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

Please refer to our “Private Fees” section.

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

Do GPs have to do non-NHS work for their patients?

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, they are not required to do such non-NHS work.

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

The British Medical Association (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 by them are intended for guidance only; they are not recommendations and a doctor is not obliged to charge the rates they suggest.

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.  Our GPs do non-NHS work out of NHS time at evenings or weekends so that NHS patient care does suffer.

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.

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

What will I be charged?

It is recommended 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.  The surgery has a list of fees based on these suggested fees.  Please refer to our “Private Fees” section.

What can I do to help?

• 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.

We administer the full range of travel vaccinations and advice.

*Patients should have their travel injections four to six weeks before they travel * 

* Patients must fill the travel questionnaire (click the link below) before they come in to see the nurse *

For current vaccination recommendations and comprehensive travel advice, check the free NHS site Fit for Travel.

It is recommended you make an appointment to see the Practice Nurse at least four to six weeks before travelling.  This gives a chance to have all the vaccines you need.  If you are travelling at short notice, we can administer an accelerated programme though this is not so satisfactory.  When booking your appointment, tell the receptionist you are coming for travel jabs.

People working abroad, especially aid workers, may require extra immunisations.

If you originally come from the country you are visiting, it is likely your immunity will have worn off so it is important to be vaccinated.

• Diphtheria / Tetanus, Polio, Typhoid, and Hepatitis vaccinations are all available free of charge.
• Meningitis A&C or ACWY, Hepatitis B, and Rabies vaccinations are chargeable (see PRIVATE FEES).
• The Japanese B Encephalitis vaccine is only available privately from Masta.
• Dip / Tet and Polio may require a booster every 10 years for travelers to certain areas
• Hepatitis A requires a booster vaccine 6-12 months after the first with boosters every 10 years.
• Hepatitis B requires a booster 5 years after the initial course of 3 injections.  Typhoid lasts 3 years.
• Yellow fever lasts 10 years

Don’t forget to take malaria tablets – these are not available on the NHS and need to be bought from a pharmacy.  Some require a private prescription, some not.  Our nurse will tell you which combination you’ll need – there may be seasonal changes.  Though vitally important, the tablets do not offer complete protection so also take mosquito protection measures (mosquito netting, repellents, long sleeves, sprays and vaporiser, all of which help to some extent).  All children will require protection; reduced dose vaccines and malaria prevention are available.

NHS Health Checks are being offered to people aged between 40 and 74 once every five years. The check is to assess your risk of developing heart disease, stroke, kidney disease or diabetes. If there are any warning signs, then together we can do something about it.

By taking early action, you can improve your health and prevent the onset of these conditions. There is good evidence for this. The check should take about 20-30 minutes and is based on straightforward questions and measurements such as age, sex, family history, height, weight and blood pressure. That will also include simple blood test to measure your cholesterol level, blood sugar level, etc.

If interested, please contact the surgery on 020 8422 1813 to make an appointment.

Take a look at the NHS Health Check Leaflet for more information about the NHS Health Check.

If you would like to book one of these clinics, please book your appointment online, or contact us on 020 8422 1813.

We offer a number of Non-NHS services to our patients or in other words there are a number of services that are run from these premises that are offered on a Private basis. They are not part of the NHS, so fees are usually payable.

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.

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

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

Time spent completing forms and preparing reports takes the GP away from the medical care of their patients. Most GPs have a very heavy workload and paperwork takes up an increasing amount of their time, so please be prepared to wait for at least TWO weeks for the completion of any forms.

There are private fees for any non-NHS work, i.e. To Whom It May Concern Letter, private medical, signing any private forms (Insurance, joining Gym, any forms for school & colleges), etc… 

See the document below for more information about fees –

PRIVATE FEES FROM APRIL 2023

Other fees, which are not listed in the above document are as follows – 

NHS Health Checks for age 40 to 74

NHS Health Checks are being offered to people aged between 40 and 74 once every five years.

The check is to assess your risk of developing heart disease, stroke, kidney disease or diabetes.  If there are any warning signs, then together we can do something about it.

By taking early action, you can improve your health and prevent the onset of these conditions.  There is good evidence for this.

The check should take about 20–30 minutes and is based on straightforward questions and measurements such as age, sex, family history, height, weight and blood pressure.  That will also include simple blood test to measure your cholesterol level, blood sugar level, etc…

If interested, please contact the surgery on 020 8422 1813 to make an appointment.

Take a look at the detailed leaflet listed below for more information about the NHS Health Check and how it could benefit you.

NHS Health Check Leaflet

Visit NHS Choices – Health Checks for further information.

Bowel Cancer

Bowel cancer is a term used to describe cancer in the colon, rectum or the small bowel.

The symptoms of bowel cancer can include:

• Bleeding from the back passage (rectum) or blood in your stools
• A change in normal bowel habits to diarrhoea or looser stools, lasting longer than 4 to 6 weeks
• A lump that your doctor can feel in your back passage or abdomen (more commonly on the right side)
• A feeling of needing to strain in your back passage (as if you needed to pass a bowel motion)
• Losing weight
• Pain in your abdomen or back passage
• A lower than normal level of red blood cells (anaemia)

Because bowel tumours can bleed, cancer of the bowel often causes a shortage of red blood cells. This is called anaemia and may cause tiredness and sometimes breathlessness.

Bowel cancer screening

How do I get a screening kit?

If you are aged 60-69 years, you will be sent your screening invitation automatically through the post. All you need to do is make sure that your GP has your correct address.

‘People aged 70 years and over or under the age of 60, who wish to be screened, should request a kit. Simply telephone the free helpline on 0800 707 60 60.’

Macmillan cancer support

Have questions about cancer? Visit the website, or call 0808 808 000 free (Monday to Friday 9am – 8pm).

Breast Screening

The National Breast Screening Programme was introduced in 1988 as an early detection service for breast cancer. It states that all women who are aged between 50 – 70 years of age will be routinely invited for free breast screening every three years. The programme is very successful and currently saves around 1,400 lives per year.

Breast screening aims to find breast cancer at an early stage, often before there are any symptoms. To do this, an x-ray is taken of each breast (mammogram). Early detection may often mean simpler and more successful treatment. When women are invited for their mammogram depends on which GP they are registered with, not when their birthday is.

The screening office runs a rolling programme which invites women by area. The requirement is that all women will receive their first invitation before their 53rd birthday, but ideally when they are 50.  If you are under 50 and concerned about any aspect of breast care, please contact the surgery to make an appointment with your GP.

Cervical screening test

Cervical screening, or smear test, is a method of detecting abnormal (pre-cancerous) cells in the cervix in order to prevent cervical cancer. The cervix is the entrance to the womb from the vagina. Cervical screening is recommended every three years for women aged 25 to 49 and every five years for women aged 50 to 64 or more frequently if smear results indicates abnormal changes.

Cervical screening is not a test for cancer; it is a test to check the health of the cells of the cervix. Most women’s test results show that everything is normal, but for 1 in 20 women the test will show some abnormal changes in the cells of the cervix.

Most of these changes will not lead to cervical cancer and the cells may go back to normal on their own. However, in some cases, the abnormal cells need to be treated to prevent them becoming cancerous.

Our nurses are qualified to carry out cervical screening and tests in the form of cervical smears. In order to have a cervical smear the patient must have received a letter requesting that they have a cervical smear and the appointment must please be made for when the patient is not menstruating.

These appointments typically take around 10 minutes. For any further information or to book an appointment, please call the surgery.

Useful links

NHS Choices – Cervical Screening