Administration
Non-NHS services and fees
Charges for private letters, forms, reports, medicals and other services not covered by the NHS.
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. In other cases it is because the service is not covered by the NHS, for example, medical reports for insurance companies, claims on private health insurance and other letters and forms which require the doctor to review the patient's medical records.
It is important to understand that GPs are not employed by the NHS. They are self-employed and have to cover their costs, which include staff, buildings, heating, lighting and so on, in the same way as any small business. The NHS pays the doctor for specific NHS work, but for non-NHS work the fee has to cover the doctor's costs.
What is covered by the NHS and what is not
The government's contract with GPs covers medical services to NHS patients. In recent years, 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 be sure that information provided is true and accurate.
Examples of non-NHS services for which GPs can charge
- certain travel vaccinations
- private medical insurance reports
- holiday cancellation forms
- referral for private care forms
- letters requested by or on behalf of the patient
- repeated requests for copies of blood, scan or urine results, clinic letters and medical records
- some fitness to work forms
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 their patients. Most GPs have a very heavy workload, and paperwork takes up an increasing amount of their time. In addition, non-NHS work must be undertaken outside of NHS contracted time.
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. Therefore, in order to complete even the simplest of forms, the doctor needs to check the patient's entire record. Carelessness or an inaccurate report can have serious consequences for the doctor, with the General Medical Council or even the police.
How are charges decided
The British Medical Association recommends that GPs tell patients in advance if they will be charged. It is up to the individual practice to decide how much to charge. The BMA has in the past provided guidance for GPs in setting their fees. This is less common now and GPs are able to set their own fees to ensure that their costs in delivering the services are covered.
Time spent completing private reports and undertaking private medical examinations is generally done outside of normal working hours as an extra commitment to a GP's workload. Higham Hill Medical Centre carries out periodic reviews of charges at other surgeries both locally and nationally and endeavours to follow a fair charging policy.
All fees are payable in advance by the patient. Any services required urgently, or which take longer than normal to complete, may be charged at a higher rate. Accepted methods of payment include cheque and cash.
Patient declaration
When you request a private service, you will be asked to confirm that you accept the charge for the service required. You will also confirm that you understand the practice reserves the right to alter the fee payable if the requirements of the work undertaken differ from those expected at the point of submission. Any difference in cost will be fully explained to you.
You will also confirm that you have been given sufficient time to consider the benefits, risks and costs of using the requested service and wish to proceed on that basis.
Medical examinations
| Service | Approximate fee |
|---|---|
| Taxi, lorry or bus medical examination and report in surgery (without eye test) | £150 |
| DVLA blood test | £39 |
| Firearms licensing, for example shotgun | £65 |
| Other medical examination and report in surgery | £130 |
| Fostering or adoption | £100 |
| Childminder health forms (OFSTED) | £100 |
Forms, letters and reports
| Service | Approximate fee |
|---|---|
| Blue badge or disability form | £50 |
| To whom it may concern short letter, maximum one page | £40 |
| To whom it may concern detailed letter, more than one page | £50 |
| Student unfit to take exam, short letter or form | £40 |
| Report for insurance applicants or private insurance, for example Bupa, Vitality or Axa Health | £50 to £104 |
| Supplementary reports | £30 |
| Amendments to letters, first amendment | Free |
Certificates and prescriptions
| Service | Approximate fee |
|---|---|
| Private medical certificate only | £30 |
| Private medical certificate and examination | £63 |
| Private medical insurance form | £50 |
| Council tax exemption form | Free |
Medical records
| Service | Approximate fee |
|---|---|
| Brief summary, print out for patient | Free |
| Immunisation record | Free |
| Medical records, for example a medical report or record that already exists, subject access request | Free |
| Supplementary reports, for example requests for copies of the same information within a short period of time | £30 |
| Extract from record, for example for an employer, solicitor or insurance company if a medical report is to be created or interpretation of existing information within the medical record, Access to Medical Reports Act | £100 |
Services we do not complete
We do not complete scuba or skydiving forms.
Last reviewed: May 2025. Fees are subject to periodic review.
Frequently asked questions
Why do I have to pay for some GP services?
GPs are self-employed and not directly employed by the NHS, so they have to cover their own costs such as staff, buildings, heating and lighting. The NHS pays the doctor for specific NHS work, but for non-NHS work, the fee has to cover the doctor's own costs.
What kind of services does the practice charge for?
Examples include certain travel vaccinations, private medical insurance reports, holiday cancellation forms, referral for private care forms, letters requested by the patient, and some fitness to work forms.
Why does it sometimes take a long time to get a form completed?
Completing forms and reports takes the GP away from the medical care of their patients, and most GPs already have a heavy workload. Non-NHS work also has to be done outside of NHS contracted time, which adds to the delay.
How much does a private medical certificate cost?
A private medical certificate only costs an approximate fee of £30, while a private medical certificate that includes an examination costs an approximate fee of £63.
How are non-NHS fees decided?
It is up to the individual practice to decide how much to charge, though the British Medical Association recommends that GPs tell patients in advance if a charge applies. Higham Hill Medical Centre reviews charges at other surgeries locally and nationally to try to keep a fair charging policy.
Are there any forms the practice will not complete?
Yes, the practice does not complete scuba or skydiving forms. For other non-NHS services, patients should check the fee list or contact the practice directly.