There’s no getting away from the fact that GP practices are moving inexorably towards a more business-focused model. This development has corresponded with a greater emphasis on optimising costs, increasing output, placing a greater emphasis on staff and patient relations and, crucially, maximising revenue streams.

Charge the going rate

An easy way to ensure you’re maximising your income is by charging at least the going rate for services provided on a day-to-day basis – things such as patient letters, doctors’ reports, taxi driver medicals and so on.

The BMA suggests fees that GPs may charge their patients for non-NHS work (i.e. work not covered under their contract with the NHS) in order to help GPs set their own professional fees. However, the fees suggested are intended for guidance only; they are not recommendations and therefore a practice is not obliged to charge the rates they suggest. Details of these fees can be found here, where there’s also a handy downloadable fees ready reckoner here (bottom of page).

The guidance is a good place to turn for anybody unsure about fees and includes information on:

• Fit notes
• Reports for insurance companies
• Fees for copies of patients’ medical records
• Working for coroners
• Debt recovery
• Guidance on adoption and fostering fees
• Who pays forensic physician fees?
• What to say when your patients ask why GPs charge fees

Priorities for PMs

Once you’re happy that you’re charging the right fees for the right work, Practice Managers should check that all GPs are charging patients for approved private items such as private certificates, travel insurance claims and travel vaccinations. Check that you have tight systems for collecting and recording the money.

Also, make sure that you’re increasing fees on an annual basis – at least by inflation. It’s also worth finding out what other practices are charging to ensure you are not too far out of line. A discussion on this topic is actually live at the moment on the Practice Index Forum.

Publicising your fees

It’s highly recommended that practices tell patients in advance if they will be charged, and what the fee will be. It’s a good idea for surgeries to have lists of fees posted on noticeboards and some may wish to add a list to their website – either on a separate page or as a downloadable pdf.

On their price lists many practices also list who is responsible for paying fees – patients, insurance companies etc – in order to clear up any confusion.

Fees from organisations

It’s also worth checking your claims and chasing late payments regularly. Fees for both PMA reports and examinations have risen considerably in recent years. If any company offers a lower fee refuse the service. Check fees for letters to solicitors and employers – when were they last increased? Charge by length of letter and get a written agreement to the fee in advance. Remember you are charging for your professional opinion as well your time. Check that all cremation fees are recorded, and chased.

Policy changes ahead?

What practices can and cannot charge for services such as minor surgery may well change soon as numerous bodies push for regulation changes. Watch this space for updates as they happen.

And finally…

While researching this blog post we were asked by a practice manager to clear up a question they had. It was: Can a practice charge if a patient does not attend for a travel vaccine appointment?

The answer is: If a practice is offering travel vaccines to its own patients, it cannot make any charge to its patients for this, not even a refundable ‘deposit’ charge. If a practice is offering travel vaccines as a private service to non-registered patients, then the practice can charge for this service.

Travel vaccines not provided anywhere under the NHS for public health reasons can be privately provided by practices. Some practices will have opted out of providing an additional service for vaccinations and immunisations, therefore they cannot provide any vaccine available on the NHS to their patients. They could privately provide vaccines not available on the NHS.

What do you charge for and how much do you charge? Let us know by commenting below or join the conversation on the Practice Index Forum here.

Topics trending in the forum:
PM appraisal (NEW REPLIES)
Staff rotas!!! (groan)
Part time practice managers – how do you do it?
Private work – fees