Providing Private Services

Patients not on your NHS registered list (and who are not entitled to be temporary or who require immediately necessary treatment).

You can not provide private services to any patient who is registered on your NHS list, or demand any payment from them.

(apart from some very limited circumstances covered in GMS contract regulation 25 & detailed below).

You can provide private services to people who are not patients on your NHS list as long as you do not offer it during NHS working time or on NHS Funded property (rent reimbursable space).

Please see BMA guidance on Private Practice.

• Travel Immunisations which are not covered on the NHS (regulation 25 g)
• Anticipatory medication linked to travel where the patient is not requiring treatment at the time the prescription was done (25h).
• Prescribing for malaria chemoprophylaxis (25l)
• Medical Examinations not including treatment. (25i)
• For reports or certificates (25f & i)

No.

In general NHS GP’s cannot charge NHS patients for prescriptions, or provide a private prescription for an item which cannot, or should not, be prescribed on the NHS.

As above the exceptions are:

• Malaria chemoprophylaxis
• Anticipatory medication for travel
• Travel vaccinations not available on the NHS

If a patient is travelling a maximum of 3 months scripts can be given on the NHS. Patients should then be advised to seek local healthcare for their needs if they are remaining abroad longer than this.

If you have been requested to prescribe medication by a private provider then you cannot provide this as a private prescription. If it is not available on the NHS for their circumstances you cannot prescribe it.

No,

You can only charge for the reason listed above as per Regulation 25.

This does not include the delivery of medications to housebound patients.

Pharmacy do not have a similar clause in their contract so they are able to charge.

Yes,

Within your GMS contract you are obliged to provide basic travel safety advice (i.e. sun protection, not drinking water from the tap, staying hydrated, malaria etc) and the NHS vaccinations.

Vaccinations and immunisations used to be an additional service, from which practices could previously opt out of. However, from the 20/21 contract changes these are now an essential service which practices are contractually required to provide.

The following vaccinations must be given as part of NHS provision and no fee can be charged to a registered patient:

• cholera
• hepatitis A
• poliomyelitis
• typhoid.

Vaccinations that are not free of charge on the NHS and can therefore be provided privately or signposted elsewhere include:

• Japanese encephalitis and tick-borne encephalitis
• meningitis vaccines
• rabies
• tuberculosis (TB)
• yellow fever
• hepatitis B (given by itself)

As per information above you can not charge an NHS registered patient for anything apart from the exceptions in regulation 25.

As such you cannot charge for taking a patient’s blood even if the sample will not be tested on the NHS.

Provision of blood tests not available on the NHS should be sent to the laboratory marked as private, the patient should be informed in advance that the lab will charge the patient direct / charge the practice and that this cost will be passed onto the patient.

The cost of the practice staff time cannot be charged.

Tests that might fall into this category

• Paternity testing.
• Serology testing for an illness where there is no clinical need / for travel purposes.

Alternatively, you can suggest that your patient goes to a private provider for these tests.

No.

If a patient is not eligible for a flu vaccination on the NHS then you can not provide it to them privately (nor can you provide and FP10).

They would need to get this privately from a pharmacy or through their employer and occupational health.

No.

If you decide to provide tests or care for a patient on the request of a private health care professional, it should be because you have determined that the care is suitable to be provided on the NHS and within your competence (see further information here ).

Your provision is still on the NHS even if the request for the test, or follow-up monitoring, was initiated because of a private episode of care.

You cannot provide private GP services to someone who is registered with you as an NHS patient.

This includes:

• blood tests
• ECG
• Monitoring
• Prescribing

If you provide these services to an NHS registered patient then they are provided free of charge on the NHS.

However, we would suggest that patients should ensure that when purchasing private treatment they get the full episode of care from their private provider.

See further information here.

Anyone, regardless of their country of residence, is entitled to receive NHS primary medical services at a GP practice. This means tourists, or those from abroad visiting friends or family in England, should be treated in the same way as a UK resident. It also means GP practices cannot charge for this.

Patients should be registered as temporary if they intend to reside in the practice area for more than one day but less than three months.

Full registration if they intend to stay longer than 3 months.

Please see BMA guidance on Patient Registration

Guidance on Registration of Overseas Visitors