What is Non-NHS Work and Why is There a Fee?

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

The Government’s contract with GPs covers medical services to NHS patients but not non-NHS work. 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.

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.
• School fees and holiday insurance certificates.
• Reports for health clubs to certify that patients are fit to exercise.
• Private prescriptions for travel purposes.

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.
• Copies of records for solicitors.