NHS or Private Fit to Fly Certificate? Cost and Timing Compared

The short answer. Fit to fly letters sit outside the NHS GP contract. That one fact explains everything else: your practice is not obliged to write one, can charge a private fee if it agrees to, and can decline entirely. Many decline. A private letter is exactly as valid — airlines care that a GMC-registered doctor signed it, not who paid.

Why your GP said no

It surprises people, and it can feel like an obstruction, so it is worth explaining properly.

NHS GPs work to a contract that defines what NHS care they provide. Medical reports, travel letters, insurance forms and fitness certificates are not part of it. They are classed as private work — which means the practice may charge, and equally may decide it does not have capacity to offer the service at all.

From the practice’s point of view, a fit to fly letter is a clinical responsibility: the doctor is putting their name and GMC number to a statement about your fitness to travel. That means reviewing your record and thinking about it properly, in time that is not funded by the NHS. Some practices absorb this; many have decided they cannot.

The two routes compared

	NHS practice (private work)	Private online GP
Available?	Only if your practice offers it — many do not	Yes
Cost	Practice sets its own fee, commonly £30–£80	From £67
Timing	Typically 1–2 weeks, often needing an appointment first	Usually same day on weekdays
Knows your history	Yes — full access to your record	Based on what you tell the doctor, plus any records you supply
Airline's own form completed	Sometimes, at the practice's discretion	Yes
Validity	Same	Same

Neither route is better in the abstract. If you have a complex history and weeks to spare, your own GP knows your record and that has real value. If your flight is on Friday, the timing decides it.

How to ask your practice, so you get a useful answer

Ring reception and ask specifically: “Does the practice provide private fit to fly letters, what is the fee, and what is the current turnaround?” Reception will know without asking a GP
Have the exact wording your airline requires to hand. “A fit to fly letter” is vague; “confirmation of due date, single pregnancy, no complications and fitness to fly, dated within 7 days of travel” is a job someone can price
Ask whether they will complete the airline’s own form if there is one
Ask what happens if the doctor concludes you are not fit to travel — you will still be charged, and you will still need that letter for your insurer

If they say no

They are within their rights, and there is no appeal. Your options are another local practice offering private services, a private GP clinic, or an online service. All produce a letter from a GMC-registered doctor, which is what the airline is asking for.

One thing worth knowing about NHS records

If your case is complex — a significant medical history, recent surgery, an ongoing pregnancy complication — any doctor writing the letter benefits from seeing your records. You can access your own record through the NHS App and share the relevant part. It makes for a better letter wherever it is written.

Common questions

Can I get a fit to fly certificate from the NHS?

Not as an NHS service. Fit to fly letters fall outside the NHS GP contract, so a practice that writes one is doing private work. It can charge its own fee, and it can decline altogether. Many do.

Why won't my GP write a fit to fly letter?

Because they are not contracted to, and are not obliged to. It is private work that takes time out of NHS clinical sessions. Some practices have a policy of not doing travel letters at all. It is not personal, and arguing rarely helps.

How much does a GP charge for a fit to fly letter?

Practices set their own fees. Around £30 to £80 is typical, and some charge more for a same-week turnaround. There is no standard NHS price because it is not an NHS service.

How long does an NHS GP take?

Usually one to two weeks, sometimes longer, and often requiring an appointment first. That timing is the single biggest reason people use a private service — not cost.

Can my midwife write a pregnancy fit to fly letter?

Most airlines accept a midwife’s letter. Whether your midwife will write one is another matter — many NHS midwives decline because it sits outside their NHS role and their trust may not permit it.

Is a private letter as valid as an NHS one?

Yes. What airlines and insurers care about is that a GMC-registered doctor signed it and that it contains what they asked for. There is no hierarchy between NHS and private letters.

Need a certificate this week?

A GMC-registered UK GP reviews your case and issues the letter the same day on weekdays — including completing your airline’s own form where they have one.

Get started

Reviewed by a GMC-registered GP. Full refund if a certificate cannot be issued on clinical grounds.

NHS or private: how to get a fit to fly certificate