Need help with a non-urgent medical or admin request? Contact us online.

Non NHS Services – Chargeable

Services which are outside the NHS Contract

The National Health Service provides most healthcare to the majority of people free of charge, but there are exceptions. GPs are self-employed and are contracted to provide NHS general medical services for their patients.

Sometimes, GPs are asked to provide additional services which fall outside their contract and in these circumstances, they are entitled to make a reasonable charge for providing them.

Your questions answered

Isn’t the NHS supposed to be free?

The National Health Service provides most healthcare to the majority people free of charge, but there are exceptions: for example, medical reports for insurance companies.

Surely the Doctor is being paid anyway?

It is important to understand that 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. The NHS covers these costs for NHS work, but for non-NHS work the fee has to cover the Doctor’s costs.

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 to do non-medical work 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 their NHS patients are:

  • accident/sickness insurance certificates
  • certain travel vaccinations
  • private medical insurance reports
  • statements of fact relating to general health e.g. for children’s dance classes
  • Letters requested by, or on behalf of, the patient
  • Holiday cancellation claim forms
  • Referral for private care forms

Examples of non-NHS services for which GPs can charge other institutions are:

  • medical reports for an insurance company
  • some reports for the DSS/Benefits Agency
  • examinations of occupational health

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 – the majority work up to 70 hours a week – 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 or even the Police.

What can I do to help?

  • If you have several forms requiring completion, present them all at once.
  • Do not expect your GP to process forms overnight

Examples of Non-NHS Services include the following: 

  • Medicals for pre-employment, sports and driving requirements (HGV, PSV etc.) 
  • Insurance Claim Forms 
  • Prescriptions for taking medication abroad 
  • Private Sick Notes 
  • Vaccination Certificates 

The fees charged are based on the British Medical Association (BMA) suggested scales and Practice Reception Staff will be happy to advise you about them along with appointment availability. 

All medicals must be paid for upon booking the appointment (non-refundable if patient fails to attend the appointment or cancels at less than 2 hours’ notice).

Other prices for non-NHS funded work available on request.

Lasting Power of Attorney (LPA)

Anyone aged 18 or older who has the mental ability to make decisions for themselves can arrange for someone else to make these decisions for them in the future. This legal authority is called “Power of Attorney”.

The person giving LPA is the ‘donor’. The person given LPA is know as the ‘attorney’ and must be aged 18 or older. There are different types of LPA: (1) Personal Welfare LPA and (2) Property and Affairs LPA. Donors should understand exactly what powers they are giving to someone else:

LPAs can be made online. Once an LPA is completed, it must be printed and signed (or ‘executed’) in the presence of a witness, who certifies that when the form was signed, the donor granting the LPA:

  • understood it’s purpose and the scope of authority being granted
  • was not being unduly pressured or being defrauded
  • was not affected by anything else that could affect the validity of the document

The certificate can be signed by either someone known to the donor for at least two years, or by someone who ‘because of their relevant professional skills and expertise, considers themselves able to provide the certificate’. This person must be acting independently, not be a relative, business partner or employee, or anyone involved in a care home where the donor lives – it is not necessary for your GP to sign as witness.

Who can be a certificate provider?

The certificate provider must be 18 years old or over and have mental capacity. They can be either:

  • someone who has known the donor personally for at least 1 years, such as a friend or neighbour (but not a relative)
  • someone with relevant professional skills, such as the donor’s GP or solicitor
  • someone who has known the donor well for at least 2 years – this could be one of the ‘donor’s’ friends or neighbours, someone they know at a social or sports club, a work colleague, or similar

The certificate provider must be more than an acquaintance. They have to know the donor well enough to have an honest conversation with them about the LPA and the power the donor is giving to their attorneys.

‘People to notify’ can be certificate providers.

Usually, someone with relevant professional skills would be one of the following:

  • a registered healthcare professional, such as the donors GP
  • a solicitor, barrister or advocate
  • a registered social worker
  • an independent mental capacity advocate (IMCA)

Other professionals may have skills that allow them to judge whether the donor can make an LPA. Contact the Office of the Public Guardian if you are not sure about the donor’s choice of certificate provider.

If you chose a professional, they may charge you a fee.

Who cannot be the certificate provider?

  • any attorney or replacement attorney for this or any other LPA or enduring power of attorney the donor has made
  • a member of the donor’s family or any of the attorney’s families – including husbands, wives, civil partners, in-laws, and step-relations
  • an unmarried partner, boyfriend or girlfriend of the donor or any of the attorneys
  • the donor’s business partner any attorney’s business partner
  • the donor’s employee or any attorney’s employee
  • anyone running or working for a care home where the donor lives, or a member of their family
  • anyone running or working for a trust corporation appointed as an attorney in this LPA
  • the donor
  • any other person the Court of Protection may consider is not sufficiently independent

If there is absolutely no possible person available as per the list then, as GPs, we can complete, but there will be a fee of between £80-£150 as it is time-consuming and not part of our usual workload.

Certificate Providers

An LPA must have a certificate provider. They must sign the LPA.

The certificate provider is an impartial person who helps protect the donor’s interests by checking that the donor understands the LPA and is making it of their own free will.

The certificate provider must discuss the LPA with the donor. It is a good idea for this discussion to happen in private, without the attorneys or anyone else present.

The certificate provider signs the LPA to certify that they have discussed the LPA with the donor, and that:

  • the donor understands the significance of their LPA
  • no one is putting the donor under pressure to make the LPA
  • there has been no fraud involved in making the LPA
  • there is no other reason for concern

The donor must sign the LPA before the certificate provider. The certificate provider can witness the donor’s signature.


  • Med 3 (fitness to work certificate after day 7 of sickness period)
  • Prescription Exemption form
  • Council Tax Exemption form
  • Concessionary Travel Pass
  • Police request to access Medical Records where disclosure is for the purpose of the prevention or detection of a crime. The police representative must demonstrate that the police authority requires the information for the purposes of investigating a crime and have statutory exemption from the fee provisions under the Crime and Disorder Act.
  • Requests from Somerset County Council regarding safeguarding concerns.

 Please note that the doctors cannot provide the following services:

  • Passport countersignature
  • Character reference