Private Fees

Below are a collection of Frequently Asked Questions (FAQs) regarding non-NHS work fees; you will also see a table showing the charges our GPs make for services that fall into this category.

The information provided can be verified on the BMA website and it is best to check with Hereford Medical Group to make sure that the prices given are current and correct.

Isn’t the NHS free?

The National Health Service provides most health care to most people free of charge, however, there are some exceptions.

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 producing medical reports for insurance companies.

Isn’t the Doctor being paid anyway?

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 in the same way as any small business would. The NHS covers these costs for NHS work, but for non-NHS work, the fees charged by GPs contribute towards their costs.

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. 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.

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.

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

With certain 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, for example for insurance purposes, they are not required to do such non-NHS work.

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

The BMA suggests 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 the BMA 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, so many GPs find they have to take some paperwork home at night and weekends.

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.

What will I be charged?

The BMA recommends 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, but the BMA produces lists of suggested fees which many doctors use.

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.
  • 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 will cost more.

Please note all laboratory tests (blood test, urine testting…) will incur an extra fee if performed by the Practice and all payments need to be made prior to appointment

Fees

Certificates

  • Holiday cancellation certificate £30.00
  • ‘To whom it may concern’ letters (short) £20.00
  • CICA criminal injuries form N/A
  • Firearms certificate £50

Reports

  • Report – detailed written report with opinion/statement of condition, with examination £150.00
  • Report – detailed written report with opinion/statement of condition, without exam. £130.00
  • Report – Simple written report with statement of condition, without examination (1 page) £60.00
  • Targeted report – detailed – on form (3+ pages) £104.00
  • Targeted report – normal – on form (1 or 2 pages) £67.00
  • Report for insurance applicants (using template) – e.g. GPR or iGPR £104.00

Medicals

  • Full medicals e.g. for insurance £100.00
  • Driver medicals – including HGV/PSV/Taxi – with medical exam £100.00 – without exam £50.00
  • Adoption medical examination – £102
  • Fostering medical examination – £120
  • Fostering and adoption update reports £50.00
  • Ofsted health declaration form £80.00

Copies of Medical Records

  • Computer records only NO CHARGE per GDPR
  • Manual paper records only NO CHARGE per GDPR

Housing Letters & GP Letters of Support

Hereford Medical Group is committed to supporting our patients. However, when applying for benefits, housing, passes, adjustments or any other matter where medical conditions may be relevant, we will only supply this information when approached formally by a third party for a factual report.

We will not supply letters of support directly to patients.

Please note all requests from the third party will require the patients’ formal consent.

We will only complete factual responses. We are not able to give an opinion. If in doubt we will refuse to complete the request and may issue a copy of medical records instead with your consent.

Be aware we charge for any requests.

Housing Applications

We do not provide letters for housing, so please do not request these.  Whilst we appreciate that housing problems can be stressful, this is a matter for the council housing office.  If the council requires additional medical information, they will send a specific form to the GP surgery. You will need to provide your written consent for this.

If you are intending to apply for a council home for health reasons you do not need to send a letter from the GP.

The Council will write, in confidence, to your doctor if further information is required.

GPs receive frequent requests for medical letters and reports in support of housing applications from a variety of sources – the local authority, housing associations, directly from patients and from patients via Citizens Advice Bureau. The arrangements for seeking GP reports and for payment vary from local authority area to local authority area, and even when clearly agreed are often not implemented by local authority staff. However all requests should come via the Council or Housing Association and not the patient.

Information in support an application based on health grounds should be supplied by the applicant using a form provided by the Housing Department (self-assessment). This should not require any input from the GP/practice.

Only if additional information is required, should the Housing Department Medical Officer obtain it from the applicant’s doctor, preferably using a standard form, provided the patient has given written consent. The Medical Officer should seek information which is only available to the GP, for example:

  • the diagnosis;
  • severity of the illness;
  • medication

We understand that patients are often wrongly advised to get a letter from their GP and we can supply you with a letter outlining the above that you can show to anyone wrongly directing you to us for such documentation.

Other services we do not offer

  • Counter signature – Driving license
  • Counter signature – Passport adult/child
  • Private blood tests
  • Private ECG
  • Private pre-admission swabs
  • DNA testing
  • Fit to fly pregnancy
  • Fit to fly/cruise
  • Private prescription for non NHS eligible medication
  • Private flu vaccination for non NHS eligible patients
  • Blue badge applications
  • Request for housing application support
  • Referral for social care support from Nursing Homes
  • Sedation scripts for hospital/dental procedures
  • Power of attorney counter-signature
  • Letters for missed examination
  • Fit for sport medicals – e.g. scuba diving/parachuting

Childhood Immunisations

If a vaccine is given when a baby still has antibodies to the disease, the antibodies can stop the vaccine working. This is why routine childhood immunisations do not start until a baby is two months old, before the antibodies a baby gets from its mother have stopped working. This is also why it is important for parents to stick to the immunisation schedule, as a delay can leave a baby unprotected. A delay can increase the chance of adverse reactions to some vaccines, such as pertussis (whooping cough).

