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 because the service is not covered by the NHS, for example, producing medical reports for insurance companies, solicitors or employers.

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.

• 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
• Private Prescriptions for travel purposes and certain travel vaccinations
• School fee and holiday insurance certificates
• Holiday Cancellation forms
• Letters requested by or on behalf of the patient
• Private medical insurance reports

• 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

With certain limited exceptions, for example a GP confirming that one of their patients is not fit for jury service, 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.

The BMA suggests 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 by the BMA are intended for guidance only; they are not recommendations and a doctor is not obliged to charge the rates the BMA suggests www.bma.org.uk

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. GPs usually do non-NHS work out of the NHS times at evenings or weekends, so that NHS patient care does not suffer.

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.

If you are a new patient, the practice may not have your medical records, so the doctor must wait for these before completing the form.

The BMA recommends that GPs tell patients in advance if they will be charged, and what the fee will be. It is up to individual practices to decide how much they will charge. Where possible, the practice bases its fees in line with the BMA Guidance. The practice has a list of fees which is available on request and the list is also displayed at the Reception Area.

• 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. Read the information that comes with these types of forms carefully before requesting your GP to complete them
• 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. Usually, non-NHS work will take 2 weeks

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. For a list of the kind of reports which can be done by any doctor, go to the www.bma.org.uk