To think this is disgusting - GP charging for form

[FrostedFancy]

GP surgery insist I must pay £40 for completion of a form from school to request online learning for my DD (14) who is suffering from MH issues due to being diagnosed with a serious health condition.

AIBU to think this is absolutely disgusting to profit from a child with medical condition and mental health issues needing access to an education?

Form literally would take 5 minutes to complete.

@Diversion in the UK a GP wouldn’t charge for a death certificate. They charge for cremation forms. Again, it’s the time and responsibility. Once a body is cremated, no further investigation can be done into their cause of death, so the doctor signing it has to be 100% sure of the diagnosis. 2 doctors in fact, as 2 doctors have to sign forms now.

The reason it was 2 lines loing is because these letters aren't supposed to be requested by the school for this reason. There is a process for pupils who are unwell for an exam and at no point in it is a GPs input required (assuming the child doesnt need gp input for medical reasons). Despite this schools still ask for these letters all the time, however when I write to the school teling them theyll have to pay for it unsuprisingly the GP letter is no longer needed (every single time, none have actually asked for the letter in the end)

you shouldn’t have to pay for diagnosis letter

dds letters from consultant to gp have all been forwarded to me as an extra copy via post

anything else in terms of opinion yes you should pay for

dds diagnosis letter was free as i just gave the copy of the consultant to gp letter in

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This used to frustrate me when I was a student needing these forms, but having been on the other side for some years now, let me shed some light as to why YABU...

GPs receive lots of requests for forms to be completed, or letters to be written as evidence for external services such as schools, benefits system, work etc. the NHS does not pay practices for this work, so it's classed as non-NHS or private work, meaning practices don't get any reimbursement for this work at all.

Some letters may take 5 minutes, the vast majority take much longer. The time it takes to look through the notes & gather the evidence, complete the form/write the letter then send it on is typically more like 10-15 minutes, and with multiple requests, this means a significant amount of a GPs time is taken up doing this. As there is such a huge demand for NHS work (more appointments needed than can be provided), GPs are having to prioritise NHS work, meaning most of the forms have to be done outside of normal working hours or clinical time, leading many GPs to work well over their scheduled hours that they are paid for each week.

The NHS pay for NHS services, like appointments, and if GPs are doing forms, they aren't doing NHS services & hence not recieving any payment. Now do you expect these GPs to work for free, out of their own goodwill, to deliver these forms? Of course the GPs are going to charge for them, as this is private non-NHS work, meaning the patient has to pay for the service provided by the GP in place of the NHS (as they don't fund this), or else the GP is working for free and we can all agree that if they did this, they would be working many hours weekly for no pay, which is not how the world works.

It really grinds on me that as a society we have become so expectant of healthcare that is free at the point of use, that we forget that the NHS is struggling & not all healthcare services are fully or even partially funded anymore, and when we are asked to pay for a private medical service provided by hard working GPs in or outside of their working hours, we get tantrums & moans, yet you would not get the same if you were asked to pay for another service that isn't healthcare related. GPs and all other healthcare professionals should not be expected to work for free, and so it is absolutely correct that they charge for these forms/letters.

if you have an issue with paying for a non-NHS letter from your GP, take it up with the person requesting it, as I can guarantee the GP would much rather not write the letter (they have work coming at them left right and centre and could do without the additional non-NHS work that most of them have to do in their own time outside of normal working hours) as much as you would prefer not to pay for it. Sometimes services ask for these letters (which can cost a lot) when it's not necessary and all that is needed is evidence from the family or school. If it is definetly required, then rightfully you will have to pay to ensure your child gets the help they need.

Hope that makes sense.

GPs do not charge for the medical certificate of cause of death as this is NHS funded work. They complete the MCCD, it goes to the registry office & then you collect the death certificate after the registrar creates it from the MCCD & the deceased demographics.

Did you by any chance get an itemized bill from your funeral directors with the £87 charge on as death certificate to the GP? As it is standard for GPs to charge for cremation forms as this is non-NHS work, and the funeral directors pay them the standard £87 for this as laid out by the government. This is routine and has always been the case in the UK.

For your information, a medical certificate of cause of death takes a GP anywhere from 5 minutes (if they knew the patient & history very well & cause of death was clear) to hours in some cases (did not know the patient, more complex history to sort through, multiple factors or potential causes of death). The cremation forms take around 30 minutes to complete as they are detailed & involve a lot of background, they often also involve a visit to the funeral home which takes around 30-45 minutes. So not quick, and actually £87 is very reasonable for that much of a GPs time. Hope that explains.

GPs already work multiple hours of unpaid overtime each week to complete their standard NHS work (clinics & admin arising directly from seeing patients). A standard session for a GP is 4 hours & 10 minutes. GPs see 18-20 patients in these sessions & do all of the admin for them.

When you go and see your GP are they often running late? Of course, because lots of things cannot be appropriately managed safely in just 10 minutes. Emergencies also occur & urgent referrals can take time with GPs being stuck on hold to emergency units/the hospital. It is virtually impossible for a GP currently to fit all of the work for 18-20 patients into that 4 hours & 10 minutes. So they inevitably go over this, and work at least 1-2 hours free on top of each session.

Putting that into perspective, if a GP works 2 sessions in a day, they are paid for 8 hours & 20 minutes, so they are paid from 9-5.20 let's say. Add in a lunch break let's then say 9-6 (but being clear, nearly every GP I know works through their lunch break). So why is it most GPs work 8am-6pm/7pm? That's because they cannot physically fit all of their NHS work into the 8 hours 20 minutes. Adding that up for a full time GP, they would on average work 6 hours unpaid every single week. That's absurd, but it's the norm.

