For a lot of clinicians, private practice starts as a quiet thought in the background. Maybe it’s the appeal of more autonomy. More time with patients. A better experience to offer. A chance to build something that feels more aligned with the way you want to work.
If you’re at that stage, you’re not alone. The idea of private work is becoming part of the conversation for more clinicians, whether that means a small number of private sessions alongside NHS work, or the longer-term ambition of building something of your own.
But before you jump straight into the practicalities, it’s worth pausing to ask a simpler question first: Is this the right move for me?
Here are five questions worth asking yourself before you make the leap.
It sounds obvious, but this is the most important place to start.
If your answer is simply to earn more, that may not be enough to sustain you through the reality of setting things up, finding your feet and building something that works.
The British Medical Association’s guidance for doctors considering private practice is pretty clear: while private work can be rewarding, it comes with real financial and operational considerations, and income may not cover your costs straight away. In its guidance for private GPs, the BMA notes that there are usually upfront costs, early deficits to cover and no guarantee that a new practice will succeed immediately.
A stronger reason might be:
If those are the drivers, you’re starting from a much steadier place. The clinicians who tend to thrive in private practice aren’t just chasing an escape route, they’re building towards a clearer vision of how they want to practise.
This is the bit that catches many people off guard. You might be excellent clinically, but private practice asks something extra of you: it asks you to think like a service designer, business owner and operator too. You take on many more roles than just clinician.
That doesn’t mean you need to become a marketer overnight or suddenly love spreadsheets. But it does mean being honest about what sits around the consultation itself:
In private practice, time is money. Clinicians need to think carefully about premises, staffing, tax, set-up costs and the practical realities of keeping a service running. Private patients often have higher expectations and will be more vocal when the experience falls short.
If you know upfront that private care is as much about how the experience works as it is about the clinical care itself, you’re already thinking in the right way.
In private practice, patients aren’t just assessing clinical expertise. They’re also assessing the experience around it.
They notice how easy it is to book, how quickly they hear back from you, whether your forms are simple to complete and whether the whole journey in general feels calm and connected. These are the things that really matter to them.
Patient expectations are increasingly shaped by the digital experiences they encounter elsewhere, from banking and retail to travel. In healthcare, the shift towards easier digital access is accelerating, and with it comes a growing expectation for speed, clarity and convenience at every stage of the patient journey.
We also know that more patients than ever are considering self-funding their care this year. As private patient numbers rise, expectations will rise with them. That means the experience you offer needs to feel seamless, reassuring, and low-friction from the outset.
So before you move into private practice, ask yourself: What do I want patients to feel when they interact with my service?
If the answer is something like ‘reassured, informed and looked after’, that gives you a much stronger foundation than simply thinking about appointment slots and fees.
Not everyone wants to build a large clinic, and that’s completely fine. For some clinicians, private practice is a small, carefully controlled part of a broader portfolio career. For others, it becomes something much bigger over time.
The important thing is to be honest about which one you’re aiming for, because the systems, processes and decisions that work for one clinic a week and a handful of self-pay patients may not be the same ones that support multiple clinicians, higher patient volumes and a stronger referral network.
Some doctors tend to keep NHS options open while building private work, particularly because of the financial risk and the fact that demand can take time to build. That doesn’t mean you need a five-year business plan, but it’s worth being honest with yourself here:
Are you setting this up in a way that matches what you want it to become, or are you adding private work bit by bit and hoping the structure catches up later?
There’s nothing wrong with starting small. But even a small private practice benefits from clear foundations. If you know you want something simple, you can build for simplicity. If you think it may grow, it’s worth making early decisions that won’t create more admin or friction later on.
This is often the point where people feel their shoulders tense. But let’s be honest: that’s completely normal.
Private practice can feel exciting right up until words like CQC registration, regulated activities, supporting documents and provider responsibilities enter the chat.
But the good news is this: compliance doesn’t need to be the thing that puts you off. In many ways, it’s simply part of building a practice properly from the outset.
If you plan to offer a regulated activity in England, you’ll need to register with the CQC, and that process is there for a reason: to make sure services are safe, effective and well-led.
Rather than seeing that as a hurdle, it can be more helpful to think of it as a prompt to get your foundations right early. The clinicians who feel most confident about this part are rarely the ones who know everything straight away, but rather they’re the ones who give themselves enough time, ask the right questions and don’t leave it until the last minute.
If compliance feels overwhelming, that usually isn’t a sign that private practice isn’t for you. More often, it’s a sign that you’ll need the right structure and support around you as you get started. Take a look at our CQC Hub to start familiarising yourself with the process and you’ll soon see it’s not so scary.
Moving into private practice doesn’t have to mean going all-in overnight. For many clinicians, it starts with a question, then a few conversations. Then a clearer sense of what they want their working life and their patient experience to look like.
So before you focus on the logistics, start here:
If those questions are already on your mind, you’re probably asking exactly the right ones.