Starting up in private practice
Post date: 28/02/2025 | Time to read article: 5 minsThe information within this article was correct at the time of publishing. Last updated 28/02/2025
Starting up in private practice can feel quite daunting and there are several things that you will need to think about before you begin. This article provides a summary of the main points and links to valuable additional resources.
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The basics
Private practice can take many forms and includes taking on additional NHS work such as waiting list initiatives, working in private hospitals, or setting up your own practice or clinic. Each of these have their particular considerations, but there are many things common to all private practice that we explore in this article.
In order to undertake private medical practice in the UK you will need to be fully registered with the General Medical Council. It is also advisable, if you wish to undertake specialist work within private hospitals or for insurers, that you have completed your specialist training and are registered in that speciality with the GMC, and hold or have recently held a substantive NHS consultant post.
Contracts and fees
The NHS consultant contract entitles you to undertake private practice, if you do so then you need to disclose information about the nature of your private practice to your NHS employer. You must ensure that you prioritise and adhere to your NHS job plan and that you do not undertake private work in “NHS time”, otherwise you may be subject to disciplinary action. This includes undertaking private work when on call for the NHS, unless in an emergency or otherwise agreed (in writing) with your employer.
Some patients may try to bypass NHS waiting lists by asking to become a private patient. Most NHS organisations have a policy governing transfer of NHS patients to the private sector, and you should be familiar with and follow the policy set by your organisation.
The guidance A Code of Conduct for Private Practice also sets out that, in the course of your NHS duties and responsibilities, you should not initiate discussions with NHS patients about providing private services.
You may set your own charges for private medical consultations and procedures but due to the rules concerning competition law you must not discuss fee rates with colleagues, unless in a legally binding partnership or a limited company with them. Some insurers insist that certain rates are charged as part of their terms of service.
For more information about contracts and fees in private practice including advice on “practising privileges” please visit BMA - Home | British Medical Association
The Information Commissioner and the Care Quality Commission
It is important to be familiar with, and to follow, legal requirements and regulations that relate to private practice, giving particular attention to additional responsibilities that may now rest with you.
You may need to be registered with the Information Commissioner and pay the Data Protection Fee. This is a legal obligation under the Data Protection (Charges and Information) Regulations 2018 which states that organisations (including sole traders) that use personal information are required to pay a Data Protection fee, unless they are exempt. The information Commissioner’s Office (ICO) provides additional useful information about your obligations under the Data Protection Regulations and a helpful self-assessment toolkit to assist you in deciding if you need to be registered and pay the fee at Information Commissioner's Office (ICO)
The Health and Social Care Act 2008 requires you to be registered with the Care Quality Commission (CQC) if you intend to provide healthcare in England. The role of the CQC is to regulate the healthcare sector in England including independent healthcare. Different but similar organisations carry out the same role in Scotland, Wales and Northern Ireland. The need to be registered will depend on the arrangements in place for your private work and more information on the requirement to be registered and what this means for you is available from the following organisations.
England: Registration - Care Quality Commission (cqc.org.uk)
Scotland: Healthcare Improvement Scotland
Wales: Health Inspectorate Wales (HIW)
Northern Ireland: Regulation and Quality Improvement Authority (RQIA)
Revalidation
As a registered medical professional in the UK, you must comply with the GMC requirements for appraisal and revalidation. This includes the need for an annual appraisal that covers all of your UK practice, including any private work that you undertake.
If you have an NHS contract and also do private work then your NHS appraiser will be able to appraise all of your work. If you work solely in private practice then you will need to identify a suitable responsible officer and appraiser, and you may be assisted in this by the independent organisation with whom you work, the relevant Royal College, or the Independent Doctors Federation.
More information about appraisal and revalidation can be found here Revalidation requirements for doctors - GMC (gmc-uk.org)
Clinical negligence indemnity
When consulting with or treating private patients, including the provision of care to a private patient in an NHS hospital or clinic, you will need to have your own clinical negligence indemnity arrangements in place and sufficient indemnity to include any staff that you employ directly to assist you in the provision of that care.
When treating NHS patients in an NHS or private setting as part of an NHS initiative (such as the waiting list initiative) you should check the indemnity arrangements. They are not always straightforward, and you should not assume that you are covered by the NHS clinical negligence indemnity scheme. You may be required to have your own indemnity arrangements in place and, where this is necessary, you must ensure that you have declared the full scope of your practice to your indemnifier.
Even if your work is indemnified by the NHS scheme, it is still recommended that you are a member of a medical defence organisation, such as Medical Protection, to assist should regulatory or disciplinary proceedings be brought against you. Further, it would be prudent to check what representation the NHS or the private hospital would provide in the event you are required to provide a statement or give evidence to the coroner, as such representation is not guaranteed.
Medical Protection provides protection for private practice (both for clinical negligence and other matters, such as regulatory proceedings), more information and a quote can be obtained by contacting us at Medical Protection.
Business insurance
It is important when starting up in private practice to consider other indemnities or insurance policies that you might need to put in place to protect yourself and your business. Public liability insurance covers claims made by members of the public for incidents that occur in connection with your business activities, including issues such as personal injury and loss or damage to property. This might include incidents that occur on your premises – for example, trips and falls (if you have your own premises) - or incidents that occur off-site, such as when conducting a home visit.
If you are an employer then you are legally obliged to have employers’ liability insurance to cover the cost of compensating employees who are injured at work or become ill through work
You can find out more information about different types of business insurance and your requirements from the Association of Business Insurers at Home | ABI
Employer responsibilities
Employing staff as part of your private practice will mean that you will have certain duties and legal responsibilities, particularly under Health and Safety law, more information and advice on this can be found at Work and employment law advice | Acas and at HSE: Information about health and safety at work. Medical Protection has also partnered with Croner to provide members with FREE advice on HR, employment laws and health and safety that can be accessed vis a dedicated advice line. Find out more.
Advertising
The private hospital or clinic that you are working for might advertise for you. You may also want to arrange your own advertising. Whichever option you choose, it is your responsibility to ensure that any information about you and your services complies with the law, guidance and regulatory codes that govern advertising.
When advertising as a medical professional the GMC states you must be honest and trustworthy and ensure that any information that you provide is accurate and verifiable and not false or misleading. When advertising you must not exploit a lack of medical knowledge or vulnerability of anyone and you must not make unjustifiable claims about your services or products that you use. You must not put pressure on anyone to utilise your services and you must declare any conflicts of interest.
For more information see our article on Advertising your practice
Tax
You will need to meet your tax liabilities in relation to any private income and register with the HMRC, if you are not already registered.
You may also wish to consider employing the services of an accountant to advise you in relation to financial matters and to help you calculate tax due from your private income.
Additional resources
Good medical practice 2024 - GMC
