Fit to work certificates-advice please....

[It's Showtime]

Isn't this interesting? NHS GPs are funded by the taxpayer... it's not like eg., a solicitor who charges £xx an hour as that is how they make a living.
I also get cross at the NHS GP 0845 numbers - this is a way for the partners in the GP practice to make even more money out of the ill - don't get me started.
However, back to 'fit for work'; I almost wish they had addressed the letter & invoice to my DS as it would have been fun seeing them trying to extract money out of a minor!! Perhaps there's a NAPM/NAPD who is a NHS GP who would like to comment?

[Hecouldshine]

We've had this debate several times on here. I have joined in a few times as I am a GP. All I can say is that NHS GPs are paid for each "item of work" for the NHS, which doesn't include producing "Fitness to Do" letters. The problem is that Gyms, Councils, employers, Housing Agencies, all would like bits of paper to say someone is or isn't fit, to stop themselves being sued. The government doesn't pay for GPs to do this; so the time spent on it is time we can't see a patient with an NHS problem, and it may actually cost us money if we have to pay our secretaries to type it up. We try to deter most organisations from demanding these certificates as they really aren't worth the paper they are written on, let alone your money for paying for them. All it does is say that the particular person doesn't have a problem on the day it was signed . If you are going to a private GP for it to be completed then how can they guarantee there is no problem? They don't have the person's NHS notes. In most cases it is the organisation who demand the letter who are ripping you off because they are not prepared to take your word that you are fit and insure themselves properly against potential problems. We, as GPs, really would prefer to not do the certificates. It can take 2 weeks because we have so much admin anyway and have to prioritise. When we see new organisations demanding certificates we usually protest to our Local Medical Committee to try to get them withdrawn. The charge is more of a deterent to stop the organisations demanding bits of paper.

Having said that there are ways of getting this done cheaply and maybe quickly . What would work best for me is if you book a routine appointment for your child (without telling the receptionist what it is for) , bring a typed letter with you saying they are fit etc etc, that all I have to do is sign and stamp, AND........don't ask for anything else. I will be sooooo grateful that you have allowed me an opportunity to catch up on my regular surgery and maybe even make the "supposed" coffee break for once, that I will smile eagerly, sign, and not ask you to pay anything. Of course I will not dare to mention this to my GP partners HOWEVER if you say "while I am here" and proceed to bring out a list of queries about anyone in the family's health, then I probably WILL remember to ask for payment

I think GPs enjoy seeing healthy happy children and won't like charging for these letters so if you have a regular and sympathetic GP you should get away with the minimum charge for a basic certificate which is in the region £11-15, or nothing if you are lucky. I know several on here say their child sings to the GP as payment

Good luck!

[It's Showtime]

Hi HCS

Thanks for that!! - Interesting insight into a GP surgery & really apreciate your time taken. Loving the 'take up an appointment time' will try that next time, although feel sooo guilty taking up GP time, but as you say NHS GPs are paid for each "item of work" for the NHS, so that appointment, a GP will get paid for.

However, 'the charge is more of a deterent to stop the organisations demanding bits of paper': can't see how that that will stop at the moment as that seems to be the pre-req & the only person who 'suffers' if you can't pay for it is the child who loses the work, that may have taken so much determination & hard work to get.

I still think I may object to 100% increase - sorry to have taken up so much time, but I have to confess, I was quite shocked at a 100% increase in such a short space of time. What do others think?

[Hecouldshine]

[quote="It's Showtime] NHS GPs are paid for each "item of work" for the NHS, so that appointment, a GP will get paid for. [/quote]
You're welcome It's showtime

Strangely enough we won't be paid for that appointment as it doesn't actually contain any NHS "item of service" work. But I would be thinking "worth losing income if it is an enjoyable short easy consultation that lets me catch up AND make my coffee break later!" Of course those GPs who think in a more business like manner won't agree with me

I think the cheapest solution will always be if you have a typed letter that just needs a signature and the practice stamp.

[It's Showtime]

Thanks HCS
Apreciate any advice & suggestion - Gosh! it's quite frightening how cost differs from practise to practise. Wish you were our GP!!!!!!! Must be so difficult trying to juggle budgets against targets & keeping everyone happy!
With best wishes to all & thanks for all comments - think it's the 1st time I've been brave enough to raise an Issue all by myself but I did feel really strongly about it ..... so thanks for being so gentle!!
& perhaps DS will try singing to our GP & I might beg! ...on second thoughts.... perhaps not. (beggin that is!)....

