Fees England Wales

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Mental health assessment fees

Please note this guidance is under review.


The NHS Act 2006 (Section 236) clearly states that under certain terms, the Secretary of State must pay a fee to a medical practitioner who undertakes a medical examination of any person with a view to applying to admit him or her to hospital for assessment, or for treatment under Part 2 of the Mental Health Act 1983.

This includes the work undertaken including the examination, the report and any expenses reasonably incurred in doing the work.

Payment depends upon the individual's terms and conditions of service so before going any further, we advise you to always first check your own contract to see whether you are obliged to undertake this work under the following two conditions:

  • As an examination carried out in the provision of primary medical services for that person
  • As an examination carried out or any recommendation or report made as part of his or her duty as an officer of a Primary Care Trust, NHS trust, Special Health Authority, NHS foundation trust or Local Health Board.

These conditions apply to all medical practitioners however there are some variations within each branch of practice and the terms and conditions held within the GP, Consultant, SAS and junior grade contracts.

Find out more

Check the NHS Act 2006

Mental health assessment fees

  • Guidance on mental health work for consultants and sas doctors on new contracts

    Consultants on the 'new' contract (after 1 April 2004), Associate specialists (2008) and Specialty doctors

    • Consultants - see schedules 10 and 11 of the consultants' terms & conditions of service (England) 2009
    • Associate Specialists - see schedules 11 and 12 of the terms & conditions of service for associate specialists (England) 2008
    • Specialty doctors - see schedules 11 and 12 of the terms & conditions of service for specialty doctors (England) 2008.

    Depending on the agreements individual consultants, associate specialist or specialty doctors have made within their contracts of employment, none of the three relevant terms and conditions of service prevent the claiming of Section 12 fees and contain the same principles governing the receipt of additional fees.

    An underlying principle of all three contracts is that doctors should not be paid twice for the work they do as work undertaken during Programmed Activities (PAs) will not attract additional fees.

    This principle applies in equal measure when remunerated by an on-call supplement as part of PA work.

    The doctor undertaking fee-paying work can keep the fee owed if they are doing the work in their own time, that means, not in NHS PAs, or if they 'time-shift' so that their NHS work is unaffected, or if the work is, by agreement, only minimally disruptive to NHS activities.

    It can be quite complicated to understand the criteria. To make things easier, we have higlighted different scenarios you may encounter.

    Download our flow chart

    Check the contracts section


    Section 12 fees

    Although the England and Wales Mental Health Act 2007 has not changed the eligibility for Section 12 fees, consultant psychiatrists should still check their individual contract to determine whether they are entitled to payment.


  • Completing COP 3 forms

    Under the Mental Capacity Act 2005 the lasting Powers of Attorney system allows an individual the donor to appoint someone the attorney to make decisions on their behalf regarding their property and financial affairs and also in respect of personal welfare and healthcare decisions.

    Doctors may therefore be asked to complete the Court of Protection assessment of capacity form (COP3).

    No national fee has been agreed for this work therefore doctors are required to set their own fees.

    What next?

    Check your contract

    Read more about the NHS Act 2006

    Read more about the Mental Capacity Act

  • Section 136 detained patients

    Fees for patients detained under Section 136 of the Mental Health Act 1983 can be claimed only if the assessment takes place in a location 'other than a hospital or clinic administered by an NHS organisation’.

    If a hospital incorporates a room or rooms dedicated to this purpose, and the work is carried out in this room or rooms then, for the purposes of claiming a fee, this counts as being a 'hospital or clinic administered by an NHS organisation.’

    Assessments on Section 136 detained patients brought to an NHS ward or Emergency Department, for example, as a designated 'place of safety’ are not eligible for a fee.

    This guidance is not intended to be exhaustive and if members are still unsure as to their position, speak to a BMA adviser.

  • Junior and hospital doctors on old contracts

    This is guidance is for Junior doctors and Associate specialists on the pre-2008 contracts, Staff grades or Consultants on the pre-2003 contract

    For Junior doctors and consultants on the old contract, Category 1 and 2 items of service (Hospital terms and conditions of service, paras 36 and 37) apply.

    Category 1 (1d for mental health work) sets out work which is reasonably incidental to contractual duties and for which charges may not be made and category 2 provides examples where charges can be made for particular types of work.

    Consultant psychiatrists who do not have Section 12 work included in their contract of employment are under no obligation to undertake these assessments.

    Download our flow chart to find out if you can charge a fee 

    Check the contract section