Professional fees FAQs


September 2006
1. What are professional fees?
Fees for work outside doctors’ main NHS contracts, including:
  • work for local and central government, e.g. social services work, mental health assessments;
  • work for the NHS that does not form part of their main contract, e.g. lectures to NHS staff, GP work in hospitals;
  • reports and examinations requested by third parties, e.g. insurance reports, medico-legal work;
  • reports and certificates requested by patients, e.g. to support an application for a driving licence, private prescriptions.
2. How are professional fees set?
Most fees are now negotiated with third parties (e.g. the ‘Treasury’ rate, insurance reports, and police surgeons' fees). Each year fees are reviewed and agreed increases will be linked to the GP's NHS net remuneration.

3. Are doctors allowed to demand pre-payment for medical reports and other work?
The Professional Fees Committee does not formally advise doctors to seek payment in advance. It is essential that fees are agreed in writing before undertaking any work and doctors who fail to undertake this precaution may encounter difficulties in recovering fees. However it is recognised that doctors are now required to take an increasingly firm approach on valuing their time and the organisation of traditional invoicing and debt collection may be prohibitive. The Committee would oppose any move to prevent doctors from charging in advance if they thought it appropriate for their circumstances.

4. What is Category One and Category Two work?
(This only applies to consultants in England, Wales, Scotland and Northern Ireland under the pre-2003 contract).
Category one: work undertaken by hospital medical staff which is reasonably incidental to contractual duties and for which charges may not be made.
Category two: examinations, reports etc undertaken by hospital medical staff which does not fulfil any of the qualifying conditions for category 1, for which charges may be made.

5. What are fee paying services?
(This only applies to consultants in England, Scotland and Northern Ireland under the new 2003 contract)
This term replaces most activities previously listed as Category Two work (see question 4 above). Fee paying services are any paid professional services, other than those falling within the definition of private professional services, which a consultant carries out for a third party or for the employing organisation and which are not part of, nor reasonably incidental to, contractual and consequential services.

6. What are collaborative arrangements?
Certain local authority services in the fields of education, social services and public health. Fees laid down by the DDRB are paid by the local authority who claim reimbursement from the PCT.

7. What are the suggested rates for undertaking a GP locum post or for locum doctors undertaking visits?
The BMA is not permitted to provide any guidance on fees for GP locums and non-principals, following an enquiry by the OFT. In 2000 the OFT ruled that suggesting rates for this work was anti-competitive and that legal action would be taken on those who did so.

8. What is the GP rate, and how is it set?
For work which can only be carried out by the patient’s own GP/practice, the rate is in fee guidance schedule 11. It is uprated annually by BMA Council in line with GPs NHS net remuneration.
Go to fee guidance schedule 11 here.

9. Why does the BMA not suggest an hourly professional fee for hospital doctors?
For hospital doctors who are not consultants, fees in fee guidance schedule 11 apply. For consultants, the BMA was prevented from suggesting fees for private work by the Monopolies and Mergers Commission in 1994.
Go to fee guidance schedule 11 here.

10. I think that some of the fees set are too low when you consider the amount of work involved. Who do I write to about this?
The Chairman of the Professional Fees Committee, BMA, BMA House, Tavistock Square, London, WC1H 9JP.

11. What legislation governs access to health records?
The Data Protection Act 1998 governs access to the health records of living people. It became effective 1st March 2000, and superseded the Data Protection Act 1984 and the Access to Health Records Act 1990, though the Access to Health Records Act 1990 still governs access to the health records of deceased people. The Data Protection Act 1998 gives every living person the right to apply for access to their health records.

(Further information about BMA’s guidelines on access to health records by patients is available here. There is also a detailed question and answer document available on the Department of Health web site at www.dh.gov.uk search under 'Access to health records').

12. How much can I charge to provide access and copies of records?
Records held entirely on computer = £10
Records held partly on computer and partly manually = up to £50
Records held manually = up to £50
To allow patients to view their records (where no copy is required) the maximum costs are:
£10, unless records are held manually and have been added to in last 40 days, when there is no charge.
Doctors must look at their actual costs, and be able to justify any charges made.

