Private (Non-NHS) Services

Patients will sometimes consult with a view to getting a note from their doctor. Some of these requests for letters are reasonable. For instance, in insurance medical reports where some knowledge of the patient's medical background is important and so the GP has something useful to contribute.

Sadly, many of these requests range from unnecessary to frankly absurd. Many are requested by people in positions of administrative responsibility who are not willing to believe information supplied by the patient, seek to avoid or shift legal responsibility for potential adverse consequences, or choose to impose effort and cost on the patient regardless of the effects on other services. Examples include letters to certify fitness to travel, fitness to work and fitness to undertake certain activities, e.g. acting, modelling, sitting examinations, using the gym, starting an exercise/diet programme, parachute jumping, diving etc.

At other times patients may come for letters on their own initiative, often in an attempt to recruit the doctor's support to avoid something undesirable, e.g. justifying an absence from work, trying to get off a speeding fine, etc.

Regardless of how valid the request may be, these letters are a form of medical report. They are therefore classed as private work and attract a fee. Please see the Practice Price List.

Letters for Court

It is not uncommon for patients to request "sick notes" to explain why they did not attend, or cannot attend, court. In some instances such requests may be motivated by an understandable anxiety due to the fact that they know they are likely to be found guilty of an offence.

All such requests must come from the courts. Doctors who have provided sick notes for such purposes, other than at the request of the court have, in the past, been heavily censured, and risk being found to be in contempt of court.

Note, also, that Med 3 and self-certification certificates are for statutory sick pay purposes only, and should only be used for statutory sick pay.

please see this link: https://www.gov.uk/jury-service/overview

Excusal from Jury Service

Similar rules apply to patients who want evidence to excuse themselves from jury service. Your doctor does not have to provide you with a letter unless asked for by the court - Delaying or being excused from jury service

In addition, if a patient requests a "sick note" because they are anxious about appearing as a witness, they might find it helpful to visit Victim Support, and they should contact the court for advice about the witness counselling and protection services that are available.

Policy regarding requests from private service providers to take blood tests

The Vale or Neath Practice adheres to the following guidance regarding requests for blood tests to be done by a private consultant or other clinician operating on a private basis. 

If a patient has chosen to pay for private healthcare because:

1. their treatment is not available on the NHS    or

2. they do not wish to be treated on the NHS     or

3. they have an insurance policy which covers private treatment.

then the patient is responsible for paying all associated costs (including blood tests), and the private service provider is responsible for managing every aspect of their healthcare. This policy will remain in place, unless the patient decides to transfer back to the NHS at a later date to continue their treatment.

For this reason, private service providers should not be asking GP's to arrange any blood tests that they deem necessary, and intend to use, to make a clinical diagnosis and/or recommend a course of treatment with.

It is the private service provider's responsibility to arrange blood tests for patients whose care they are managing, and the patient's responsibility to pay for such tests.

Policy regarding requests from private service providers to start or take over prescribing medication

In addition to the above policy, The Vale Of Neath Practice cannot prescribe medications on behalf of private service providers, nor continue to supply prescriptions which have previously been supplied by the private service provider. We are not permitted to have shared care protocols with private service providers.

Private consultants wishing to transfer patients to NHS care should directly refer their patient to the appropriate NHS service who will reassess and, if appropriate, take over the patients treatment. At the point where the patients care has been taken over by an NHS service, a request may be made by the NHS service to share prescribing responsibility with the practice.