Fitness certificates fall outside a GP's NHS terms and conditions which means doctors can charge their own rate for undertaking the work.

When it comes to issuing fitness certificates for travel insurance or for health club membership, there are medico-legal reasons why you need to be careful. Read our guidance to make sure you cover yourself.

You will need to carry professional indemnity for this type of work. It is not covered by the clinical negligence scheme for trusts or general practice.

Even if a thorough history, examination and any necessary investigations are carried out, doctors are still not in a position to guarantee that a patient is fit for a particular activity.

If a patient is fit

We discourage doctors from signing certificates which indicate that the patient will, for example, be fit for the duration of the holiday, as current fitness is not a guide to future fitness. Doctors can only report on what is written in the patient notes, and reporting on future fitness could have medico-legal consequences for you.

Therefore we advise that if certificates are provided, they should include words to the effect that:

"Based on information available in the medical notes, the patient appears to be fit to travel."

Certificates relating to illness during exams

There is no statutory requirement for doctors to provide exam certificates.

Private certificates may be provided where the doctor is aware of a medical problem that may have had an adverse effect at the time of the patient's examination.

We advise that doctors should exercise caution on providing medical certificates based on hearsay, and should use their judgement at all times.