13. Are police authorities exempt from paying a fee for access to health records requests?
Where a proposed disclosure is for the purposes of the prevention or detection of crime, or apprehension or prosecution of an offender, and when failure to disclose would be likely to prejudice these objectives in a particular case, then the fee provisions of the Data Protection Act 1998 do not apply. The police representatives contacting the data controller (GP or PCT) have the responsibility of demonstrating the necessary statutory exemption from the fee regime. Therefore the police representative must state that the police authority require the information for the purposes of investigating a crime and have statutory exemption from the fee provisions under the Crime and Disorder Act.

Detailed advice regarding confidentiality and disclosure of information to the police can be found in guidance produced by the BMA Ethics department, called 'Confidentiality and disclosure of health information'. Read more here.

14. Is it reasonable to invite a solicitor to come to the surgery to make copies of voluminous records using the practice's photocopier to make copies, and for what fee?
Some practices are inviting solicitors to come into the surgery to make the copies. This action is allowed where it is considered convenient for both parties and no ethical or legal difficulties arise, provided that the other conditions in the Act are met. In particular, doctors allowing solicitors to make copies of records must ensure that the records they are copying do not reveal any information that is exempt from the access provisions of the legislation.

15. What are the suggested rates for completing a report as a professional witness at the request of a solicitor?
If it is a report for the prosecution, the fee is set by the Crown Prosecution Service (CPS) and published in the fees guidance on medico-legal fees (FGS 10). If not - if the report is for the defence solicitor, for example - these are among the fees that the OFT has said that the BMA should no longer publish as it is work that could be undertaken by any doctor. Doctors should therefore determine their own fee, taking into account the costs involved in doing the work and the value they place on their professional time. The BMA advises doctors to agree any fees in writing before undertaking any work.

16. What are the suggested rates for completing an expert witness report at the request of a solicitor?
An OFT ruling prevents the BMA from suggesting fees for this work. Generally doctors can set their own fee, however it is wise to check that the organisation responsible for paying the fee does not have its own schedule of fees i.e., CPS – see fee guidance schedule 10.
Go to fee guidance schedule 10 here.

17. I am no longer required to attend court but had made arrangements for locum cover and done the preparatory work. Am I entitled to a fee?
Yes, if you have agreed in advance that in the event of cancellation there will be no problem in receiving fees for your work or for your locum costs.

18. A firm of solicitors is not paying my fees – what can I do?
Each firm of solicitors should have its own internal complaints procedure. If that does not resolve the matter, then you can take them to the small claims court (or County Court if the sum is more substantial). It is understood that the OSS will no longer look at the non-payment of fees unless this option has been pursued. The BMA advises its members to agree fees in writing before undertaking any work.

19. What is the fee for CP3 Court of Protection forms?
This fee can be found in fee guidance schedule 6.
Go to fee guidance schedule 6 here.

20. What is the fee for certificates for priority/change of housing, both from the patient themselves and also the Council?
It is possible that the local authority would be prepared to pay a fee under the ‘other examinations and reports section’ of the ‘collaborative arrangements’ (FGS 2). If not, doctors can charge the patient their own fee (fee guidance schedule 11).
Go to fee guidance schedule 11 here.

21. What can I charge for an occupational health report?
The fees for an occupational health report prepared by a GP are contained within FGS 11, section A2. An Occupational health report is normally required for pre-employment purposes or for an assessment of a current employee. However if the GP is preparing a report for current and prospective local authority employees the fee is listed in FGS 2, Section B2 (d). Also if they are preparing a report for prospective NHS employees the fee is listed in fee guidance schedule 3, Section D1.
Go to fee guidance schedule 3 here.

22. I saw an accident on the street. Though I rendered no medical assistance, I have been called to attend Court as a witness – what can I charge?
Witnesses to fact can only be reimbursed their out of pocket expenses as they are acting as members of the public and not in a professional capacity. If you are called to give evidence as a doctor, you should ask the CPS to reclassify you as a professional or expert witness (fee guidance schedule10)
Go to fee guidance schedule 10 here.

