Fees for part-time medical services
December 2004
Private medical practice
The extent to which NHS doctors - consultants, GPs or others - may practise privately, ie treat patients by private arrangement, is governed by their individual contract or laid down in their terms of service.
General practitioners
GP practices have no limit on receiving income from private practice and commercial contract work provided NHS commitments are met. However, if NHS staff or premises are used and private practice income is 10 per cent or more of total practice receipts, any reimbursements by the PCT will be abated proportionally (go to reference 1). Fees may not be charged to their own NHS patients except where specifically permitted under the terms of service.
Senior hospital doctors
The gross private practice earnings of consultants (go to reference 2) (on NHS terms and conditions of service agreed before 1 April 2004) and associate specialists with whole-time NHS contracts may not normally be permitted to exceed 10 per cent of their gross whole-time salary. This includes distinction awards and discretionary points but excludes Category 2 work and domiciliary visit fees. There is no limit on part-time or maximum part-time practitioners, provided their NHS commitment is met. Work performed on NHS patients by separate arrangement outside the principal contract of employment, eg waiting list initiatives, is regarded as private practice and earnings are included in the 10 per cent limit. However, this does not apply where the doctor has a contract with their employer for an additional notional half-day (or part) to carry out this work.
Under the new consultant contracts for England, Scotland, Northern Ireland and Wales there is no restriction on private practice earnings, but consultants must demonstrate that they are fulfilling their NHS commitments, and there must be no conflict of interest between NHS work and private practice work. Different terms and conditions apply to the four national contracts and members are advised to seek further advice from askBMA.
Junior hospital doctors and staff doctors
There is no limit on private practice provided the work is undertaken outside contractual hours and does not interfere with NHS duties. It is advisable to seek the agreement of the relevant consultant(s) before undertaking private practice.
1. The National Health Service (General Medical Services – Premises Costs) (England) Directions 2004, paragraphs 49-50.
2. Including consultants in public health medicine