[Hecouldshine]

There used to be list of recommended prices for different medical certificates, examaninations, reports etc etc that aren't covered by the NHS, produced by the British Medical Association, but they discontinued it about 2004 because it left GPs vulnerable to anti competition accusations. Since then GP practices have roughly increased (or decreased) it in line with inflation or anything else they think a suitable way of estimating a fair price. Traditionally they have looked at the hourly rate that solicitors or accountants charge, and pegged it somewhere around there. Hope that makes the system a little more understandable (if not bearable ).

[It's Showtime]

Really Helpful HCS -thanks!

[Dawn]

What would work best for me is if you book a routine appointment for your child (without telling the receptionist what it is for) , bring a typed letter with you saying they are fit etc etc, that all I have to do is sign and stamp, AND........don't ask for anything else. I will be sooooo grateful that you have allowed me an opportunity to catch up on my regular surgery and maybe even make the "supposed" coffee break for once, that I will smile eagerly, sign, and not ask you to pay anything. Of course I will not dare to mention this to my GP partners HOWEVER if you say "while I am here" and proceed to bring out a list of queries about anyone in the family's health, then I probably WILL remember to ask for payment

Great advice HCS but I tried this (as we were told writing in would take at least 2 weeks to get a reply ) the GP was lovely to my dd and we were only in the room 2 minutes. She signed the letter and stamped it . . . . . and then told me it would cost me £26 and to pay on the way out! I did challenge her but she said it was "practice policy"

Good luck to anyone else trying.

Dawn .x.

[Hecouldshine]

Oops. I'm really sorry about that Dawn I guess it was worth a try, but I'm sorry my suggestion didn't work

[tikka]

DS hasn't been to a doctor for about 11 years (not bad going as he is now 15!) but had a letter a while ago about going for a 'youth check up'. I thought I could take him in for this, and at the same time ask them to sign a letter to say he's fit . Then, just in case he gets a part in something needing a licence, we are ready! Just wondered.....
If I type out a letter for them to sign whose address do at put at the top - mine doesn't seem right, doesn't seem right to use the doctors one either! Think what I'm asking is...what do I put on the piece of paper I want the doctor to sign!

[Hecouldshine]

Hi tikka. If you leave a space at top, address it "To Whom it may concern" then put DS name and address and dob below, and get practice to stamp the top and bottom as well as sign, then it should be fine, so long as the practice stamp/GP stamp has the address on it, which it should do! Sounds like quite a good way of doing it, via a youth health check! Suspect they will still charge something

Be warned, you may find they are using the youth checks to plug the chlamydia testing, as they need to get numbers up for this government initiative!

[tikka]

Plan didn't work! the 'health check' is done by a nurse, who can't issue med cert, so may still have to make an appointment to see a doctor to get the letter signed! The receptionist emailed the doctor to ask how to get a certificate, but the doctor won't deal with it till thursday during her admin time...and then she might say to book an appointmnet to go in....so it could take me a couple of weeks to get it sorted. Just as well I'm not in a desperate hurry. Price quoted was 15-30 pounds depending on how long it took to do.

[Fruitcake]

We have never paid for a letter fromr GP, but we know which one to go and see! I always make a routine appointment to see a certain GP who used to be a professional actor, so is always very interested in what DS is up to!!!! He has never charged me, and we are only ever in there a few minutes.

However, I once needed one very urgently and had to make an appointment with another partner. She initially refused to do it, saying we would have to book a long appointment for a "Health Check" and it would cost some extortionate amount of money (can't remember exactly how much now). After a little wrangling and appealing to her better nature, she agreed, albeit extremely begrugingly, to do it for me "just this once" but said in future I'd have to book aHealth Check appointment and pay for it. She said that the other GP was totally wrong in doing it for me for nothing and that she would be bringing it up at the next staff meeting!!!

Needless to say, I just went back to the other partner next time, who did it for me for nothing as usual!!!

[GEORGIEROSE]

We have vever paid either,
I booked normal routine GP appointment had a note written myself saying dd fit to perform etc,GP signed and stamped it there and then after very brief look at her and chat and that was it,perhaps we have been lucky.

[tikka]

Phoned to ask for a letter last friday. They have just phoned to say it will be ready next weds, and it will cost 9 pounds (anyone know how to fix my 'pound' sign, it does hash instead?). Good job we aren't in a hurry.

Next time I will just book an appointment and take a letter along for her to sign as it will be quicker.