23. Can my doctor charge me for my travel vaccinations?
The BMA has no suggested fees for vaccination and immunisation for travel abroad. Our advice would be that doctors may charge a fee per course of injections (excluding cost of vaccines) if no remuneration is payable by the PCT or the health board. The situation under the new contract is:
  • travel vaccines that are not provided anywhere under the NHS for public health reasons can be privately provided by practices;
  • a limited number of travel vaccines are provided on the NHS for public health reasons, and appendix 1 of the guidance document available from the General Practitioners Committee will elaborate;
  • some practices will have opted out of providing additional service for vaccinations and immunisations, therefore they cannot provide any vaccine available on the NHS to their patients. They could privately provide vaccines not available on the NHS.
(Further information on this matter may be sought by BMA members from askBMA on 0870 60 60 828).

24. An insurance company has asked me to provide a fitness to travel certificate for one of my patients – what is the fee for this?
There is no agreed fee for this work and you should set your own. However, the BMA discourages doctors from signing certificates which indicate that the patient will be fit for the duration of the holiday. If the patient is subsequently taken ill whilst under such a guarantee there may be medico-legal consequences for the doctor.

25. What is the BMA Position regarding fees for doctors giving emergency treatment on an aircraft?
There are no current guidelines about recovering fees for doctors who have given emergency treatment on an aircraft for either passengers or staff. The BMA would hope that airlines might be willing to make a gesture of goodwill to the doctor as a good Samaritan by making a direct payment to the doctor for the services provided, or alternatively making some form of gift in kind. Although a doctor may make a claim for the recovery of fees in accordance with their private rate, there is no guarantee that this claim will be successful.

26. How much can I charge to be retained to attend emergencies at an airport?
See fee guidance schedule 11.
Go to fee guidance schedule 11 here.

27. How much do I charge for notification of an infectious disease?
The fee applicable for certificates sent for cases of other notifiable infectious diseases or food poisoning can be found in fee guidance schedule 3. GPs are advised that some notification of infectious diseases has to be provided under statute and therefore no charges can be made (for a list of notification covered by statute contact the GPC).
Go to feeguidance schedule 3 here.

28. As an employer, how much should I expect a GP to charge me for a medical report on his patient/my employee?
This depends on the level of work undertaken to write the report. See fee guidance schedule 11, where no agreement applies.
Go to fee guidance schedule 11 here.

29. A patient failed to keep an appointment arranged for life assurance purposes. Am I entitled to charge a fee?
50% of the fee should be paid by the insurance company (fee guidance schedule 5).
Go to fee guidance schedule 5 here.

30. I have been asked to write a report for a patient wishing to join a health club – what can I charge?
This comes under the heading ‘services which can only be provided by the patient’s own GP or other attending doctor’ (fee guidance schedule 11).
Go to fee guidance schedule 11 here.

31. I have written an occupational health report for a patient joining the fire brigade – how much can I charge?
This fee is directly reimbursed by the local authority as it is considered part-time or occasional work (fee guidance schedule 2).
Go to fee guidance schedule 2 here.

32. What is the fee for a new driving licence photo-card form?
The doctor can charge his/her own fee if the patient makes the request. If the request comes from a DVLA form, the DVLA will pay a fee under the BMA ‘Treasury ‘ rate fees (fee guidance schedule 1).
Go to fee guidance schedule 1 here.

33. What is the fee for an HGV/PSV licence form?
There is currently no agreed fee in place for completion of an HGV/PSV licence form for any type of employee including local authority employees
and police officers. Doctors are therefore advised to set their own fees for this type of work ensuring that the fee is reasonable, transparent and
justifiable. As far as possible fees should be agreed in advance before the work is undertaken.
Go to fee guidance schedule 2 here.

34. What are the fees for Ministry of Defence work?
The BMA and MoD no longer agree fees, (although there were agreements in the past). BMA advice to doctors undertaking work for the MoD is to set their own fee, although we understand that the MoD has its own schedule of fees.

35. What is the fee for being a doctor at a sports event?
This is one of the BMA’s ‘suggested’ fees that we are no longer able to offer as a result of the OFT enquiry. Doctors should therefore set their own fee. The BMA does publish professional guidance on attendance at sporting events, entitled 'Doctors assistance to sports clubs and sporting events' and is available from BMA Science Department.

