Fees & Funding for Nexus ABI Clinical Services
Our Approach to Pricing
We believe that transparency in pricing is a fundamental part of clinical governance — not just a commercial nicety. Case managers and financial deputies are responsible for justifying every clinical expenditure they authorise, and they cannot do that effectively if fee structures are opaque, variable or only revealed at the point of invoicing.
All Nexus ABI fees are published in this schedule. Where a service requires a bespoke quote — because the scope or complexity varies significantly between clients — we will always provide a written estimate before work commences. There are no retrospective charges, no hidden administration fees, and no variable pricing that is not explained in advance.
The resulting report is detailed, evidence-based, and written to the standard required by the Court of Protection, case managers, solicitors, and rehabilitation teams.
Table of Contents
Assessment Services
| SERVICE | FEE | NOTES |
|---|---|---|
| Initial Needs Assessment (INA) — Standard | From £[TBC] | 5–7 working day report. Includes consultant-led assessment + peer-reviewed report. |
| Initial Needs Assessment (INA) — Expedited | From £[TBC] | 48–72 hour report from assessment date. Subject to availability. |
| INA Follow-Up / Updated Assessment | From £[TBC] | Where clinical circumstances have significantly changed. |
| Capacity Assessment (MCA 2005) | From £[TBC] | Standalone capacity assessment and written report. |
| Expert Witness Report | From £[TBC] | Pricing on application. Includes court attendance by arrangement. |
Remote GP Services
| SERVICE | FEE | NOTES |
|---|---|---|
| Standard consultation (20 minutes) | From £[TBC] | Acute presentations, straightforward reviews, prescribing. |
| Complex ABI review (40 minutes) | From £[TBC] | Multi-system or polypharmacy cases, capacity-sensitive consultations. |
| Urgent same-day consultation (20 minutes) | From £[TBC] | Subject to availability. For acute deterioration. |
| Annual health check (60 minutes) | From £[TBC] | Structured comprehensive review for residential care patients. |
| Monthly retainer — residential care provider | POA | Regular scheduled consultations. Quote on request. |
Endocrinology Services
| SERVICE | FEE | NOTES |
|---|---|---|
| Endocrinology initial assessment | From £[TBC] | Includes consultation + hormone panel interpretation + treatment plan. |
| TRT follow-up review (3-month) | From £[TBC] | Bloods interpretation, dose review, clinical summary. |
| TRT ongoing management (per month) | From £[TBC] | Includes monitoring coordination and prescribing. Bloods extra. |
| HRT initial assessment (Well Woman Clinic) | From £[TBC] | Includes consultation + bloods interpretation + NICE NG23-aligned plan. |
| HRT ongoing management (per month) | From £[TBC] | Includes monitoring and prescribing. Bloods extra. |
Weight Management Program
| SERVICE | FEE | NOTES |
|---|---|---|
| Initial medical assessment | From £[TBC] | Includes cardiovascular risk scoring, full metabolic assessment, programme design. |
| Monthly monitoring review | £[TBC] | Weight, BP, medication review, symptom check, progress report. |
| 3-month formal clinical review | £[TBC] | Includes repeat bloods interpretation, dose review, case manager report. |
| Medication cost (pharmacological treatment) | At Cost | Billed at cost price plus dispensing administration fee. Transparent itemisation. |
Diagnostic Monitoring & In-Home Services
| SERVICE | FEE | NOTES |
|---|---|---|
| Standard in-home clinical visit (up to 1 hour) | From £[TBC] | Travel within [X] miles included. Extended radius: mileage supplement. |
| Extended in-home visit (up to 2 hours) | From £[TBC] | Complex assessment or multiple clinical procedures at same visit. |
| Urgent in-home review visit | From £[TBC] | Same-day or next-day. Subject to availability and clinical urgency. |
| Monthly monitoring package (4 visits) | From £[TBC] | Scheduled weekly visits with monthly collated summary report. |
| Post-discharge monitoring programme (4 weeks) | From £[TBC] | Structured post-discharge programme including medication reconciliation. |
Phlebotomy & Nursing Services
| SERVICE | FEE | NOTES |
|---|---|---|
| In-home phlebotomy visit | From £[TBC] | Travel within [X] miles. Laboratory costs billed separately at cost. |
| Nursing visit — wound care / procedure (up to 1 hour) | From £[TBC] | NMC-registered nurse. Clinical documentation included. |
| Injection administration (in-home) | From £[TBC] | Per injection. Includes MAR documentation. Medication cost extra. |
| Standard hormone blood panel | From £[TBC] | Laboratory analysis billed at cost. No mark-up. UKAS-accredited lab. |
| Comprehensive metabolic panel | From £[TBC] | Full panel including hormones, metabolics, FBC, LFTs, renal. At cost. |
Cardiology & Clinical Observations
| SERVICE | FEE | NOTES |
|---|---|---|
| 12-lead ECG (in-home, with interpretation) | From £[TBC] | Interpretation letter produced. Abnormal traces reviewed same day. |
| Routine clinical observations visit | From £[TBC] | BP, HR, SpO2, orthostatic protocol, clinical documentation. |
