Fees for part-time medical services
December 2004
Fee paying work (terms and conditions of service, section 4.3 and appendix 5(a) – for doctors under the new consultant contract (Scotland) April 2004)
1. Fee-paying work is work which is not part of contractual work and not reasonably incidental to it and is listed in this paragraph and paragraph 2. Items may be added to this list by agreement between the employer and the local negotiating committee (LNC) for medical and dental staff. This work should be undertaken outwith a consultant’s programmed activities or during periods of leave, with the fee retained by the consultant.
Where such work involves minimal disruption, at the discretion of the employer, this work may be done within programmed activities with the consultant retaining the fee.
Employers have the discretion to make reasonable charges to consultants for the use of NHS facilities outside programmed activities, although consultants should not be charged for the use of patient records.
Fees for NHS work under section 9 of the terms and conditions of service may only be claimed for work undertaken outwith agreed programmed activities.
Where fee-paying activities, defined as ‘appendix 5(a) activities’, are undertaken on a regular basis, they will be included in the job plan.
a) work on a person referred by a medical adviser of the Department for Work and Pensions or by an Adjudicating Medical Authority or a Medical Appeal Tribunal, in connection with any benefits administered by the Department for Work and Pensions
b) work for the Criminal Injuries Compensation Board, when a special examination is required or an appreciable amount of work is involved in making extracts from case notes
c) work required by a patient or interested third party to serve the interests of the person, his or her employer or other third party, in such non-clinical contexts as insurance, superannuation, foreign travel, emigration, or sport and recreation. (This includes the issue of certificates confirming that inoculations necessary for foreign travel have been carried out, but excludes the inoculations themselves. It also excludes examinations in respect of the diagnosis and treatment of injuries or accidents)
d) work required for life insurance purposes
e) work on prospective emigrants including X-ray examinations and blood tests
f) work for Procurators Fiscal, and attendance at fatal accident inquiries as medical witnesses
g) work requested by the courts on the medical condition of an offender or defendant
h) attendance at court hearings as a medical witness, otherwise than in the circumstances where the consultant is giving evidence on his or her own behalf or on behalf of his or her employer in connection with a case with which the consultant is professionally concerned
i) work on a person referred by a medical examiner of HM Armed Forces Recruiting Organisation
j) work in connection with the routine screening of workers to protect them or the public from specific health risks, whether such screening is a statutory obligation laid on the employer by specific regulation or a voluntary undertaking by the employer in pursuance of the employer’s general liability to protect the health of its workforce
occupational health services provided under contract to other NHS, independent or public sector employers
k) work on a person referred by a medical referee appointed under the Workmen’s Compensation Act 1925 or under a scheme certified under section 31 of that Act
l) work on prospective students of universities or other institutions of further education, provided that this is not covered by the consultant’s contract. Such examinations may include chest radiographs
m) examinations and recommendations under Part V of the Mental Health (Scotland) Act 1984:
- i) if given by a doctor who is not on the staff of the hospital where the patient is examined; or
- ii) if the recommendation is given as a result of a special examination carried out at the request of a local authority officer at a place other than a hospital or clinic administered by an employer.
n) services performed by consultants for government departments as members of medical boards
o) work undertaken on behalf of the employment medical advisory service in connection with research/survey work, ie the medical examination of employees intended primarily to increase the understanding of the cause of a disease, other than to protect the health of people immediately at risk
p) completion of Form B (Certificate of Medical Attendant) and Form C (Confirmatory Medical Certificate) of the cremation certificates
q) work as a medical referee (or deputy) to a cremation authority
r) examinations and reports including visits to prison required by the Prison Service which do not fall within a consultant’s contract and which are not covered by separate contractual arrangements between the consultant and the Prison Service
s) examination on blind or partially-sighted persons for the completion of form BP1 (except where this information is required for social security purposes, for the Department for Work and Pensions, for the Employment Service or for the patient’s employer and a special examination is not required). Where the examination is in connection with registration with a local authority, payment will be made by the NHS board under the collaboration arrangements in accordance with the appropriate schedule of fees for such work.
2. Fee-paying work also includes work undertaken by consultants in public health medicine, including services to a local or public authority of a kind not provided by the NHS, including:
a) work as a medical referee (or deputy) to a cremation authority and signing confirmatory cremation certificates
b) medical examination in relation to staff health schemes of local authorities and fire and police authorities and to driving licences
c) lectures to other than NHS staff
d) medical advice in a specialised field of communicable disease control, eg membership of a departmental panel for an infectious disease
e) work for water authorities, including medical examinations in relation to staff health schemes
f) attendance as a witness in court (other than in the course of a consultant’s normal duties)
g) medical examinations and reports for commercial purposes eg certificates of hygiene on goods to be exported or reports for insurance companies
h) advice to organisations (including NHS employers), other than the doctor’s employer, on matters which the doctor is acknowledged to be an expert
i) examinations and recommendations under Part II of the Mental Health Act 1983 and under Part V of the Mental Health (Scotland) Act 1984.