If we can't charge for travel medicine must we do it free?
Is travel medicine a core service that GPs have to do? If it isn't, but we are not allowed to charge for the service, are we obliged to do it for nothing?
Primary medical services for NHS patients remain free at the point of delivery in the new contract and the existing prohibition on charging NHS patients remains, except in a very limited range of circumstances that are outlined in the contract.
Currently, a GP may charge for many travel vaccines, but these are provided free for infectious diseases if there is a risk that the traveller could return and spread disease in the UK. Vaccinations against typhoid, polio and hepatitis A are included in this category.
Paragraphs 462.7 and 462.8 of the new contract make it plain that some charges for travel requirements are still permitted.
This includes the sale of drugs that may be required while the patient is away, but which are not needed immediately.
It is not clear what payments the PCO will be required to make in order to prevent the spread of infectious disease.
However, if a PCO is not prepared to pay, it will be permissible for the practice to charge for the supply
and administration of the travel vaccines.
A practice is not bound to provide travel vaccinations, but if it does it will be bound by the specifications contained in the new contract.
A practice that does not choose to provide travel vaccines under the NHS would probably find it
difficult to run a travel clinic privately.
It is still not clear whether a GP may charge for travel advice and this will probably not be established until a test case is brought.
Dr Bob Button, chief executive, Wessex LMCs
· Schedule 5 page 36 (Fees and Charges) of the NHS (GMS) Regulations 2004 replaces the current paragraph 38 and does not essentially change the situation regarding
travel vaccines. Travel vaccines
that the GP could charge for in the old contract can still be charged for in the new contract.
· Travel vaccines that were given by the doctors with the item of service A or B fee under the old contract have now been included in the global sum as an additional service. An opt-in is therefore assumed but should the practice opt-out its global sum will be reduced by 2 per cent. This is detailed on page 9 of the statement of financial entitlements (SFE).
· The personal administration system will continue under the new contract and is detailed in the SFE in paragraphs 18.2 and18.3.
· Page 24 of the new GMS contract regulations provides further information about vaccinations and immunisations in terms of advice
that must be provided to the patient, the training of staff and the audit trail needed.
Neither Pulse nor Wessex LMCs can accept any legal liability in respect of the answers given. Readers should seek independent advice before acting on the information concerned.