Letters

Fit to perform, run, attend, travel letters etc	£ 27.00
Certificates without examination Updated 01/04/11
Straightforward certificates of fact	£ 16.00
More complex certificates                                                 £27.00 to £57.00 private sick note (incapacity certificate), required by patient for presentation to an employer (except those that the doctor is obliged to provide for statutory sick pay (SSP) purposes) accident or sickness insurance certificate - short certificate of incapacity without examination for patient to claim under accident or sickness insurance freedom from infection certificate, eg for school, travel or employment validation of private medical insurance (PMI) claim form, to support a claim or benefit in connection with private medical insurance, or completion of a 'pre-treatment' form school fees and holiday insurance certificates health club; brief written report to certify that a patient is fit for exercise Note: Patients have the right to see the report before it is sent to the insurance company. If a request is made, the insurance company should inform the GP and the patient has 21 days to arrange to see it.
Passport form countersignature	We no longer provide this service for our patients.
Proof of registration letters ONLY given to asylum seekers / refugees on request from the Home Office	No Charge
Claim form: Sickness/accident benefit	£16
Wandsworth Council Medical Assessment	£25.15
DVLA Medical Questionnaire without Examination	£39.00
Ofsted Childminders Form	£87.50
Solicitor’s report up to 2 hours / Daily Maximum	£52.80 / £211
Reports
• GP report for insurance applicants (written or typed in    templates)	£97
• Supplementary report	£25
Access to medical records under Data Protection Act
• Computerised records only	£10.00 maximum
• Manual or combined manual/computerised records	£50.00 maximum

Work for pharmaceutical companies

Updated 01/04/2008
Note: No fee can be charged for notification of adverse drug reactions.
a) Post-market surveillance forms -     per form                                  -     more detailed form                 b) Completion of medical research              questionnaire c)      Participation in clinical trials (per hour)	£16.50 £32.50 £42.50 to £106 £223
Coroner’s Report
Updated 01/04/09    For funeral director members of NAFD and SAIF Allowances:  Mileage at 56.4p per mile
a)         Form 4             -           certificate of medical attendant:         £73.50 b)         Form 5             -           confirmatory medical certificate:        £73.50
Medical Examinations
Pre-employment examination	Charged at the rate of £196 / hour
Driving
• Elderly, taxi, racing driver fitness, HGV, with/without examination	Charged at the rate of £196 / hour
Sports fees
• Full examination with report	Charged at the rate of £196 / hour
Fitness to attend Sports, school, university, etc.	Charged at the rate of £196 / hour
• Full examination and report
Vaccinations
International certificate of vaccination	£16.00
Private Yellow Fever	£50.00

• Please note that we will no longer be able to accept cash payments at week-ends for Non-NHS work. Payments at week-ends must be by cheque only.
• Prices are updated in line with annual recommendations. Last updated May 2011.

 

Not all services that we are required to provide are funded by the NHS, for example medicals for travel, insurance or employment. 
Balham Park Surgery is entitled to charge for all Non-NHS Services. We generally apply rates recommended by the BMA (British Medical Association).

See our current pricing structure for Non-NHS services. (last updated May 2011)

Please note: Prices are updated in line with annual recommendations.

Why GPs charge fees?
Accessing your medical record.

GP Referrals To Private Consultants

Patients may have private health cover which they wish to use to see a specialist privately.  If their insurance company require a referral from a GP, the GP may ask to see them to discuss it first, and provide a referral letter at a later date.

Prescription Requests Followings Private Consultations

GPs are not obliged to prescribe drugs at the request of a private specialist or a patient following a private consultation.

Local guidance on this subject dictates that;

"If patients opt to be treated privately then they should be prepared to be responsible for all costs associated with the management of what they are being seen for, including drugs".

Medications recommended following a private consultation may be prescribed at the discretion of GPs if they feel it falls within their remit and it is in-line with what they normally would have prescribed had the patient been seen under the NHS (with reference to local and national guidelines). Patients should therefore note that these drugs will not necessarily be prescribed on the NHS .

In general, private referral and all costs associated are the responsibility of the patient. Costs of any prescribed medications resulting from private consultations are also the responsibility of the patient, who should not expect them to be prescribed on NHS prescriptions.

Access to Medical Record

How do I access my medical records?

Doctors have always had the discretion to allow patients to see their health records and to share information where appropriate with the carers of children and incapacitated adults. Additionally in recent years Acts of Parliament have given certain statutory rights of access to records. None of the legislation prevents doctors from informally showing patients their records or, bearing in mind duties of confidentiality, discussing relevant health issues with carers.

