Patient Charges

Why do GPs charge fees – Your questions answered

Isn't the NHS supposed to be free?

The National Health Service provides most health care to most people free of charge, but there are exceptions. Prescription charges have existed since 1951, and there are a number of other services for which fees are charged. Sometimes the charge is made to cover some of the cost of treatment, for example, dental fees. In other cases it is because the service is not covered by the NHS, for example, medical reports for insurance companies, claim forms for referral for private care and other letters and forms which require the doctor to review the patient's medical records.

Surely the doctor is being paid anyway?

It is important to understand that GPs are not employed by the NHS. They are self employed, and they have to cover their own costs such as staff, buildings, heating, lighting etc., in the same way as any other small business. The NHS pays the doctor for specific NHS work, but for non-NHS work the fee has to cover the doctor's costs.

What is covered by the NHS and what is not?

The government's contract with GPs covers medical services to NHS patients. In recent years, more and more organisations have been involving doctors in a whole range of non-medical work.

Examples of non-NHS services for which GPs can charge their NHS patients are:

  • Private prescriptions*
  • Private sick notes (if requested for the first 7 days when patients can self certificate)
  • Some travel vaccinations
  • Private medical insurance reports
  • Holiday cancellation claim forms
  • Referral for private care forms
  • Other letters requested by, or on behalf of, the patient

*A doctor can write a private prescription for a patient if they feel it is clinically appropriate and they are happy to take responsibility for that prescribing decision. Under NHS regulations, a dr, or his deputy, can write a private prescription for a patient but cannot charge the patient a fee for doing so if the patient is registered for NHS care with that GP/practice. The only exceptions to this rule are when an NHS GP writes a private prescription for:

  • Drugs that are being issued solely in anticipation of the onset of an ailment whilst outside the UK, but for which the patient does not require treatment when the medicine is prescribed, or,
  • Drugs issued for the prevention of malaria

Examples of non-NHS services for which GPs can charge other institutions are:

  • Medical reports for an insurance company
  • Some reports for the DSS/Benefits Agency/DVLA
  • Examinations of local authority employees

Why does it sometimes take my GP a long time to complete my form?

Time spent completing forms and preparing reports takes the GP away from the medical care of his/her registered patients. GPs have a very heavy workload and paperwork takes up an increasing amount of their time.

I only need the doctor's signature - what is the problem?

When a doctor signs a certificate or completes a report, it is a condition of remaining on the Medical Register that they only sign what they know to be true. Therefore, in order to complete even the simplest of forms, the doctor needs to check the patient's entire medical record. Carelessness or an inaccurate report can have serious consequences for the doctor, with the General Medical Council or even the Police.

What will I be charged?

The BMA recommends that GPs tell patients in advance if they will be charged, and how much. It is up to the individual practice to decide how much to charge, but the BMA produces lists of suggested fees for the Doctors to use as a guideline.

Charges at Shotfield Medical Practice

At Shotfield Medical Practice we have a guide to private fees available at reception, and they are also listed below.

You will be asked to pay, when you collect the form/letter and you will not be given this item until the payment has been made.

What can I do to help?

Not all documents need signature by a doctor. For example, you could ask another person in a position of trust, who may be willing to sign a passport application or other similar document free of charge, eg bank manager, teacher, accountant.

Do not expect your GP to process forms overnight, urgent requests may mean that a doctor has to make special arrangements to process the form quickly, and this will cost more. We normally say you should allow a minimum of 10 working days for the processing of such forms and always ring to check they are ready before you attend to collect them.

Private Charges – from April 2021


Private sick notes


Other vaccination certificate


Private prescription (Malaria, private patients & for items issued in anticipation of being required when outside UK only – see above)


School certification




£30.00 - 63.00


DVLA – relating to the withdrawal or reinstatement of a licence:

VOC Certificate (relates to the medical condition of the patient)


Copy of report on patients visual fields (can be done by an administrator)


VOC resting ECG certificate (can be completed by a practice nurse)


Fitness for gym/sports, freedom from infection, fitness to travel


Holiday cancellation form


Insurance claim forms & form to appeal decision re: DVLA, Attendance Allowance, etc


Extract from medical records:








GP report for insurance applicants (written or template)


GP supplementary reports or letters


Copy of doctor's report to insurance company (up to 6 mths after)


Consultation with doctor to discuss the report


Access to Medical Records

Fee (GDPR 25.5.2018) for copy notes/access requests

Free of Charge unless request manifestly unfounded or excessive

Access Charges:

Access fee

Free of charge

Photocopying charges

Free of charge


As incurred


Private consultation – per 15 mins (if home visit required additional time/travel will be charged)


Housing/social services letters

£25.00 - 35.00

Pro-forma report



Brief letter


Letter & Extract


Detailed letter


Extra info

£20.00 - 40.00

Power of attorney cert and will competence

£50.00 - 100.00 depending on time taken & whether consultation takes place in surgery or at patients home

OFSTED Childminder Form


Abbeyfield Form



General medical exam and report
(this fee is due in advance and is non-refundable)


HGV/MGV/PCV/racing/sport/taxi medical and form
(this fee is due in advance and is non-refundable)


Elderly & fostering


Comprehensive exam and report
(this fee is due in advance and is non-refundable)


  • Passport signing is not undertaken by any doctor at the practice.
  • The Metropolitan police will pay a fee of up to £38.00 for a brief/basic statement/report and there is a form to complete to claim this fee which should be provided by the patient requesting the report. Further charges may apply if a request is made for more detailed information.

Travel Charges

For more information on current charges to patients for travel vaccinations or certificates, please see our Travel Advice & Vaccinations page.

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