Services outside the scope of 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.
How do I request a report or letter?
The Spa Surgery does provides Non NHS services, this work is completed outside of NHS time and we ask that all requests for these services are submitted using our Request Form.
Payment is required when the request is submitted, as unfortunately from time to time patients have asked for a report and then refused to pay once it has been completed by the doctor. This means we now usually ask patients to pay for the report before the doctor completes any work.
The Government’s contract with GPs covers medical services to NHS patients, however, in recent years more and more organisations have been involving doctors in a wide range of non-medical work, such as Insurance forms and reports, employment medicals and Solicitors reports to name a few examples. 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, employer or public body wants to ensure that the information provided to them is true and accurate.
What fee should I expect to pay?
We have provided below details of our fees, which are based on BMA suggested fees guidance. Whenever we receive a request for a letter or report the doctor will review the request in order to work out how long they need to complete the report and therefore what fee to charge.
We will always tell the patient what the fee will be before the report is completed, so they can decide whether they want to go ahead.
Payment for non-NHS services
To make the invoice and payment process as easy as possible for our patients, our preferred payment method is via a secure link within the invoice. The online payment facility is administered by Stripe.com
Please note that we do not accept payment by credit card.
What if I cannot afford to pay a fee?
The practice recognises that many of our patients may have significant financial difficulties and would not wish to increase their financial stress. For this reason the practice offers two levels of support:
- Provide the patient with a summary of their medical record including key diagnosis and current medications as previously recorded and read coded in their medical record. There is no charge for this level of support.
- Provide a specific letter or report to patients for a fee.
Whilst we understand the financial pressures patients may be experiencing, we receive a high volume of these requests and set all of our fees based on the time the GP takes to complete the work, so that we are equitable and fair to all patients and our doctors. We are not able to negotiate our rates or offer reduced prices.
How much notice do you need for reports or letters?
We require up to 20 working days from receipt of payment to process and complete the work. Although many are completed within this time period the current demand on primary care is causing this work to take longer to complete. Where a patient has an urgent request this should be explained to the Care Navigator, however, more clinically urgent work cannot be delayed.
Taxi Medicals
We regret to inform patients that we are still unable to undertake HGV and Taxi medicals. This is due to the current and expected demand for NHS appointments.
There are alternative organisations that are able to provide these services within the Leeds and York areas, these include:
Please note that the practice is providing these details for information purposes ONLY, other organisations are available. The Surgery does not endorse any of the organisations mentioned. It is entirely up to you who you choose to provide these services for you.
Subject Access Requests (SARS)
You will appreciate that health data relating to any individual is highly confidential and the Practice must ensure that it releases such data only to the person to whom it relates, or to a person authorised to act on his or her behalf. If you require to see any health data, please complete this online Request Form as fully and accurately as possible to enable us to locate the exact information you require.
The General Data Protection Regulations (GDPR) gives you the statutory right of access to any information, manual (paper) or computerised. You may wish to authorise someone else to make your application on your behalf and if you have parental responsibilities you may make an application to see your child’s notes, if they are under the age of twelve years.
You do not have to give a reason for applying for access to your General Practice records. If you do not need access to your entire records, it would be helpful if you would inform us of the periods and area of your health records that you require, along with details which you feel may have relevance (e.g. clinic type, location, dates).
Timescale
The Practice will deal with your request as quickly as possible. If you request copies of all or part of your medical record, these will be ready within the allocated timescales specified by the Regulations (which is currently 28 days from receipt of your accurately completed form and confirmation of consent), and we will telephone you when they are available for you to come to the Practice to collect them. Under certain circumstances, this period can be extended to 3 months but we will keep you informed of the progress of your request during this extended period.
Fees
We will not make a charge for the first request for access to your medical records. We may, however, charge for subsequent requests or if we deem that the volume of information requested is excessive. You have the right to simply view your records (i.e. not receive a copy in a permanent form); information on how to arrange this is detailed below.
Type of request
If you request to see the original records, you will be invited to make an appointment at a mutually convenient time to view them. If you request copies, these will be ready within the allocated timescales specified by the Regulations, and we will telephone you when they are available for you to come to the Practice to collect them.
Proof of identity
Two forms of identity must be provided (one of which must be photographic). This is to ensure information is not released to unauthorised individuals. The table below outlines the proof of identity we can accept.
| TYPE OF APPLICATION | IDENTIFICATION REQUIRED |
| Patient applying for their own Can be waived if the applicant is known to the Staff Member accepting the request | One which must be photographic i.e. passport. One containing individuals name and address |
| Third Party Applying. Consent of Patient will be required BEFORE the request will be processed | One containing Third Party name and address One must be Photographic ID of Third Party |
| Applying on behalf of a child We will ALWAYS obtain consent for release of records from a child age 12+ to <16 if a third party is making request | One which must be Child’s birth certificate Photographic ID of person with parental rights |
If you are completing this application on behalf of another person, the Practice will require their authorization before we can release the data to you. The person whose information is being requested should sign the relevant section within the online form. If the patient is a child (i.e. under 16 years of age) the application may be made by someone with parental responsibilities – in most cases this means a parent or guardian. If the child is capable of understanding the nature of the application, his or her consent should be obtained or, alternatively, the child may submit an application on their own behalf. Children will, generally, be presumed to understand the nature of the application if aged between 13 and 16 however, all cases will be considered individually.
Query regarding medical terminology
Medical records often contain abbreviations – this is often to help staff document things in the most time efficient way as there is no additional time after an appointment to write in the record – the length of your appointment includes time for the clinician to write in your record. Here is a link to common abbreviations you might find in your record.
As a health organisation, we make every effort to keep your records accurate. However, there are occasions where information may need to be amended.
If you think there is information in your health record which is factually inaccurate, you can request the information to be corrected. There are limited reasons for which we can remove data from your record.
Here are some examples where the information can be amended:
- Your address is wrong
- Your date of birth is wrong
- Your name is either spelled wrong or we have you registered under an old name.
Sometimes you may disagree with the information recorded, but the information is factually correct. For example, you may disagree with a diagnosis you received in the past.
Sometimes where information is agreed by all parties to be factually incorrect, it may be necessary for us to retain this information in your record. For example, if the information was taken into consideration when making decisions about your subsequent care, this information would need to remain to explain treatment decisions or audit the quality of care you received. If this is the case, you can request an entry to be made in your record that you disagree with the content and what you think it should say.
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.