The implementation of data protection legislation in early 2000 changed patients' statutory rights of access to their health records. The purpose of this guidance is to set out in some detail the legal requirements on doctors as holders of health records. This summary highlights the main points.

What records are covered?

All manual and computerised health records about living people are accessible under the Data Protection Act 1998.

Does it matter when the records were made?

No, access must be given equally to all records regardless of when they were made.

Does the Act cover all of the UK?

Yes.

Who can apply for access?

Competent patients may apply for access to their own records, or may authorise a third party, such as their lawyer, to do so on their behalf. Parents may have access to their child's records if this is in the child's best interests and not contrary to a competent child's wishes. People appointed by a court to manage the affairs of mentally incapacitated adults may have access to information necessary to fulfill their function.

Are there any exemptions?

Yes, the main exemptions are that information must not be disclosed if it:

• is likely to cause serious physical or mental harm to the patient or another person; or
• relates to a third party who has not given consent for disclosure (where that third party is not a health professional who has cared for the patient).

Must copies of the records be given if requested?

Yes, patients are entitled to a copy of their records, for example a photocopy of paper records or print out of computerised records.

Can a fee be charged?

Yes, and the fee varies depending on the type of record and whether the patient wants copies of the records or just to see them.

Charges to provide access and copies:

Records held totally on computer: £10 
Records held in part on computer and in part manually: a reasonable fee of up to £50 
Records held totally manually: a reasonable fee of up to £50

Charges to allow patients to read their records (where no copy is required):

Records held totally on computer: £10 
Records held in part on computer and in part manually: £10 
Records held totally manually: £10 unless the records have been added to in the last 40 days when no charge can be made

If you are applying to access your health record you will need to;

• Let our Non NHS / Finance Administrator know in writing.
• Provide identification as well as proof of current address. Original copies must be available when collecting your information.
• An initial administration fee of £10.00 will be charged. This must be paid by cash or cheque. Please make all cheques payable to Balham Park Surgery.
• There may be an additional charge payable when you collect your records.

What about access to the records of deceased patients?

The Data Protection Act 1998 only covers the records of living patients. If a person has a claim arising from the death of an individual, he or she has a right of access to information in the deceased's records necessary to fulfill that claim. These rights are set out in the Access to Health Records Act 1990 or Access to Health Records (Northern Ireland) Order 1993. The provisions and fees are slightly different from those in the Data Protection Act.

In these circumstances please contact our Non NHS / Finance Administrator  on 020 8772 3322. Latest guidance on confidentiality and on sharing information with relatives and carers is available from the BMA's Medical Ethics Department.

All doctors and nurses are happy to advise about methods of contraception.

• Oral contraceptives: please make an appointment with a practice nurse (or a GP)
• Diaphragms: can be fitted by Sara, Lead practice nurse
• Coils: Fitted by Dr Swanne.  Please make a telephone appointment with her to discuss.  For a “coil check” please book an appointment with a practice nurse.
• Contraceptive implants: we offer the implant Nexplanon, please book an appointment with a practice nurse to discuss this option.
• Contraceptive injections: are administered by the practice nurses.
• Emergency Contraception: Please contact a practice nurse (or a GP) as soon as possible.

See the patient information leaflet Contraception Choices.

If you are planning a pregnancy, please make an appointment to see the practice nurse for health advice.
Please make an appointment with the GP in the first 8 weeks of pregnancy: the GP can provide you with information and advice about common symptoms of pregnancy and will arrange for referral for booking at the hospital of your choice.
We usually provide shared care with your hospital. You can see your doctor in a normal surgery for ante-natal and post-natal checks, or see a midwife at Balham Health Centre.
Community midwife office: 020 8725 2535

To book a tour of the maternity unit at St George's Hospital you can call: 02087252536
Postnatal check: 6 weeks after having your baby you should make an appointment with the GP for a general health check.
Pregnancy Information Leaflet

Health visitors will provide support and advice in the weeks following birth, and up until your child is 5 years old. 
You will be contacted by the health visitor and visited at home soon after birth.
You will be contacted by letter to invite you to the clinic for an 8 month and a 2 year developmental check.

Our Health Visitors are not based at the surgery, but run drop in clinics here on a Thursday from 13.00 – 14.45.  They also run a pre-booked clinic on Mondays, but this is generally reserved for 8 month checks. 
They would prefer you to access their help via the drop in clinics, but can also be contacted on 020 8767 0193.

