Private practice for General Medical Services (GMS) and Personal Medical Services (PMS) contractors is tightly regulated, particularly when it comes to charging NHS-registered patients for care. Under Part 5, Regulation 24 of the National Health Service (General Medical Services Contracts) Regulations 2015, as well as corresponding clauses in PMS contracts, there are clear restrictions on charging NHS patients for medical services. These regulations exist to ensure that NHS services remain free at the point of delivery for those registered with NHS practices.
GMS and PMS contracts do not prevent contractors from accepting private patients, but there are specific stipulations. Notably, private patients cannot be registered with the NHS practice under the same contract. In other words, patients who choose to pay for private services must not be included in the practice’s NHS roster for the purpose of NHS care.
There are very limited exceptions where a fee may be charged to NHS-registered patients. For more information on these specific instances, please refer to the section “What can I charge for?”
In October 2019, new regulations were introduced to prevent conflicts of interest between private and NHS services. Specifically, these regulations prohibit GP practices from offering or advertising private services during NHS working hours or on NHS-funded property if the private services fall under the category of primary medical services. Essentially, NHS practices cannot charge for, or even offer, the same primary medical services during NHS hours and on NHS premises.
However, these regulations do not prohibit practices from charging non-registered patients for services outside the scope of NHS primary medical care, nor do they prevent practices from charging for certain services under specific conditions. Practices are still permitted to charge for services not commissioned by the NHS or for private services provided to patients who are not NHS-registered.
Despite the general prohibition against charging NHS-registered patients, there are some instances where practices may charge for specific services. According to Schedule 5 of the GMS contract and Schedule 3 of the PMS agreement, practices may charge for the following services:
It is important to note that NHS-registered patients cannot be charged for healthcare services, whether those services are available through the NHS or not. The exception to this rule is limited to the circumstances outlined in Schedule 5 (GMS) or Schedule 3 (PMS), which include:
While GMS and PMS contracts allow for the possibility of private practice, the ability to charge NHS-registered patients is highly regulated. Practices must carefully adhere to the rules to ensure that they are compliant with the regulations governing NHS care. In general, NHS-registered patients cannot be charged for services, except in the limited circumstances outlined in the GMS and PMS agreements. Practices must be aware of the restrictions surrounding private services during NHS hours and on NHS premises to avoid legal and financial repercussions. For further clarification or specific inquiries, we recommend seeking advice from legal professionals or regulatory bodies.