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There are a number of useful and interesting ways in which GPs can supplement their NHS income with private earnings ­ but don't give

up the day job, advises

Dr Peter Stott

NHS general practice offers a number of opportunities to earn private fees from NHS patients. They are very limited, however.

Most practices earn less than 8 per cent of their income this way because if private income earned within the practice premises is more than 10 per cent of all earnings, then the cost or notional rent is abated pound for pound. For the average practice with five whole-time equivalents, about £60,000 private earnings is average. But with a little ingenuity, this can be increased.

Practices can increase their private income by developing clinics like nurse-led travel clinics, insurance medicals or medical advice (not GMS/PMS services to nursing homes). Medical examinations for employment, third-party reports for insurance companies, medicals for flying or police work are all well remunerated at around the BMA-recommended rate of £176 per hour. Some, however, require further diplomas.

The qualification for flight crew certification is a two-week intensive course. Police surgeons are expected to sit for the diploma of jurisprudence. There is also a diploma in occupational medicine.

Remember the 10 per cent rule. If you intend to earn more, then think of working off the premises.


1. BMA 2004. Focus on private practice for GPs

Private fees which can be charged to NHS patients1

·Defined fees from statutory bodies for services related to various functions (eg, disability or fostering)

·Routine medical examinations requested by any body responsible for the care of the patient (eg employer or school)

·Services that are not primary medical services (eg, accommodation and services for private patients or those in a registered nursing home)

·Emergency care after a road traffic accident

·Care given at a police station

·Care for the purpose of creating a medical certificate or medical report for compensation

·Immunisations for foreign travel that are not remunerated by the PCO

·Prescribing drugs for malaria prophylaxis

·Prescribing drugs and appliances that may be needed during travel abroad

·Seat belt examination and exemption certificates

·Fitness to travel certificates

·Eyesight tests for driving

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