Request for Private Administration

This leaflet and form is intended for all patients making a request for a non-NHS (ie private) service from the Practice. We would ask that you read this carefully. Private forms are not part of the NHS services provided by the Practice and as such are completed by the doctors voluntarily and at their discretion. However, we have always offered this service in the best interests of our patients. In addition, we are also aware that in the majority of cases, these requests have significant financial implications for our patients such as insurance claims.

However, the Surgery’s priority will always remain the healthcare of our patients and therefore private forms will be completed ‘as and when’ the doctors are able. In recent years the volume of private requests (such as holiday, mortgage, property, occupational, insurance, sport, leisure forms to name just a few) has soared and as such represent a significant threat to our core NHS work. At present the doctors work 13-15 hour days dealing with core NHS work and therefore time spent on your form will be after this time.

The Surgery cannot predict or guarantee when your form will be ready but (apart from during periods of partner annual-leave) we will attempt to complete forms within around 3 weeks (15 working days) from the date they are submitted. Forms will be completed on a strict first-come basis (as we understand that all forms are important and ‘pressing’ for all our patients). Please ensure that all relevant ‘initial’ sections of the form which are not intended for the doctor have been completed by yourself prior to submitting the form (failure to do this will lead to delays). Once you have completed this sheet and your private request has been logged by one of our administrative staff, we would request that you do not try and contact them within a 2 week period (10 working-days) as this only reduces the time they have available for NHS (and non-NHS) services. If you would like to receive an e-mail to inform you when the form is ready for collection, we will be pleased to contact you by this means. Please note that the surgery never posts private forms onwards (even if a SAE or pre-post envelope is included). You will always therefore need to collect your form.


We must charge for any form or letter which falls both outside core NHS healthcare work (ie is private) and requires a professional signature and indemnification must be charged for. This also helps the Practice to protect front-line acute NHS services through offsetting the time spent on the current volume of non-NHS work. Note that a form requiring only a minimal review of medical records and just a professional signature (with no other sections to complete) will still take 15-20 minutes to process (including records review/form completion/scanning, recording and other administration time). Charges will be based upon time taken though the following table will give you a guide to the charges. (Our charges are equal to or lower than national guidance figures). Once the form is submitted we will have to make a charge even if the request is subsequently no longer needed. We DO NOT make a charge for completing the single page at the back of Attendance Allowance applications.