Why GPs sometimes charge fees
Surely the doctor is being paid anyway?
It is important to understand that many 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 not for non-NHS work so the fees charged by GPs contribute towards offsetting their costs.
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 organizations 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:
- accident or sickness certificates for insurance purposes
- school fee and holiday insurance certificates
- reports for health clubs to certify that patients are fit to exercise
- certificates confirming fitness to travel or participate in an event
Examples of non-NHS services for which GPs can charge other institutions:
- 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
Do GPs have to do non-NHS work for their patients?
With certain limited exceptions, GPs do not have to carry out non-NHS work on behalf of their patients. Whilst GPs will always attempt to assist their patients with the completion of forms, for example for insurance purposes, they are not required to do such non-NHS work.
Is it true that the BMA (British Medical Association) sets fees for non-NHS work?
The BMA suggest fees that GPs may charge their patients for non-NHS work (i.e. work not covered under their contract with the NHS) in order to help GPs set their own professional fees. However, the fees suggested are intended for guidance only; they are not recommendations and a doctor is not obliged to charge the rates the BMA suggest.
Can a fee be charged by a GP for the completion of cremation forms?
It is important to differentiate between death certificates (which are completed free of charge) and cremation forms. Cremation forms, unlike death certificates, require doctors to make certain investigations which do not form part of their NHS duties.
A deceased person cannot be cremated until the cause of death is definitely known and properly recorded. Before cremation can take place two certificates need to be signed, one by the GP and one by another doctor.
- Cremation Form 4 must be, as stated, completed by the registered medical practitioner who attended the deceased during their last illness.
- Form 5 must be completed by a registered medical practitioner who is neither a professional partner nor a relative of the doctor who completed form.
A fee can be charged for the completion of both forms 4 and 5 as this does not form part of a doctor's NHS duties - Doctors normally charge these fees to the funeral director, who, generally passes on the cost to the family.
The fees for cremation forms 4 and 5 (which are agreed with the National Association of Funeral Directors, NAFD, the National Society of Allied and Independent Funeral Directors, SAIF, and Co-operative Funeralcare) are available on the BMA website.
Doctors are also entitled to charge a mileage allowance, where appropriate.
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.
If you need a form to be completed and returned within 1 week, please inform the Receptionist when you hand it in.
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 (the doctors' regulatory body) or even the Police, as well as potentially invalidating the form.
What will I be charged?
We recommend that GPs tell patients in advance if they will be charged, and what the fee will be.
It is up to individual doctors to decide how much they will charge, but the BMA produces lists of suggested fees which many doctors use. Sandhurst Group Practice has a list of fees which is available to view at Reception on request.
What can I do to help?
- Not all documents need a signature by a doctor, for example passport applications CAN NO LONGER BE VERIFIED BY A DOCTOR. 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 may cost more.
What type of report work doesn't have to be done by my GP?
There is some medical examination and report work that can be done by any doctor, not only a patient's GP. For this work there are no set or recommended fees which means doctors may set their own fees.