Courses/groups run by the health visitors:

• Post-natal course: this takes place on a Wednesday morning over 4 weeks.
  It is a great opportunity to meet other mums from the area whilst discussing and learning about common issues affecting newborns and new mothers.  It is held at the surgery. 
• Weaning group: this takes place on a Wednesday from 11.00 – 12.00 and is held at Hillbrook Childrens Centre in Tooting

Please discuss with the health visitors or call the team on the above number if you would like to attend one of these groups.

Local breast feeding support services.

The practice nurses will give routine childhood immunisations as outlined in the following schedule:

When to immunise	Diseases protected against
Two months old	Diphtheria, tetanus, pertussis (whooping cough), polio and Haemophilus influenzae type b (Hib) Pneumococcal infection
Three months old	Diphtheria, tetanus, pertussis, polio and Haemophilus influenzae type b (Hib) Meningitis C
Four months old	Diphtheria, tetanus, pertussis, polio and Haemophilus influenzae type b (Hib) Meningitis C Pneumococcal infection
Around 12 months old	Haemophilus influenza type b (Hib) Meningitis C
Around 13 months old	Measles, mumps and rubella (MMR). Pneumococcal infection
Around 18 months old	Measles, mumps and rubella (MMR).
Three years and four months or soon after (pre school booster)	Diphtheria, tetanus, pertussis and polio. Measles, mumps and rubella (MMR)
Girls aged 12 to 13 years	Human papillomavirus types 16 and 18.
13 to 18 years old	Diphtheria, tetanus, polio

Immusation Clinics

Monday, Tuesday and Wednesday afternoon are designated for children’s immunisations.  However, if you cannot make these clinics, the practice nurses are usually able to see you in one of their other clinics. 

8 weekcheck appointments will be held on either a Monday or a Wednesday between 13:00 - 14:00.  This is one appointment which consists of a development check by the GP and the 1^st set of immunisations with the nurse.

If you have any queries about childhood immunisations or are worried that your child’s immunisations may not be up to date, please make an appointment with a practice nurse.

**REMEMBER TO BRING THE CHILD’S RED BOOK TO ALL APPOINTMENTS**

If you need a smear, please make an appointment with the practice nurse.

Cervical smears test cells from the cervix to check for early abnormalities which, left untreated, could develop into cervical cancer.

Current UK guidelines recommends 3 yearly smear from the age of 25y to 49y and then 5 yearly until 64y.  However, if there are any previous abnormalities or concerns you may need to be seen more frequently than this (you will be informed about this with the results of your test if this is the case).

You will get a letter informing you of the results of your smear and any recommendations after about 2 weeks.  Please let us know if you don’t receive a letter.

See the leaflet for more information, Cervical Screening - the facts.

There are several options for psychology therapies including one to one therapy, group therapy and guided self-help. 

Please make an appointment with a GP to discuss your symptoms and they will advise on how to access the "psychological therapies in primary care" service.

We have 2 psychologists based at the practice who are linked to this service.

Physiotherapy is a key service for those with physical impairments resulting from injury or disease. Physiotherapy aims to help patients regain their full physical abilities or make best use of impaired function. A physiotherapist uses their skills to assess and treat conditions through the application of specialist techniques. In some cases they advise patients how to self manage their condition/symptoms using home programmes and health education/information.

A physiotherapy service is provided at Balham Park Surgery by a physiotherapist from St George's Hospital on a Friday. If you feel you may benefit from physiotherapy please make an appointment to discuss your symptoms with your GP. They can then advise you on how to access the service. You will either be seen at the surgery or at St George’s Hospital. However, some services such as women’s health, paediatric physiotherapy and neurological physiotherapy are based at St George’s Hospital. Should you require these services or there is a significant waiting list at the surgery you will be seen at St George’sHospital.

Watch our Introduction to Physiotherapy on our podcast page. 

Information relating to Arthritis.

We have a phlebotomy service at the practice on most days of the week- if the doctor or nurse has advised a blood test please book an appointment at reception.

You can also have blood tests at:

Balham Health Centre

Monday to Friday: 08.30-12.30
No appointment necessary

St Johns Therapy Centre

Monday to Thursday: 08.00 – 13.00, 14.00 – 16.00, Friday: 08.00 – 13.00
No appointment necessary

St Georges Hospital (Lanesborough Wing)

Monday to Friday: 08.00 – 16.30, Saturdays: 09.00 - 13.00
No appointment neccessary

Please click here for blood test information leaflet

FASTING BLOOD TESTS:

if you have been asked to have a fasting blood test you should attend in the morning and have had nothing to eat for 12 hours prior to the test. You may drink water but nothing else in this time period.

RESULTS:

It is important that you follow up and find out the results of your blood tests.  You may have been asked to make a follow up appointment to discuss your blood tests.  If you are phoning for results please allow about 1 week before calling the surgery (your GP will inform you if the test may take longer to come back) 

• Normal results: the receptionists may be able to tell you over the phone if all the tests were normal
• Abnormal results: the GPs review all the results and will contact you if there is anything that needs to be discussed urgently.  If not, they may contact you by phone/letter or wait for you to phone in.  Ideally you should speak with the GP who ordered the results, who has assessed you and understands your case- if the GP concerned is not working on the day you phone in, this may mean arranging with reception a call back from that GP when they are next in. When the GP gives you the blood form please check what days they are at work and, therefore, available to discuss results.

Sara Moloney (Lead Practice Nurse) does minor surgery clinics at the practice for treatment and/or removal of minor skin problems such as warts, skin tags and some moles and cysts. Treatment is quick and easy.
Before booking an appointment in the minor surgery clinic you need to see Sara (or a GP) in a routine surgery to assess suitability for the service.

Joint injections: Dr Onyett and Dr Ellingham have training in giving joint injections. Your GP will be able to advise if you may benefit from this, or you could book an appointment with Dr Onyett or Dr Ellingham.

GP's do not deal with travel immunisations and antimalarial medication- you will need to see the practice nurse.  Please tell the receptionist when you book the appointment that it is for travel advice/medication. 

For “gap year” or “backpacking” trips you need to come at least 8 weeks before you travel; for more standard holidays 2 weeks before travel is usually sufficient. As these are usually longer appointments and can get booked up, please remember to book in plenty of time

Tetanus, diphtheria, polio, hepatitis A, hepatitis B & typhoid:	no charge
Yellow fever:	we are a yellow fever centre and will issue a certificate.  The vaccine costs £60.
Malaria tablets:	these are issued on a private prescription (you will have to pay for them at the pharmacy)

We do not stock certain vaccines (eg rabies, Japanese B encephalitis), but if these are required we can recommend where you can get them.

Useful websites:
www.fitfortravel.nhs.uk
www.nathnac.org

Karen Henderson (Senior Health Care Assistant) is our smoking cessation counsellor and she consistently has one of the highest success rates in Wandsworth at helping people quit smoking.
She can advise and support you in all aspects of smoking cessation, including medication and nicotine replacement therapy.

Your GP/practice nurse may advise you to make an appointment, or you can self refer to the service by booking at reception. Please tell reception the reason for the appointment as the initial appointment needs to be for 30min.

A message from Karen: "It's never too late to give up. Even if you've tried before...try, try again!"
www.smokefree.nhs.uk
www.smokefreewandsworth.nhs.uk

If you need help to stop smoking don’t go it alone, call the Wandsworth NHS Stop Smoking Service today on freephone 0800 389 7921 and get details of the best clinic for you. You can also visit www.wandsworth.gov.uk/stopsmoking or Healthy Wandsworth or follow #HealthyWandsworth on twitter.

When you first join the practice you will be asked to have a "new patient health check" with the Health Care Assistant (HCA).

You can also see the HCA or the practice nurses for health checks and "well man"/"well woman" checks- you can book these appointments at reception.

We recommend that all patients have a health check at least every 5 years, more often for certain conditions and for the over 75's.

Patients aged 40-75 are entitled to the new NHS healthcheck to assess for cardiac risk factors- please book an appointment for a fasting blood test then after the results are back (usually one week) please book a further appointment with Daksha (healthcare assistant) for the full health check.

Claire Bown is the Primary Care Liason Nurse for Substance Misuse.  Currently, she runs clinics at the surgery on Wednesdays.

She deals with patients who have problems with:

• Alcohol dependency
• Illicit drug dependency
• Cannabis use
• Prescription dependency (for example, to pain killers or sleeping tablets)

She will also see patients who are at risk of relapse from any of the above problems.

The GP may suggest a referral or patients can self-refer by booking an appointment with Claire via reception.

District nurses are available 24 hours a day year-round to provide clinical support, including palliative care, to adults patients who are housebound.

District nurses are based in this practice. Their employer is St Georges Healthcare, however they are very much part of our team.

Referrals may be made on discharge from hospital, via your GP, or patients can self refer by calling the "Harmoni" number on 0845 602 6292. When you are under their care they will be able to give you a direct line number.