Rubislaw Place Medical Group

NHS Scotland

Non NHS Services – Chargeable

Services which are out with NHS contract

The National Health Service provides most health care to most people free of charge, but there are exceptions. GPs are self-employed and contract 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 health care to most people free of charge, but there are exceptions.  For example, medical reports for insurance companies.

Surely the GP 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 GP’s costs.

In recent years, more and more organisations have been involving GPs 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 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.

I only need the GP’s signature – what is the problem?

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 GP 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 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: