Private GP: To prepare a medical report for the Scottish Public Pensions Agency (SPPA)

bkmla

This post concerns the potential cost of a report summarising someone’s medical records obtained under a subject access request.

The background to this is that my friend in Scotland suffered a few strokes two years ago, and this caused him to quit his job. His employer (the NHS) supported an application to the Scottish Public Pensions Agency (SPPA) for early retirement benefits.

Unfortunately, the SPPA initially rejected his application because it has insufficient information on his medical conditions. It has asked him to send some information relating to this, but his GP refused to supply a report, saying it was his job to look after a patient’s health and not to write reports.

In response to this, I helped him make a subject access request to obtain his medical records in order to assist the SSPA in its request for additional information.

Obviously, the cheap way of proceeding would be to send the records on to the SSPA for it to review. However, I suspect that in terms of his application being accepted it might be more effective to pay a GP to analyse the records and write a report.

Therefore, I did a Google search for private GPs who could do this. Unfortunately, not one of the private medical practices/organisations websites listed this service. Also, one organisation listed the cost of a one-hour consultation with a GP as being £150. So goodness knows how much it would cost for a GP to read and summarise 150 pages of medical records and write a report.

Does anyone know of a way to obtain a written report inexpensively?

Flugelhorn

It probably doesn't have to be a GP - most of these are done by consultants - I have found a few by googling.

It will not be cheap - it is private work and there is indemnity / admin etc to cover. 

bkmla

Flugelhorn said:

It probably doesn't have to be a GP - most of these are done by consultants - I have found a few by googling.

It will not be cheap - it is private work and there is indemnity / admin etc to cover. 

Can you provide a few links?

DoublePolaroid

GP here (NHS). 

Whilst his GP is completely entitled to refuse to oblige the request as it’s not NHS work, the majority of GP’s with NHS contracts do at least some private/non-NHS work on behalf of NHS patients for a fee and most tend to charge at a rate less than a purely private provider doing the same work might. It would also undoubtedly take less time for a doctor who is familiar with your friend’s medical history to summarise his medical records than a doctor who starts from scratch with 150 pages of notes if front of them. 

It might be worth trying to negotiate with the GP practice by asking what amount they might be willing to do the work for. 

If it’s possible it’d be worth trying to find out precisely what information the SPPA need to order to make a decision. I’ve drafted medical reports for pension trustees with respect to medical retirement and been asked specifically whether I think the punter qualifies for medical retirement based on the scheme criteria. I’ve refused to do so on the basis it’s beyond the scope of my practice (this would be within the remit of an occupational health doctor). On the other hand simply drafting a report summarising potentially relevant diagnoses, the associated symptoms and their impact on the person’s day-to-day function is bread-and-butter work. 

It’d be rare that any such report would take me more than an hour and we charge circa £150 (flat fee) for such things, as it happens. Though all bets are off as far as price goes if recruiting a private provider. 

Marcon

DoublePolaroid said:

If it’s possible it’d be worth trying to find out precisely what information the SPPA need to order to make a decision. I’ve drafted medical reports for pension trustees with respect to medical retirement and been asked specifically whether I think the punter qualifies for medical retirement based on the scheme criteria. I’ve refused to do so on the basis it’s beyond the scope of my practice (this would be within the remit of an occupational health doctor). 

Quite - because nothing is going to be accomplished until that's been clarified and supplied.

OP - has your friend had the required report completed: https://pensions.gov.scot/sites/default/files/2020-02/NHS_Application_for_Retirement_Benefits_Preserved_Member_AW8P_Med.pdf

Whether they will take the same view as the GP posting here is another matter. I've dealt with many GPs over the years in respect of ill health retirements and often the problem is stopping them from recommending their patient should be given ill health retirement (however far off meeting the criteria of the scheme in question!). As you will see, the SPPA's form has very specific questions, and if your GP isn't prepared to answer all of them - assuming all the information is still needed - you're on a hiding to nothing. Your friend's GP is perfectly entitled to take the same view as DP - that they aren't in a position to answer.

Flugelhorn

Agree with @DoublePolaroid - definitely wouldn't take own GP long to summarise records and state diagnoses / create timeline etc - agree also that the problem comes when GPs are asked for an opinion on medical retirement -  that normally comes down to the Occ Health doctors 

bkmla

Marcon said:

DoublePolaroid said:

If it’s possible it’d be worth trying to find out precisely what information the SPPA need to order to make a decision. I’ve drafted medical reports for pension trustees with respect to medical retirement and been asked specifically whether I think the punter qualifies for medical retirement based on the scheme criteria. I’ve refused to do so on the basis it’s beyond the scope of my practice (this would be within the remit of an occupational health doctor). 

Quite - because nothing is going to be accomplished until that's been clarified and supplied.

OP - has your friend had the required report completed: https://pensions.gov.scot/sites/default/files/2020-02/NHS_Application_for_Retirement_Benefits_Preserved_Member_AW8P_Med.pdf

Whether they will take the same view as the GP posting here is another matter. I've dealt with many GPs over the years in respect of ill health retirements and often the problem is stopping them from recommending their patient should be given ill health retirement (however far off meeting the criteria of the scheme in question!). As you will see, the SPPA's form has very specific questions, and if your GP isn't prepared to answer all of them - assuming all the information is still needed - you're on a hiding to nothing. Your friend's GP is perfectly entitled to take the same view as DP - that they aren't in a position to answer.

I'm not certain whether my friend has completed the form related to the link above. Also, I doubt whether he could tell me, as his strokes seem to have had a substantial impact on his cognitive abilities, especially his short-term memory.

His former employers are NHS Greater Glasgow and Clyde. They supported his application to the SPPA for early retirement benefits, so I assume that they (possibly their Occupational Health people) would have completed the form for him to sign.

bkmla

Probably the best way forward would be a second letter to his GP, again offering to pay a fee, and emphasising the importance of him/her supplying a report.

Marcon

bkmla said:

Probably the best way forward would be a second letter to his GP, again offering to pay a fee, and emphasising the importance of him/her supplying a report.

I'd go back to his former employer first and ask them what information is outstanding and why, if they supported his application, they did not ensure adequate medical information was requested, and what exactly is needed now.

Nebulous2

Is your friend a union member, or getting union support?

While unions often don't have experts in complex matters, and their support can be variable, my experience has been that they play a role in helping people in the NHS to get ill-health retirement.  

bkmla

Nebulous2 said:

Is your friend a union member, or getting union support?

While unions often don't have experts in complex matters, and their support can be variable, my experience has been that they play a role in helping people in the NHS to get ill-health retirement.  

No, my friend is not a member of a union.