Why, if this an NHS Practice, are fees charged for some work

Although many services are indeed provided free of charge under the NHS, there are a number of additional services that we are asked to provide, that do not form part of the NHS core services. Charges may be made for work which is not part of a doctor's normal NHS responsibilities, for example: medical examinations for employment purposes, letters, and the endorsing of passport applications and photographs.

The charges which are made at this practice are displayed on the Reception Desk. They may occasionally be reduced or waived, but only in exceptional circumstances.

The reasons why there are charges are as follows:

• the doctors believe that it is reasonable that they receive appropriate remuneration for work for which they are not remunerated by the NHS
• the practice is committed to informing all patients in advance of the existence of a charge
• the doctors review the level of charges on a regular basis, and will occasionally reduce a fee if they conclude that it is inappropriately high (this has happened in the past); however they would like patients to be aware that often it is not obvious how much work has been needed to produce the end product, which may sometimes be only a short letter; the charges reflect:
• the time taken by doctors to review patient notes
• the responsibility that the doctors take when they declare a patient, for example, fit or not fit to drive or travel
• administration costs (involving secretarial and reception staff).