36. What is the fee for BUPA forms?
For the form that BUPA and other PMI providers ask new and potential subscribers to complete, there is no agreed fee. However some insurers, on request, are prepared to offer a ‘contribution’ to GPs’ costs, which in the case of BUPA is £15.

37. What is the fee for completing a medical research questionnaire for a pharmaceutical company?
The BMA and the ABPI have agreed fees (FGS 6).
Go to Fees guidance schedule 6 here.

38. How much can I charge for completing cremation forms?
Before a cremation can take place there are a series of forms to complete. Information on the forms and fees are in fee guidance schedule 6. Information on pacemaker removal can be found in fee guidance schedule 11.
Go to fee guidance schedule 6 here.
Go to fee guidance schedule 11 here.

39. What is the fee for taking blood for a paternity test?
Fees for a blood test for evidence of paternity are established by the Blood Test (Evidence of Paternity) Regulations 1971, and are agreed with the BMA (fee guidance schedule 10).
Go to fee guidance schedule 10 here.

40. I have undertaken an assessment and written a report for the Probation Service, who are saying they have no money to pay my fee. I have already handed over the report, can I therefore insist on payment?
The BMA strongly suggests agreeing a fee in writing prior to undertaking the work. The BMA cannot get involved in fee disputes.

41. I have been asked to be a consultant member on an Appointments Advisory Committee from outside the Trust – what can I charge?
These fees are included in fee guidance schedule 3.
Go to fee guidance schedule 3 here.

42. Are GP’s obliged to complete forms from the Commission of Social Care Inspections (CSCI) which give the GPs opinion of residential nursing homes?
There is no regulatory obligation for GP’s to fill in the CSCI comment cards on care homes, although it would appear an ideal conduit to share information to promote and ensure the safe and effective delivery of health and social care. Irrespective of the comment form, there would be an ethical duty to inform the CSCI about aspects of a care home’s delivery of care in certain circumstances. E.g. If the care administered in a care home posed a serious and imminent threat to public health or to the life or health of another individual.

43. Is a fee chargeable for the completion of “Welfare of the Child” Questionnaires?
Under the terms of the Human Fertilisation and Embryology Act (1990), any fertility centre in the UK offering licensed treatment services that might result in the birth of a child must take into account the welfare of any child who may be born as a result of the treatment, or of any other child who may be affected by the birth. In regards to the completion of the welfare of the child questionnaires by GP’s, if the work is required by the HFEA on a clinical level then no charge should be made. However, if the work is required to comply with HFEA commissioned work then the work could be subject to a charge, as determined by the GP based on the time taken to complete the form.

44. Is a fee chargeable for the completion of applications for firearms?
The completion of applications for firearms is not covered under doctors’ NHS terms and conditions of services. Doctor’s that chose to do this work may, therefore, charge a reasonable fee based on the time spent completing the form.
When a doctor is presented with a firearms application, the following principles should be considered:
  • There is nothing to prevent doctors from countersigning firearms applications when they are simply acting as a person of good standing i.e. where the applicant is not, and never has been, their patient.
  • Where the applicant is a patient, doctors are advised not to support firearm applications unless they believe that they have sufficient knowledge about an individual to justify a judgement that the individual could safely possess and control such a firearm. Such occasions will probably be rare.
  • Doctors must make it clear that they are in no position to judge the ‘future dangerousness’ of any applicant.
  • If doctors have reason to believe that an individual has access to firearms and is currently a danger to him or herself or to society they should encourage the individual to return the licence and surrender the firearms. Doctors should, however, also be prepared to breach confidence and inform the appropriate authorities if necessary. They need to bear in mind that they may need to justify the decision if confidentiality is breached without the individual’s permission.
45. What provisions for patient consent should be considered when responding to access to patient records by solicitors?
The BMA and Law Society have produced a joint consent form for use in England & Wales and Scotland. When an individual makes a legal claim, solicitors or agents often need to see the individual’s health records in order to assess which parts are relevant to the case. In addition, if the legal claim goes ahead, the person who the claim is against and relevant insurance companies may ask for copies of the health records. By signing the consent form, the patient gives the doctor permission to give copies of their full GP record, and/or hospital records relating to the incident, to their solicitor or agent. Health records are released under the Data Protection Act 1998 and the doctor must release copies of the records unless any of the exemptions set out in The Data Protection (Subject Access Modification) (Health) Order 2000 apply. The doctor may charge the usual fees authorised under the Act for providing the records.

