Fees & 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 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. 

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:
Certain travel vaccinations
Private medical insurance reports
Holiday cancellation claim forms
Referral for private care forms
Letters requested by, or on behalf of, the patient

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
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.    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 Upton Group Practice
At Upton Group Practice we have a list of fees displayed at reception, and they are also listed below.

In the past we have completed reports and forms before payment has been made, but have sadly found there to be too many occasions when the doctor has given up the time to do the work, but the fee has not been forthcoming.  Therefore, from the 1st July 2010, the fee must be paid in advance at the time the request for the letter or form to be completed is made or when the appointment for a medical is booked.


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 free of charge.  (Teacher, Accountant, etc)

You can complete the form to the best of your ability in pencil, so the doctor just has to quickly verify your entries against the information we hold.

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.

Private Charges – as from January 2024

Private sick note £23-00
Short private note – To Whom it May Concern letter £23-00
Cholera certificate £23-00
Other vaccination certificate £23-00
Sickness (Accident – short certificate without examination) £23-00
Private prescription for drugs not normally prescribed for patients travelling abroad £23-00
Fitness to travel certificate without examination £33-00
Driving licence signature £23-00
Student health questionnaire £40-00
BUPA, PPP etc. Claim  forms £40-00
School fees insurance claim forms £40-00
Insurance claim form £40-00
Holiday cancellation insurance report £40-00
Character reference £40-00
Completion of form to appeal decision made re DLA, Attendance Allowance etc £45-00
Extract from medical records         Short



(Note Total Fitness reports are usually done as a short extract from the notes and the fee is therefore)





Power of Attorney – patient needs to be seen £120-00
Copy of doctor’s report to insurance company

(up to 6 months after report returned to insurance company) 

Consultation with doctor to discuss the report £45-00


The charge for all the following examinations is : £120

All medicals must be paid for upon booking of the appointment.  As we need to allocate half an hour of GP time to each medical examination this fee is non-refundable if the patient fails to attend the appointment or cancels at less than 2 hours notice.   

*           Pre-employment

*           Medicals for third parties

*           HGV medical

*           PSV medical

*           Taxi driver medical

*           Elderly driver medical

*           Racing driver medical

*           Diabetic driver medical

*           Sports medical eg. Diver, gliding etc.

*           Visa application medical

*           Oil rigs fitness

*           Holiday cancellation examination and  report

*           Seat belt exemption examination and report

*           Fitness to travel examination and report

If a patient also needs blood tests or x-rays, they would have to be done privately at Murrayfield hospital or here at the practice. For these, there would be an extra cost of £50 plus laboratory costs. 


All GP practices are required to declare the mean earnings for GPs working to deliver NHS services to patients at each practice.

The average pay for GPs working in Upton Group Practice in the last financial year was £53,099 before tax and National Insurance. This is for 8 part time GPs who worked in the practice for more than six months.