Private Services

Information about Private Referrals

If you have requested a private referral, as a practice we wanted to make you aware of the following guidance for patients who have sought care privately.

Private Tests and Investigations

If a test or investigation is recommended by a private provider, the private provider retains responsibility for this test. This would include x-rays, scans and blood tests as well as procedures such as an endoscopy. This is the same as the guidance applied to the rest of the NHS in Wales.

This includes responsibility for:

Arranging the test and any medications you may need to take before or after, including pain relief.
Explaining what the test entails and what you need to do on the day of the test.
Providing you with the results and explaining what this means for your care or condition. This may involve a letter or follow-up appointment with the specialist.
Arranging any follow-up required after the test including onward referral to other private or NHS services.

It is important to consider the cost of these tests, if they are not covered by your health insurance. Please do not contact the practice to discuss the results of tests organised by practitioners outside the practice. Please contact your private provider for these results.

Medication

The medication GP practices can prescribe fall within strict guidance. This includes, but is not limited to, national medication licenses, NICE guidance, local protocols and the Health Board formulary. These guidelines are in addition to the prescriber's responsibility to their regulator, such as the General Medical Council, Nursing and Midwifery Council and the General Pharmaceutical Council, to ensure they are prescribing safely. This means your GP practice may not be able to take over prescribing a medication from a private provider.

Usually when patients are seen by a private provider for a single, short-term episode of care any medication should be prescribed by them and paid for either by the patient or their medical insurance. This is because the private provider has clinical responsibility for the treatment of that particular condition.

Where longer term treatments are recommended, medication may be added to a patients repeat prescription providing it would be available from a GP for that condition under the NHS and the GP practice team are comfortable to prescribe it.

Examples where the practice would not be able to prescribe a medication includes:

Its use is restricted to hospital specialists.
The medication is not licensed for the indication it has been given.
Insufficient detail has been given regarding dose, duration, indication or monitoring requirements for the drug.
It interacts with other medications you are prescribed or is contraindicated due to your other medical conditions.
A more cost-effective treatment is appropriate for the management of your condition.
The medication is available to purchase, for example from a supermarket or pharmacy.

In every case, the private provider is responsible for providing you with enough medication until the practice can take over prescribing. This is usually considered at least 7 days.

Some medications require particularly close monitoring to ensure patients remain safe while taking them and would only be provided by GP practices following a ‘shared care’ agreement with a hospital team. These include medications used for arthritis such as Methotrexate, and medications for ADHD. These are not available for GPs to prescribe on their formulary and require ongoing monitoring from a specialist team. If these treatments are started, they will need to continue being prescribed by the private provider until you are seen by an NHS specialist team who can continue the treatment if they feel it is appropriate for you. Unless this medication is covered by your health insurance you will need to pay for this treatment up until an NHS specialist takes over prescribing for you.

Referrals to Other Services

If your private provider recommends you be referred to another private specialist or NHS team, they are responsible for making this onward referral and should not ask your GP practice to do this. This is the same as the guidance that applies to specialists working within the NHS.

Request for a ‘Sicknote’

If your private provider recommends a period off work, the private provider is required to provide a sicknote that covers the entire duration of this period, as well as any extensions they recommend after this. This is the same as the guidance that applies to specialists working within the NHS.

Screening tests carried out by private providers which have not been approved by the UK National Screening Committee

The practice supports the national guidance which can be found on the RCGP website.

If the patient chooses to have private screening tests or investigations that are not available or recommended by the NHS, they should ensure that they have the funds or insurance in place to cover the costs of any additional treatment or investigation that is incurred as the NHS may not cover these.

Non NHS Services - Private Work Fees

Medical examinations for special purposes e.g. elderly drivers, pre-employment, insurance medicals can be arranged by appointment. A fee is payable for these examinations. The doctors will complete certain forms and certificates requested by the patient, for example private sick notes and fitness to travel forms. A charge is payable for providing non NHS forms and certificates.

We DO NOT complete passport forms

We no longer complete Blue Badge Forms at the surgery. Please contact Cardiff Council for this service. You do not need any information from your GP regarding this.

Details of current fees are below.

Adoption and Fostering			Who pays	Charge
Adoption fees normally paid by parent; fostering by NHS, but sometimes paid by the adoption/fostering agency
Form IHA Initial Health Assessment				£120.00
Form AH Health assessment, Prospective carer				£77.07
Form AH2 Update report, parent/carer				£35.00
Certificates and forms		Who pays		Charge
Freedom from infection certificate		Patient		£35.00
Letter re fitness to exercise, travel, weight watchers, slimming world compete cycling race or marathon etc – with no exam		Patient		£40.00
Private Sick Note (any sick note within 7 days is private)		Patient		£35.00
Private Health Insurance claim form (e.g. BUPA/PPP)		Patient		£60.00
Dentists, completion of Application for first registration of a dentist (GDC)		Patient		£50.00
Camp America		Patient		£75.00
Dental Council		Patient		£70.00
Student Health Forms (DSA etc)		Patient		£35.00
Welsh Water Assist		Patient		£30.00
Driving	Who pays				Charge
Taxi Medical	Patient				£140.00
PSV Medical	Patient				£140.00
HGV Medical	Patient				£140.00
Employment/Insurance	Who pays				Charge
Full medical with report or certificate	Patient/Employer/Insurance				£170.00
Report without examination	Patient/Employer/Insurance				£150.00
Report on Pro-forma	Patient/Employer/Insurance				£130.00
Questionnaire	Patient/Employer/Insurance				£120.00
Letter to disclose History eg. Heart Disease	Patient/Employer/Insurance				£60.00
GP supplementary report	Insurance Company				£27.00
Holiday Cancellation form	Patient				£80.00
Local Authority/Police/NHS	Who pays				Charge
Shotgun or Firearms Medical Report	Patient				£55.00
Letters	Who pays				Charge
To whom it may concern letter for (School, University, Work etc)	Patient				£40.00
Private Prescription	Who pays				Charge
Private sick note/prescription	Patient				£35.00
Travel Abroad	Who pays				Charge
Pregnant Woman's Medical Certificate Attesting Fitness to Fly noting their good health and indicating the baby's expected date of birth	Patient				£40.00
Fitness to travel certificate - pre-existing illness	Patient				£40.00
Vaccination certificate	Patient				£35.00

Why do GP’s charge fees?

The National Health Service provides most health care to most people free of charge, but there are exceptions. 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 isn’t covered by the NHS, for example medical reports of insurance companies, claims on private health insurance and other letters and forms which require the doctor to review the patient’s medical record.

It is important to understand that GP’s are not employed by the NHS, they are self-employed and they must cover their costs – staff, buildings, heating, lighting etc – in the same way as any 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. Our fees are calculated based on our GPs Private hourly rate.

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. Sometimes the only reason that GPs are asked is because they are in a position of trust in the community, or because an insurance company or employer wants to be sure that information provided is true and accurate.

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

Certain travel vaccinations
Private medical insurance reports
Holiday cancellation forms
Referral for private care forms
Letters request by, or on behalf of, the patient
In certain instances fitness to work forms
HGV/LGV/PCV examinations

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

Medical reports for an insurance company
Some reports for the DSS/Benefit Agency
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 patients. Most GPs have a heavy workload – the majority of GPs work up to 60 hours per week and paperwork takes up an increasing amount of their time. In addition non-NHS work must be undertaken outside of NHS contracted 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 may need to check the patient’s entire record. Carelessness or an inaccurate report can have serious consequences for the doctor, with the General Medical or even the police.