Medical certificates and reports
July 2004
Collaborative arrangements
The collaborative arrangement certificates and reports are not obligatory in terms of statute but they do allow for the smooth running of aligned local authority services which include: psychiatric sectioning, adoption, fostering and children in care reports and reports for priority housing to name a few. GPs will often feel a moral obligation to engage in this work and fees are paid to GPs for this work. The fees for all this work are recommended by the DDRB after considering evidence provided by the BMA’s Professional Fees Committee. Details of the fees are published each year through a Department of Health circular letter. GPs should refer to Fees Guidance Schedule 2 – Work for Local Authorities (only BMA members will be able to access this link).
The 'collaborative arrangements' between health authorities and local authorities were established under legislation in 1974 (current legislation is contained in sections 26-28 of the NHS Act 1977). They allowed certain local authority services in the fields of education, social services and public health to be provided by the corresponding health authority without charge. They include a number of services provided in the community health service (particularly sessional work in family planning) which were transferred to the NHS in 1974.
Apart from the services specifically listed in the work for local authorities fees schedule, it is the view of the NHSE "that the services provided under the 'collaborative arrangements' should be decided at a local level dependent upon the individual needs of an area." Hence, for example, it would be a matter for local decision whether attendance at multi-agency risk panels or reports for local authority housing associations were covered by the 'collaborative arrangements'.
It has been agreed with the BMA that basic health information provided by GPs for community care purposes would not attract a fee. Guidance on this was issued by the then GMSC to LMCs in October 1992. Any community care work undertaken by GPs that goes beyond the provision of basic health data does, however, attract a fee as outlined in the fee schedule.
Please note GPs cannot renegotiate the fee for work listed in Fees Guidance Schedule 2 but they can refuse to do it. Local negotiations on fees can take place where an arrangement exists that is outside the remit of Schedule 2.