Some services available at Church Street Practice are not NHS services, and as a result if you need one of these services you can be charged for it.

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, providing copies of health records or producing medical reports for insurance companies.

It is important to understand that many GPs are not employed by the NHS; they are self-employed and have to cover their own costs – staff, buildings, heating, lighting, etc – in the same way as any small business. The NHS covers these costs for NHS work, but non-NHS work there is no payment from the NHS. The fees charged by GPs contribute towards their costs in these cases.

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 and HGV medicals, as requested by employers

• Private prescriptions, e.g. for malaria

Examples of non-NHS services for which GPs can charge other institutions are:

• Life assurance and income protection reports for insurance companies

• Some reports for the Department For Work and Pensions (DWP)

• Medical reports for local authorities in connection with adoption and fostering

Often we are asked why we are charging just for a signature. However, 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.

Our charges reflect the recommendations by the British Medical Association.