Vaccination Schedule

At two months old: 

  • Diptheria, tetanus, pertussis (whooping cough), polio and Haemophilus influenzae type b (Hib) (DTaP/IPV/Hib) – one injection 
  • Pneumococcal infection – pneumococcal conjugate vaccine (PCV) – one injection 

At three months old:

  • Diptheria, tetanus, pertussis (whooping cough), polio and Haemophilus influenzae type b (Hib) (DTaP/IPV/Hib) – one injection 
  • Meningitis C (meningococcal group C) (MenC) – one injection 

At four months old: 

  • Diptheria, tetanus, pertussis (whooping cough), polio and Haemophilus influenzae type b (Hib) (DTaP/IPV/Hib) – one injection 
  • Meningitis C (meningococcal group C) (MenC) – one injection 
  • Pneumococcal infection – pneumococcal conjugate vaccine (PCV) – one injection 

At around 12 months old: 

  • Haemophilus influenzae type b (Hib) and meningitis C (Hib/MenC) – booster dose in one injection

At around 13 months old: 

  • Measles, mumps and rubella (German measles) (MMR) – one injection 
  • Pneumococcal infection – pneumococcal conjugate vaccine (PCV) – one injection 

Three years four months to five years old (pre-school): 

  • Diphtheria, tetanus, pertussis (whooping cough) and polio (dTaP/IPV or DTaP/IPV) – one injection
  • Measles, mumps and rubella (German measles) (MMR) – one injection 
  • 13 to 18 years old: 
  • Diphtheria, tetanus and polio (Td/IPV) – one injection

Further reading

There are some excellent websites that will answer all your questions and queries about immunisation and vaccination. If you are worried about giving the MMR vaccine, you should access the MMR site.

  • NHS Choices – Immunisation Information
    The most comprehensive, up-to-date and accurate source of information on vaccines, disease and immunisation in the UK. 
  • NHS Choices – MMR Information
    This website has been put together to answer any questions you might have about MMR. You can look for information and resources in the MMR library, ask an expert panel a question, and read up on the latest news stories relating to MMR.

Cervical Screening: Smear Tests

Women aged between 24 and 64 should have a cervical screening every 3 to 5 years to help prevent cervical cancer. The screening is quick and painless and can be done here in the practice.

If you are aged over 24 and have never had a smear test, or if it has been more than 3 to 5 years since your last screening, you should arrange an appointment with our Practice Nurse. You should not have the test while you are having a period or in the 4 days before or after your period as this can affect the sample.

If you want to check whether you are due for a cervical smear or would like to book an appointment. Please fill in one of our online forms

What is cervical screening?

Cervical screening is not a test for cancer. It is a method of preventing cancer by detecting and treating early abnormalities which, if left untreated, could lead to cancer in a woman’s cervix (the neck of the womb).

A sample of cells is taken from the cervix for analysis. A doctor or nurse inserts an instrument (a speculum) to open the woman’s vagina and uses a spatula to sweep around the cervix. Most women consider the procedure to be only mildly uncomfortable.

Early detection and treatment can prevent 75 per cent of cancers developing but like other screening tests, it is not perfect. It may not always detect early cell changes that could lead to cancer.

Who is eligible for cervical screening?

All women between the ages of 25 and 64 are eligible for a free cervical screening test every three to five yearsThe NHS call and recall system invites women who are registered with a GP. It also keeps track of any follow-up investigation, and, if all is well, recalls the woman for screening in three or five years time. It is therefore important that all women ensure their GP has their correct name and address details and inform them if these change.

Women who have not had a recent test may be offered one when they attend their GP or family planning clinic on another matter. Women should receive their first invitation for routine screening at 25.

Why are women under 25 not invited?

This is because changes in the young cervix are normal. If they were thought to be abnormal this could lead to unnecessary treatment which could have consequences for women’s childbearing. Any abnormal changes can be easily picked up and treated from the age of 25. Rarely, younger women experience symptoms such as unexpected bleeding or bleeding after intercourse. In this case they should see their GP for advice.

Why are women over 65 not invited?

Women aged 65 and over who have had three consecutive negative results are taken out of the call recall system. The natural history and progression of cervical cancer means it is highly unlikely that such women will go on to develop the disease. Women aged 65 and over who have never had a test are entitled to one.

What about women who are not sexually active?

The NHS Cervical Screening Programme invites all women between the ages of 25 and 64 for cervical screening. But if a woman has never been sexually active with a man, then the research evidence shows that her chance of developing cervical cancer is very low indeed. We do not say no risk, only very low risk. In these circumstances, a woman might choose to decline the invitation for cervical screening on this occasion. If a woman is not currently sexually active but has had male partners in the past, then we would recommend that she continues screening.

When your results should arrive

You should get your results within 14 days but they can take longer to arrive. 

If you have waited longer than you expected, call your GP surgery to see if they have any updates.

  • Try not to worry if your results are taking a long time to get to you.
  • It does not mean anything is wrong, and most people will have a normal result.

What your results mean

Your results letter will explain what was tested for and what your results mean.

Most people will have a normal result. This means you do not need any further tests and you’ll be invited for screening again in 3 or 5 years.

Sometimes you’ll be asked to come back in 3 months to have the test again. This does not mean there’s anything wrong – it’s because the results were unclear.

If you have an abnormal result

Your results letter should explain what will happen next.

You may need:

  • no treatment
  • another cervical screening test in 1 year
  • a different test to look at your cervix (colposcopy)

There are different kinds of abnormal result depending on if your sample was tested for:

  • abnormal cell changes in your cervix – left untreated, this could turn into cancer
  • HPV – some types of HPV can lead to cell changes in your cervix and cancer