Charges for NHS Patients
NHS GPs are required by their terms of service to render to patients on their lists the following essential services:
- Management of patients who are ill or believe themselves to be ill, with conditions from which recovery is generally expected, for the duration of that condition, including relevant health promotion advice and referral as appropriate, reflecting patient choice wherever practicable.
- General management of patients who are terminally ill.
- Management of chronic disease in the manner determined by the practice, in discussion with the patient.
GPs must not charge their registered patients unless they are certain that the regulations allow for it. Schedule 5 of the GMS contract regulations sets out the circumstances under which GPs may demand or accept a fee. For more information see the BMA guidance Charges to NHS Patients.
Charges for certificates
While some certificates may be charged for, NHS GPs are obliged to provide a number of certificates free of charge. These include certain certificates supporting some claims by their patients for social security benefits, and those enabling their patient to register as an absent voter on grounds of physical disability, or to establish unfitness for jury service. See Schedule 4 of the GMS Regulations List of Prescribed Medical Certificates.
Charges for professional fees and collaborative arrangements
Until 2006/07 the BMA provided guidance about fees for providing non-NHS services but since then fees have not been nationally set or agreed. The BMA advises individual doctors and GP practices to establish and agree their own fees in advance of undertaking the work. For more information, see the BMA guidance on collaborative arrangements.
There is a lot more information on the BMA fees guidance page.
Charges for safeguarding children reports
In 2007 both LMC subcommittees agreed that GPs have an ethical and contractual obligation to ensure the safety and protection of children first and foremost, and therefore concluded that:
- Under Essential Services, GPs have an obligation to assist social services in the Initial Enquiry as part of the determination of whether a child or children within a family are at risk of harm. Therefore, they should provide brief reports to this end without charge. This view is backed by the Children’s Act and GMC guidance on confidentiality.
- If, however, Social Services request attendance at or a full report for submission to a case conference, then this is outside normal contractual obligations and a GP is entitled to submit a reasonable bill, which fully reflects the work involved and/or costs incurred for this piece of work agreed between the parties in advance. This paragraph relates to the necessary information required by local authorities as part of the evidence at the Child Protection Conference giving the full medical and social details necessary for the protection of the child, which should include relevant information about the rest of the family, especially essential care-givers, as well, to help the conference decide whether to register a child to safeguard him or her, and to develop a protection plan to ensure this.
Further information can be found in the full policy agreed by the subcommittees.
For further information search the Library on this website. If you are not able to find an answer to your query in this way, please contact the LMC office to see if we can help further.
Library Documents Include:
|5305||A User's Guide to Late Payment Legislation|
|13098||BMA Fees Guidance Page|
The BMA (through its professional fees and forensic medicine committees) negotiates a range of fees to cover part-time medical service work, local and central government work, medico-legal work, insurance work and a wide range of reports, examinations and certificates for patients or third parties. The BMA also provides advice and written guidance to members on issues surrounding professional fee work.
|7335||Charges to NHS patients|
|23067||Getting the Most Out of the Fit Note|
|25539||Medical Certification of Short Term Sickness|
Guidance from Beds and Herts LMC Ltd
|10417||Payment for Reports on Children|
|16353||Road Traffic Accidents: Emergency Treatment|
Guidance regarding fees
|6895||Schedule 5 |
Last reviewed on 8th December 2015 (HB)