It should be noted that doctors who receive requests with a different consent form are still obliged to comply, provided the consent is valid. Doctors can however ask solicitors to use the joint BMA and Law Society consent form in future, but they cannot insist upon it. For full details of the form, go to:
www.bma.org.uk/ap.nsf/Content/bmalawsocform2 for the form for Scotland
www.bma.org.uk/ap.nsf/Content/bmalawsocform for the form for England and Wales

46. Is a GP required to undertake a report on the vulnerability of a homeless patient, when commissioned to do so by the housing agency, and can a fee be charged?
Under the GMS Terms of Service, doctors are not obliged to undertake this work, and therefore a fee may be charged when such reports are undertaken. Any fee should be charged to the Housing Agency, as they have commissioned the report.

47. Is a doctor required to have written consent from a patient before providing a disability living allowance report for the Benefits Agency/ Atos Origin?
Under their Regulations GPs are obliged to provide medical officers with certain information relating to patients on whom a certificate is being considered. The Regulations also state however that doctors can rely on the written assurance from the medical officer, or other officer of the Department for Work and Pensions who holds the patient’s written consent, that consent has been given, unless the doctor has reason to believe otherwise. For consent to be valid the patient must be fully informed about the purpose of the examination and/or disclosure and relevant information cannot be withheld.

48. If a patient receiving incapacity benefit is declared fit to work and asks a doctor for a medical report to appeal against withdrawal of the allowance, is the doctor obliged to supply the report?
If the patient requests a report to appeal against the withdrawal of the allowance, then the doctor is not obliged to provide it. If, however, the national insurance department dealing with the appeal requests a certificate, the doctor is obliged to provide it as a prescribed certificate under schedule 4 of the NHS GMS Regulations 2004 and a fee cannot be charged.

49. Insurance companies frequently ask doctors to complete medical reports based on a patient’s medical history, when taken ill abroad. The company refuses to authorise payment of treatment until the report has been received. How should doctors reply to such requests and can the reports be faxed?
Doctors are not bound by their Terms of Service to provide these reports, and are entitled to a charge at their own rate for providing the report.

The Association of British Insurers (ABI) and the BMA have joint guidelines regarding medical information and insurance. The guidelines state that consent is needed before information is disclosed to insurance companies for the purpose of verifying claims, for example before a company organises repatriation of a policy holder taken ill abroad. In such cases, the company must approach the policy holder for permission to release sufficient information to verify the claim. Evidence of consent must be provided to the policy holder’s doctors in the usual way. If the policy holder is not competent to give consent, doctors may release information necessary to satisfy the claim provided that doing so is in the person’s best interests and not contrary to his or her previously stated wishes.

Sometimes insurance companies need information about people other than the holder of the policy. This is most often the case with travel insurance, for example where a close relative of the policy holder becomes ill and the policy holder has to curtail a holiday and return home. In such cases insurance companies will want to confirm that the illness of the relative was sudden and unexpected and occurred at the time the policy holder claimed. Depending on the nature of the policy, the company may also want to confirm that the condition was such that the policy holder was urgently required to attend the relative. If competent to give it, the relative’s consent is needed before doctors can release information to verify the claim. If the relative is not competent, doctors may disclose relevant information to the company provided this is not contrary to their patient’s wishes or interests. The insurance company will explain what information is required in each case.

The view of the Professional Fees Committee is that if the above conditions are met then GPs should aim to co-operate with any reasonable requests. GPs should not however be blackmailed with any threats that certain action will compromise the validity of the patient's insurance and the repatriation process.

