Non-NHS work

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.

Sometimes the charge is because the service is not covered by the NHS, for example, providing copies of health records or producing medical reports for insurance companies, solicitors or employers.

The Government’s contract with GPs covers medical services to NHS patients but not non-NHS work. 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, etc. – in the same way as any small business.

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.

• accident/sickness certificates for insurance purposes
• school fee and holiday insurance certificates
• reports for health clubs to certify that patients are fit to exercise
• private prescriptions for travel purposes

• 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
• copies of records for solicitors

With certain limited 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, they are not required to do such non-NHS work.

The BMA suggest 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 them are intended for guidance only; they are not recommendations and a doctor is not obliged to charge the rates they suggest.

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. Our GPs do non-NHS work out of NHS time at evenings or weekends so that NHS patient care does suffer.

When a GP 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 GP with the General Medical Council (the doctors’ regulatory body) or even the Police.

If you are a new patient we may not have your medical records so the doctor must wait for these before completing the form.

It is recommended 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. The surgery has a list of fees based on these suggested fees which is available on request.

• Not all documents need a signature by a doctor. Our GP’s do not sign passport application forms. You can ask another person in a position of trust to sign such documents free of charge. Please read the guidance from the passport office regarding these forms
• 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 may cost more. Usually non-NHS work will take 2 weeks.

Bath Laser Clinic is a private service run at Oldfield Surgery providing a wide range of laser therapies including hair removal and thread vein treatment.

• Hair reduction for all skin types
• Leg and facial veins
• Pigmented lesions
• Age/Sun spots
• Freckles
• Haemangiomas
• Wrinkle reduction
• Skin tightening

Please see our website www.bathlaserclinic.com for price lists and special offer.

To book an appointment with one of our laser technicians please phone 07932 997697 or email us with any queries on bathlaserclinic@hotmail.com.

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Although referral can be made to St Martins Hospital on the NHS, the practice also offers in house private chiropody services by Jane Yates at St James’s Surgery.

Treatment of corns, calluses, hard skin, cracked heels and nail problems. Sessions 40 minutes, £40.

Jane’s mobile number is 07791 943852 to book an appointment.

The St James’s Practice has a qualified osteopath, Charlotte Knight, of whom is registered with the general osteopathic council and is licensed to practice osteopathy in the UK. Charlotte is available on a Monday, Thursday and Friday morning for patients and non-patients of the surgery.

Osteopathy is a safe, effective treatment of many conditions. Osteopaths specialise in musculoskeletal health, however this is not the limit of what they can treat. Conditions commonly treated by osteopaths include:

• General aches and pains
• Neck pain
• Headaches
• Frozen shoulder
• Tennis/golfers elbow
• Lower back pain
• Arthritis
• Digestive & circulatory problems
• Pain due to pregnancy
• Sports injury

The osteopath at St James’s Surgery is also trained in medical acupuncture and cranial osteopathy.It is a private service for the elderly, adults, children & babies, which is covered by most insurance companies. It is not necessary to be referred by doctor.

For any further information, don’t hesitate to contact the surgery where they can put you in contact with Charlotte Knight or visit her website, www.charlotteknightosteopath.co.uk.

The active ageing service visits older people in their homes and provides a support service to those who are aged 80-84. The team aims to enable older people to maintain independence and to promote dignity and quality of life in their own homes by offering health advice.

The team consists of health visitors and health visitor support workers who are based in the community. We are able to help people access services, such as medical, social, home environment and financial. We also support carers.

The active ageing team works in partnership to help identify health needs and to signpost families to the services they may require in order to maintain independence.

The service offers

• Falls and accident prevention
• Advice on memory loss and dementia
• Support for those who have been recently bereaved
• Advice on managing long term health conditions
• Health education
• Signposting to local and national support services