Date posted: 03/07/2003

Issue: Revised charges for pension scheme medical advice provided by the scheme medical adviser

Action: This Notice will be of particular interest to:

  • Those people who refer cases to the scheme medical adviser, and who are responsible for paying the adviser’s subsequent fees
  • To note the new charges

Timing: The revised fees will be applied to cases submitted on or after 1 July 2003


PC/152, EPN45


  1. The contract for Civil Service pension scheme medical advice, which is managed by the Cabinet Office, allows for an annual revision of the charges for services made by the scheme medical adviser, which is currently BMI Health Services. The increase is based on the rise in the Retail Price Index (RPI) for the preceding 12 months.
  2. The last time contract prices were increased in line with RPI (or indeed at all) was in April 2001, as announced in PC/152. Due to issues over poor performance by BMI during 2001/2 it waived any RPI increase to its fees for that period.

Raising current charges in line with RPI

  1. EPN45 announced the Cabinet Office’s decision to extend the medical advice contract with BMI services for at least one year, to March 2004, on the basis of important changes to BMI’s performance framework, taking effect from 13 January 2003. The tighter structure and focus introduced by the revised performance standards provides the basis for our agreeing to an increase in BMI’s fees, linked to RPI in the period 2002/3, but coming into effect from 1 July 2003. The RPI figure for the year to 31 March 2003 was 3.16%. Overall, however, the fee increase is effectively 2.97% (excluding medical appeal board fees, see below) as amounts have been rounded. Attached at Annex to this EPN is the new fee structure.

Increase in fees for Chairs and Members of Medical Appeal Boards

  1. BMI has reported difficulties in recruiting Chairs and Members of Medical Appeal Boards (MABs). Such persons are a scarce resource in the UK and are, therefore, much in demand. BMI often struggles to attract people to undertake this work, with one of the difficulties being cited as the relatively low level of fees being offered. Indeed, many NHS trusts will not permit their doctors to do this work for the fees we are offering. MABs are an important part of our medical retirement arrangements; without them far more work (and costs) would be likely to fall on employers and APACs in meeting the demands of complaints under the pension scheme’s Internal Dispute Resolution procedures and, potentially, Employment Tribunals. An increase in the fees for this work is considered necessary to help to try and address this difficulty.
  2. The revised rates remain moderate in comparison with the level of fee expert occupational health physicians are generally able to command. The revised fees are, with immediate effect, for Chairs £325 per day (was £257) andfor Members £258 per day (was £205). This is, however, only an interim price adjustment, because it is unlikely to fully address the difficulties we are experiencing far into the future. We are currently working with BMI to see what fee may be charged that is more in line with the market, but which will still represent value for money for employers and the pension scheme.


Enquiries about content:

Employer Helpdesk

01256 846414

Enquiries about distribution of EPNs:

Judith Horny


3 July 2003
Last updated:
24 April 2023