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How to deal with requests for non-contractual work

GPs have the difficult job of trying to be both Mother Teresa and Lord Sugar. Patients don’t understand our funding arrangements, and why should they?

Here are my five tips:

1. Have a poster in your practice explaining that some consultations and reports require a fee because they are outside the GP contract – for instance, reports for exams, fitness to travel, fitness for sporting events.

2. Give a list of these on your website.

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3. Give information about private GP services in your area (if there are any).

4. For the new school reports, there seems to be no information about who will pay or how they will be funded. A fee of £150 an hour is reasonable. One option is to refer all such requests to the community paediatricians or the public health service.

5. Be prepared to explain that it is not up to the practice to develop care plans for the pupils, but you would be happy to follow/implement them once they have been written. Suggest that the school might contact the Department for Education for information on protocols for the development of care plans.

Dr Fiona Cornish is a GP in Cambridge and a former chair of the Medical Women’s Federation