Now add on all of these non-NHS jobs, like forms, letters, reports etc. these have to be done outside of NHS contracted time. Well GPs already work many hours for free each week on NHS time, so adding even more free work time is just not feasible. Hence why practices charge so their GPs are fairly compensated for non-NHS work.

I don't think GPs would mind at all the odd form every now & again if they didn't work loads of free overtime every week, but they do work loads of free overtime already and are inundated with requests for forms and loads of other things. They need sleep & time with their families too...

It really grinds on me that as a society we have become so expectant of healthcare that is free at the point of use

@Muffins28 why would this ‘grind on you’? At the end of the day it’s what we pay NI for. I agree with some of your later points about non-NHS services, but generalising is unhelpful.

If we’re not to expect healthcare that’s free at the point of use, the we should be able to opt out of NI and get private health insurance instead.

I think as hospital consultants are employed directly by the NHS (and not by a private GP practice that is contracted to do NHS work), this is why it differs.

GPs are not contracted to write the letters, it's not part of their NHS GP contract, and hence falls outside of reimbursement by the NHS to practices. I think as a hospital consultant, these letters are classed as contractual NHS work (just like discharge letters are), meaning you are already being paid by the NHS for this work so you cannot charge extra. Realistically we all know you also have to slot these letters in during admin time as time isn't always alloted, but I think the difference is the differing consultant & GP contracts here.

I'm also not sure how many requests you get for these letters? GPs get quite a lot, often a GP will be asked to write a letter or complete a form for a patient they haven't directly consulted with or know very little about as the patient is registered under them. I think if the NHS added completing these forms into the GP contract they would go bankrupt as the GPs would be doing forms on NHS time (rather than privately on non-NHS time, but on the practices business time) and the number of patients being seen by their GP would plummet.

It would be interesting to hear your perspective a little more on this as I find it very fascinating how our jobs differ so much between primary and secondary care purely due to the contract.

You're right, but the school shouldn't need them to go into detail. If this was a student in FE or HE the institution would work with the student to formulate a support plan. This often does involve remote lectures/seminars and alternative assessments to presentations.

Everything important is under resourced and half-arsed in this country.

Do you have much experience of SEND legislation and the responsibilities it places on the NHS?

But will write something different if OP pays them 40 quid? Unlikely.

Yes I don’t have to fill anything like that number and it does relate to my speciality.

What has that got to do with GP practices??? Different organisation altogether! Like I said GP practices work alongside other services not FOR them!! GPS are by LAW allowed to charge for filling in forms - that includes forms regarding education! YOU or nobody else can change that just by making up something in your head about what you think GP practices should and shouldn’t do just because they work alongside 3rd party organisations - usually for safeguarding purposes! Not for education matters! GP practices are not a hub for education resources! Maybe research the BMA recommended guidelines regarding what GPs are allowed to charge for private non NHS work which is what filling out 3rd party forms is classed as - PRIVATE non- NHS work!

Exactly this!!!! That is correct - the school have all the relevant information to hand. Its all about getting a signature from the GP so they can wash their hands of any legal responsibility

So that’s the difference then. You may decide not to charge for those forms just because you might have to complete one every once in a blue moon but GPs get all sorts of forms - anything between 5 and 10 a day thrown at them that are completely unrelated to the NHS or general practice therefore it isn’t really fair to say that just because you don’t charge then GPs shouldn’t either.

Yes YABVU. The entitlement of some on this thread is also mind blowing.

Also by that theory you might as well say that schools shouldn’t be charging parents for school trips/ after school clubs/ school discos/ dress up days/ school dinners etc just because the NHS doesn’t charge patients for appointments because they have some sort of ‘responsibility’ placed upon them to work alongside educational services!!! It’s just a pointless non argument unfortunately and makes no sense 🙄

Its ok for schools to ask parents to pay ridiculous amounts of money for the services they provide to children - which those costs over the space of a school year equate to way more than £40 but it’s not ok for a GP to charge for a service that is completely unrelated to their actual job which is treating patients - Okay!

the fact that GPs are private businesses is ridiculous in the first place (and one of the root causes of current issues with primary care!)

GPa are NOT private businesses - they provide an NHS service by treating NHS patients. They are not private practices who charge for private consultations. However, filling out forms that are completely unrelated to the NHS (they don’t charge to fill out forms for other NHS services btw) is classed as private non NHS work for a GP therefore they are entitled to charge for that service

@Muffins28

you forgot that GPs actually CHOSE that much paperwork per patient when renegotiated the NHS contract. They were offered a flat rate with less paperwork but they wanted to be paid more per variable rate depending on type of work / patient /illness etc. So now them complaining about oh so much admin and forms is a bit rich

@littlebopeepp234

yes they are private businesses who have contract with NHS for NHS work only (hence are able to request payment for non NHS work). They are not NHS employees. The contract is regularly renegotiated too

I don't think forms know the differnce between for a child or adult, there is a fee that needs to be paid regardless of who the form it for

@Muffins28 I know GPs charge for cremation forms. But in the deaths I have had to deal with the GP has never visited the funeral home. Why would they?
What has always happened is the hospital Dr signs cause of death - they usually know what is the cause already. And if they dont a post mortem is organised. And a second Dr signs the form.
It is informally known as Ash Cash and an easy way to make extra money by Drs.