| Clozapine monitoring programme (per month) | From £[TBC] | Includes bloods coordination, ECG, metabolic monitoring and reporting. |
| Cardiology observations + ECG package | From £[TBC] | Combined visit. Discount vs. individual service pricing. |
Toxicological Screening & Testing
| SERVICE | FEE | NOTES |
|---|---|---|
| Urine drug screen — point-of-care (in-home) | From £[TBC] | Preliminary immunoassay. Result within 10 minutes at visit. |
| Urine drug screen — laboratory confirmed (GC-MS) | From £[TBC] | UKAS-accredited. 3–5 working days. Required for legal proceedings. |
| Oral fluid (saliva) test — laboratory confirmed | From £[TBC] | Recent use detection. 3–5 working days. |
| Hair strand test (3-month history) | From £[TBC] | Highest evidential value for legal proceedings. 10–14 working days. |
| Medico-legal toxicology report | From £[TBC] | Written interpretation for Court of Protection / legal use. |
| Bespoke / expanded panel | POA | Quote on request. All substances and timeframes available. |
Medication & Prescription Management
| SERVICE | FEE | NOTES |
|---|---|---|
| Comprehensive medication review report | From £[TBC] | Full polypharmacy review, interaction analysis, deprescribing recommendations. |
| Ongoing prescribing & management (per month) | From £[TBC] | Regular prescriptions, dose management, monitoring coordination. |
| Safe administration guidance document | From £[TBC] | Plain-English carer guide. Updated with every medication change. |
| High-risk monitoring programme — clozapine | POA | Full CPMS programme management. Quote on complexity. |
| High-risk monitoring programme — lithium / valproate | From £[TBC] | Monitoring coordination, results review, GP correspondence. |
| GP / shared care correspondence letter | From £[TBC] | Per letter. Included as standard within ongoing management packages. |
Funding Routes — A Guide for Referring Professionals
Personal injury compensation fund
The most common funding route. Clinical costs are drawn from the compensation fund held under Court of Protection management. All expenditure requires deputy authorisation and is subject to OPG review. We provide full clinical justification documentation.
NHS Continuing Healthcare (CHC)
Where a client meets the NHS CHC eligibility criteria (National Framework for NHS Continuing Healthcare, 2022), clinical services may be funded wholly or in part by the NHS. Nexus ABI can assist with clinical documentation for CHC applications. We do not bill NHS commissioners directly — CHC funding must be authorised via the appropriate clinical commissioning pathway.
Local authority — Care Act funding
Where the client’s needs are assessed under the Care Act 2014, some clinical services may be incorporated into a funded care package or personal budget. We can provide clinical assessments and reports to support needs assessments and direct payments applications.
Court of Protection — welfare deputyship
Where a welfare deputy is authorised to make healthcare decisions, clinical expenditure is authorised directly by the deputy as part of their statutory function. We provide all documentation required for welfare decision justification and Court of Protection reporting.
Solicitor instruction — litigation fund
Where clinical services are required in the context of ongoing personal injury litigation — for example, an INA or expert witness report — these are typically funded directly by the instructing solicitor from the litigation fund, subject to costs agreement.
Private funding
Services can be funded privately where the client has independent means. The same governance, reporting and invoicing standards apply. Full invoices and receipts are provided for estate management and tax purposes. No minimum spend or ongoing commitment is required.
How to request a quote
- Submit a referral via our secure portal and mark 'Quote required before commencement'
- Email our clinical team at [CLINIC EMAIL] with a brief description of the service required
- Call us on 020 7551 7055 — our clinical coordinator will take the details and confirm a written quote within 1 working day
- All quotes are provided in writing, valid for 30 days, and can be countersigned as a formal instruction to proceed
Frequently Asked Questions
Our FAQ section is here to answer the most common questions about this service and help you feel fully informed before getting started. If you don’t see the answer you’re looking for, please don’t hesitate to get in touch—our team is always happy to help and provide clarity where needed.
Are all Nexus ABI prices fixed or can they vary?
The fees published in our schedule are our standard rates for each service as described. For services marked ‘POA’ (price on application) — such as expert witness reports, bespoke toxicological panels and complex monitoring programmes — pricing depends on the specific scope and clinical complexity of the instruction. For all other services, the published price is the price. Where a service is likely to exceed the standard fee due to exceptional clinical complexity, we will inform the referring case manager or deputy in advance and obtain written authorisation before proceeding. There are no retrospective charges.