We would also advise that the doctor checks that the person requesting the report is who they claim to be and to ensure that they will respect the patient’s confidence. In addition if the report is to be faxed, we would advise that the report is first anonymised and the patient’s identity sent separately. The recipient should be informed when the fax is being sent and asked to acknowledge receipt of the report.

50. The Office for Standards in Education (OFSTED) requires individuals wishing to be registered as childminders to have their suitability checked by the completion of a childminder health form. Can a fee be charged and, if so, who is responsible for paying the fee?
The responsibility for the regulation of childminding and day care for children under the age of eight transferred from local authorities to OFSTED in 2001, and it is a statutory duty under the Children Act 1989. The BMA and OFSTED have agreed a fee for the completion of childminder health forms, and is detailed in BMA’s fee guidance schedule 6. OFSTED is not responsible for paying the fee, which should be paid by the intended childminder, the person in charge or the employer.
Go to fee guidance schedule 6 here.

51. Are doctors entitled to charge a fee for providing a patient with a certificate, at the request of the Housing Association, which states that the patient is fit to accept young people, who may have previously been in Local Authority care, as lodgers?
Certificates requested by the Housing Association are not part of a GPs NHS Terms and Conditions of Service and therefore the GP is entitled to charge a fee for undertaking the work.

It is the view of the Professional Fees Committee that doctors have a responsibility to provide confirmation of a statement of fact, but not the provision of a professional opinion in the form of a health declaration of a patient’s suitability to accept young people as lodgers. A doctor can verify a simple statement regarding any documented history on a patient’s behaviour that may be incompatible with their health profession duties, but they are not in a position to provide a general opinion regarding their fitness to have young lodgers. This opinion is based on the fact that past performance is not a guide to future activities.

Any certificate produced should be provided direct to the patient, rather than the Housing Association, as the patient may not have been fully informed of the nature of the information required. The patient can subsequently decide whether to release the certificate to the Association.

52. Does the BMA have agreed fees with the Association of British Insurers for the completion of targeted reports?
A number of insurance companies have recently introduced targeted reports for life assurance and income protection. These reports are shorter than a GP reports and require information on a single condition.

The Professional Fees Committee has not supported the introduction of these targeted reports, and therefore there is no fee agreement with the Association of British Insurers (ABI). Whilst the BMA/ABI agreement remains in place for the GP and supplementary reports, we would suggest that doctors’ charge at their own rate for undertaking targeted reports. It should also be noted however that there is no obligation on the doctor to undertake this work, but where the work is declined the doctor-patient relationship should be considered.

53. Are the fees under the BMA/ ABI life assurance and income protection agreement binding?
The fees under the BMA/ ABI agreement are only binding on member companies of the ABI and with whom the BMA negotiates nationally. These fees are not binding on general practitioners who may wish to seek a higher fee. However, GP’s wishing to do this should accept that such requests are likely to be unsuccessful and that refusal to carry out the work may affect the doctor/patient relationship.

54. What is defined as emergency treatment under the Road Traffic Act and can a doctor charge a fee for treatment under the Act?
The Road Traffic Act is silent as to what is defined as immediately required treatment. It is a common understanding that some injuries may not manifest until several hours after the accident and do not warrant a visit to a hospital accident and emergency department, but do warrant the attention of the local primary health care team. Under such circumstances where a claim is to be made, the Professional Fees Committee believes that the patient should be seen within one working day.

The BMA’s legal advice is that, while treatment provided at the scene of the accident will be most common, treatment provided at the GP’s surgery can be included in the definition of ‘emergency treatment’ and therefore attract a fee under the Road Traffic Act.

The fee under the Act is set by Government and is a statutory fee of £21.30. The person driving the vehicle at the time of the accident is responsible for meeting the doctors professional fee for themselves, their passengers or anyone injured by their vehicle. All UK motor insurance policies cover the payment of such fees.

55. Are doctors required to provide exam certificates relating to illness that may have had an adverse effect on a patient’s exam performance?
There is no statutory requirement for doctors to provide exam certificates. Private certificates may be provided where the doctor is aware of a medical problem that may have had an adverse effect at the time of the patient’s examination. Doctors should excise caution however on providing medical certificates based on hearsay, and should use their judgement at all times.

