurance company
  • some reports for the DSS/Benefits Agency
  • examinations of local authority employees
  • DS 1500 Form (Disability Living/Attendance Allowance)

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

The BMA suggests fees for non-NHS work which is not covered under a GP’s NHS contract, to help GPs set their own professional fees. However, these fees are guidelines only, not recommendations, and a doctor is not obliged to charge the rates suggested.

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 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 doctor to decide how much to charge, but the BMA produces lists of suggested fees which many doctors use. Surgeries often have lists of fees on the waiting room wall based on these suggested fees.

What can I do to help?

  • Not all documents need 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 all at once as a (job lot) at a reduced price.
  • Do not expect your GP to process forms overnight. You should expect the form(s) to take up to 4 weeks for the GP to complete and return

Request a Letter from Your GP

“I need a letter from my GP”

Our doctors are frequently asked to provide private or ‘To Whom it May Concern’ letters or reports for third parties. The standard fee for this is £27, which is payable in advance. More complicated letters or reports may attract a higher fee.

“Why do I have to pay?” 

The preparation of these letters or reports is not covered by the NHS. The doctor must complete them during their own time and as such there is a fee payable. All letters require the doctor to take time to review a patient’s medical records to ensure that the information provided is correct, then the doctor has to dictate the letter, and finally a medical secretary has to type and print it. 

“How long will it take?” 

Private letters do not take priority over NHS work and hence may take some time to prepare. Please allow at least two weeks.

“But I need it today/tomorrow/next week/sooner than that!”

In genuinely urgent cases, we will do our best to meet your deadline; however, we cannot promise this. If you cannot wait, we will refund your fee if the letter has not yet been written.

“The doctor has to write these exact words…”

We are very sorry, but we usually cannot accept requests for the doctor to write the letter in a specific way. The doctor will write what he or she knows is supported by your medical record, and his or her opinion on what that should be is final. Kindly note that our doctors reserve the right to refuse your request or provide alternative wording. 

Please note: if you insist on the doctor changing your letter to suit what you think it should say, or if you want to dictate the contents, we will withdraw our offer to write the letter and refund your fee. Please remember that the doctor is not obliged to write a letter for you at all, as this is not an NHS requirement. 

“I want the doctor to write me a job reference.”

These kinds of requests are not appropriate and we will not be able to write a letter for you. 

Examples of suitable requests:

  • Fitness to travel, or cancellation of holidays
  • Confirmation of medication or a medical condition
  • Letters for school, universities, employers or courts, etc.
  • Letters to the Council/housing requirements 

Example of requests we cannot fulfil:

  • Confirmation of address or other proof of residence or ID (We have no means of verifying this
  • Countersigning passport applications (A GP is no longer required on the form)
  • Letters stating something that is not supported by your medical record