Practices charging too much for non-contractual services to receive visit from patient watchdog

Healthwatch has already held a discussion with the General Practitioners Committee (GPC), outlining the fees as ‘unfair’ and ‘disproportionate’.

GP leaders have responded by pointing out that, as independent contractors, they are unable to set national fees for such services, meaning there is no national NHS guidance for the GPs.

The watchdog claims that one incidence saw a practice charge £350 for a letter confirming a child with special needs was well enough to take part in a Christmas play.

NHS England’s head of primary care Dr David Geddes wrote to Healthwatch in April, voicing concerns that the there was an ‘unacceptable variation and inconsistency in charging policy by some GPs’.

Following meetings with the GPC, Healthwatch said it will visit practices that it believes are charging patients too much.

A number of incidents have come to light where patients have been over charged. These include a man being charged £110 for a copy of his medical records, which he required to appeal against the suspension of his employment and support allowance; a person charged £50 for medical records to support their claim for indefinite leave to remain as a victim of domestic violence and varying fees in one area ranging from no cost to £250 for a GP to sign power of attorney letters of support.

Subsequent to the meeting, Healthwatch England said it is putting pressure on the GPC. In a statement, Healthwatch chief executive Katherine Rake said: "We met with the GPC and have asked them to encourage consistency in charges and transparency in why they are being charged and what they will be charged for."

She added: “We will also continue to work with the BMA to support the Healthwatch network in checking for letter-charging fees during their Enter and View visits, to ensure better transparency for the public.”

The GPC confirmed it has discussed the issue with Healthwatch England and explained the BMA’s own guidelines on setting fees.

Dr Richard Vautrey, deputy chair of the GPC, said: “We met with Healthwatch because they wanted to understand why there was inconsistency in approaches by practices on the issue of charging for private work, such as writing letters or doing reports for patients.

“We explained how practices are independent contractors and that the GPC is not in a position to set fees nationally and we also discussed our guidance, which they found helpful.”

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