56. Are doctors required to complete fitness certificates e.g. fitness to travel or for sporting activities.
GPs are increasingly being approached to complete an array of certificates for medico-legal reasons. The completion of fitness certificates raises concern because even if a thorough history, examination and any necessary investigations are carried out, doctors are still not in a position to guarantee that a patient is fit for a particular activity. The BMA discourages doctors from signing certificates which indicate that the patient will, for example, be fit for the duration of the holiday, as current fitness is not a guide to future fitness. Doctors can only report on what is written in the patient notes, and reporting on future fitness could have medico-legal consequences for the doctor. The Association would therefore advise that if certificates are provided they should include words to the effect that ‘based on information available in the medical notes, the patient appears to be fit to travel’. Fitness certificates fall outside a GPs NHS Terms and Conditions and doctors can charge at their own rate for undertaking the work.

57. Can GP’s charge for the completion of pension reports for the armed forces?
The completion of pension reports for the armed forces falls under schedule 4 of the NHS GMS Regulations 2004 and therefore no fee can be charged.

58. What services are medical practitioners obliged by statue to provide?
There are a number of items of non-NHS work that are subject to a statutory obligation. There is no definitive list published by the Government in England or in the devolved nations. However the Professional Fees Committee notes that Medical practitioners are obliged by statue to provide the following services:
  • Access to health records by patients (Data Protection Act, 1998). Access to health records of deceased patients where the applicant has a claim arising from the death of the patient (Access to Health Records Act, 1990, and Access to Health Records (Northern Ireland) Order, 1993).
  • Death certificate, including death within 28 days of birth: the registered medical practitioner in attendance during the deceased’s last illness must by law provide a certificate of cause of death (S22, Births & Deaths Registration Act, 1953).
  • Notification of infectious diseases (S11, Public Health (Control of Disease) Act, 1984).
  • Coroner’s post-mortem: although rarely used, the coroner has power under section 19 of the Coroners Act, 1988 to direct that a post-mortem shall be conducted by the deceased’s general practitioner.
  • Professional evidence in court: under the Supreme Count Act 1981, any registered medical practitioner may be directed to give professional evidence.
  • Services which doctors are not obliged to provide, but when they do, the fee payable is governed by statue: for example, fees for taking samples of blood required in cases of disputed paternity under the Blood Test (Evidence of Paternity) Regulations.
59. Is there a list of prescribed medical certificates for NHS general practitioners for which fees may not be charged?
Column 1, schedule 4 of the NHS, GMS, Regulations 2004 state that the following certificates must be provided free of charge:
  • To support a claim or to obtain payment either personally or by proxy; to prove inability to work or incapacity for self-support for the purposes of an award by the Secretary of State; or to enable proxy to draw pensions.
  • To establish pregnancy for the purpose of obtaining welfare foods.
  • To secure registration of still-birth.
  • To enable payment to be made to an institution or other person in case of mental disorder of persons entitled to payment from public funds.
  • To establish unfitness for jury service.
  • To support late application for reinstatement in civil employment or notification of non-availability to take up employment, owing to sickness.
  • To enable a person to be registered as an absent voter on grounds of physical incapacity.
  • To support application for certificates conferring exemption form charges in respect of drugs, medicines and appliances.
  • To support a claim by or on behalf of a severely mentally impaired person for exemption from liability to pay the council tax or eligibility for a discount in respect of the amount of council tax payable.
Acronyms
AAC Advisory Appointments Committee
ABPI Association of the British Pharmaceutical Industry
CPS Crown Prosecution Service
DDRB Doctors and Dentists Review Body
EOLG Employers Organisation for Local Government
FGS Fee Guidance Schedule
GPC General Practitioners Committee
FMC Forensic Medicine Committee
HIA Highlands and Islands Airports Limited
JNC Joint Negotiating Committee
MMC Monopolies and Mergers Commission
OFT Office of Fair Trading
OSS Office for the Supervision of Solicitors
PFC Professional Fees Committee
RTA Road traffic accident

© British Medical Association 2008

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