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Practices set for visits from patient watchdog over charges for medical letters

Exclusive The patient watchdog is set to visit practices that it deems are charging too much for non-contractual services, after NHS England branded variations in charges as ‘unacceptable’, Pulse has learnt.

Healthwatch has already held talks with the GPC over what it calls ‘unfair’ and ‘disproportionate’ fees charged by practices for services that fall outside their contractual work, such as providing medical letters and records.

But GP leaders have pointed out that, as independent contractors, GPs are unable to set national fees for such services and there is no national NHS guidance for GPs.

The watchdog claims that one practice charged £350 for a letter to report her 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 agreeing there was ‘unacceptable variation and inconsistency in charging policy by some GPs’.

However, he ruled out Healthwatch’s suggestions that such services should become contractual duties.

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

The watchdog wrote to Dr Geddes earlier this year listing examples it claims to have uncovered, including:

  • A man charged £110 for a copy of his medical records, which he needed to appeal against the suspension of his Employment and Support Allowance
  • A mother charged £350 for a letter to report her child with special needs was well enough to take part in a Christmas play
  • A person charged £50 for medical records to support their claim for indefinite leave to remain as a victim of domestic violence
  • Varying fees in one area ranging from no cost to £250 for a GP to sign Power of Attorney letters of support

In particular, the group queried why patients were being charged for medical reports and assessments ‘given the Government’s agenda on transparency and patient empowerment’ and whether in future GP medical letters of support for patients ‘is going to be considered as part of the commissioning responsibilities of GP contracts’.

Following that initial 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 had met with representatives from Healthwatch England and had 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 GPC is not in a position to set fees nationally and we also discussed our guidance, which they found helpful.’