Non-NHS Services

Not all services are free on the NHS. There is a range of non-NHS services for which GPs can charge a fee which is based on the time and effort involved.

Why Do GPs Charge Fees?

The NHS provides most healthcare free of charge, but there are exceptions, such as prescription charges. There are also a number of other services for which fees are charged. Sometimes fees cover the cost of treatment, for example, travel vaccinations or dental treatment. In other cases, the service is not covered by the NHS, such as medical reports for insurance companies, private health insurance claims, and other letters or forms that require a doctor to review a patient’s medical records.

GPs are not directly employed by the NHS; they are self-employed and must cover costs such as staff, premises, heating, and lighting, similar to any small business.

The NHS pays GPs for specific NHS work, but non-NHS work is not funded. Completing forms or preparing reports takes time away from patient care and must be undertaken outside NHS contracted hours. When a doctor signs a certificate or completes a report, they are legally and professionally required to only sign what they know to be true, which means reviewing medical records—even for seemingly simple forms.

Since 25 May 2018, patients can request access to their medical records via a Subject Access Request (SAR) free of charge, including if access is authorised by a third party such as a solicitor. A reasonable fee may be charged only if the request is manifestly unfounded or excessive. Requests for medical reports (rather than SARs) are handled under the Access to Medical Reports Act (AMRA), and this process remains unchanged by GDPR.

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