Are Nexus ABI fees subject to VAT?
Medical services provided by registered healthcare professionals in the UK are generally exempt from VAT under HMRC’s VAT Notice 701/57 (Health professionals and pharmaceutical products). However, some services — such as medico-legal reporting or services delivered by practitioners who are not registered healthcare professionals — may be subject to VAT. Our invoices clearly specify the VAT status of each service line. If you require clarification on the VAT treatment of a specific service for accounting purposes, please contact our practice manager.
What is included in the laboratory analysis costs and how are they billed?
Laboratory analysis costs — for blood tests, toxicological screening, drug level monitoring and other laboratory-processed samples — are billed at cost price with no mark-up or administration surcharge. We use a UKAS-accredited laboratory partner and are invoiced directly by the laboratory. These costs are passed on to the referring party at exactly the price we are charged, with the laboratory invoice available for review on request. Laboratory costs appear as a separate line item on all Nexus ABI invoices, clearly distinguished from clinical service fees.
Can I get a written cost estimate before authorising services?
Yes — and we actively encourage this. For all planned services, we will provide a written fee estimate or fixed-price quote before commencement. This can be issued on the same day as the referral for services within the standard fee schedule, or within 1 working day for services requiring a bespoke quote. The written estimate can be countersigned by the case manager, deputy or solicitor as a formal instruction to proceed, creating a clear audit trail. We will never commence a non-emergency service without prior written authorisation.
How quickly are invoices issued after a service is delivered?
Invoices are issued within 5 working days of the clinical activity being completed. For ongoing monitoring programmes, invoices are produced monthly at the end of each billing cycle. For INA reports and other report-based services, the invoice is issued on the same day as the report is delivered. Payment terms are 30 days from invoice date. We accept BACS bank transfer and business cheque. For organisations with pre-agreed billing arrangements, we can align invoicing to quarterly or specific billing cycles on request.
Can Nexus ABI services be funded through an NHS Continuing Healthcare package?
Yes, in principle. NHS Continuing Healthcare (CHC) funding can cover clinical services that are assessed as primarily health needs under the National Framework for NHS Continuing Healthcare (2022). However, the process requires a CHC eligibility assessment by the relevant NHS integrated care board, which is a clinical and administrative process separate from any instruction to Nexus ABI. We can assist with the clinical documentation required to support a CHC application — including a clinical needs summary and supporting evidence from our service records. We do not bill NHS commissioners directly; CHC funding is disbursed through the deputy or the authorised intermediary.
What happens if a client's funding source changes during an ongoing programme?
Changes in funding source — for example, a litigation settlement being reached while an ongoing monitoring programme is in place, or a CHC funding decision being reversed — should be notified to our practice manager as soon as possible. We will pause invoicing while the new funding arrangement is confirmed and will work with the incoming payer to transfer billing arrangements smoothly. Clinical services will not be interrupted by funding transitions except in exceptional circumstances where no authorised payer can be identified.
Are there discounts available for multiple services or ongoing programmes?
Yes. For clients receiving multiple Nexus ABI services concurrently — for example, a combination of in-home monitoring visits, phlebotomy and medication management — we apply bundled visit pricing where two or more services are delivered at the same visit, reducing the effective cost per service compared to individual bookings. For residential care providers or case management organisations referring multiple clients, please contact our practice manager to discuss organisational account arrangements and volume pricing.
Can Nexus ABI provide a projected annual cost for planning purposes?
Yes. For clients on established ongoing clinical programmes, we will produce an annual cost projection at the start of each calendar year — specifying the services anticipated, their frequency and their projected cost. This is updated at the 6-month clinical review and shared with the case manager and deputy. Annual projections are formatted to support Court of Protection Deputy Annual Report preparation and OPG review. Where a client’s clinical needs are likely to change significantly during the year, we will flag this proactively rather than presenting an unexpected invoice.
What documentation do you provide for Court of Protection submissions?
Our invoices are produced in a format that meets the documentation requirements for Court of Protection Deputy Annual Report submissions and OPG review. Each invoice specifies the service, clinical indication, date, clinician name and registration number, duration (where relevant), and all associated costs as separate line items. We can also produce an annual clinical services summary — a structured document listing all services provided during the reporting year with costs, clinical justifications and outcomes — on request.
Is there a fee for the initial referral triage or consultation?
No. The initial referral triage — review of the submitted referral, contact with the case manager or deputy, and clinical consultation to determine the appropriate service pathway — is provided at no charge. The first billable event is the commencement of the specific clinical service requested. For services where a pre-commencement consultation with the case manager or deputy is required (for example, to scope a complex INA), this is included within the service fee and not billed separately.