Private practice is medical work you do outside the NHS, where patients pay directly or through private medical insurance rather than through NHS funding. For a UK consultant, it typically means seeing self-pay or insured patients in a private hospital or clinic, alongside or instead of an NHS contract, with you responsible for fees, indemnity and marketing.
Is private practice a spinoff of Grey’s Anatomy?
Yes, there is a TV show called Private Practice. It is a 2007 American spinoff of Grey’s Anatomy following Addison Montgomery at a Los Angeles wellness practice, and it ran for six seasons. That is why search results for this phrase are a mix of television recaps and careers advice and why its important to get search right!
In the UK, private practice means independent clinical work outside NHS funding, and the rest of this post covers what that actually involves: who pays, what you are responsible for, and how it differs from running a clinic.
What is private practice all about?
Private practice means patients fund their own care, through one of two routes. Insured patients claim through a private medical insurer such as Bupa, AXA Health, Aviva or Vitality, each of which recognises consultants individually and publishes fee schedules you agree to work within. Self-pay patients pay your fees directly, which gives you more pricing freedom but means they choose you on reputation and visibility rather than an insurer’s list.
The infrastructure is yours to arrange. You need GMC registration with a licence to practise, indemnity that explicitly covers private work (NHS indemnity does not extend to it), practising privileges granted by a private hospital’s Medical Advisory Committee, and a way to handle bookings and billing. If you hold an NHS consultant contract, the 2003 contract requires you to declare private commitments and keep them compatible with your job plan. Under the CMA’s Private Healthcare Market Investigation Order 2014, consultants must also submit fee and activity information for publication through PHIN, the Private Healthcare Information Network.
The part most consultants underestimate is that patients now have to find you. In the NHS, work arrives through referral pathways. In private practice, an insured patient often picks a name from a list, and a self-pay patient searches online, compares websites and books the surgeon who looks credible and reachable. That is why a website built for a consultant practice and SEO and content that answer patient questions sit alongside indemnity and privileges as practical requirements rather than extras.
One thing agencies rarely say plainly: marketing is not where to spend first. In the opening months, insurer recognition, GP and physio relationships and word of mouth from NHS colleagues will bring you more patients than any campaign. A new website alone rarely moves rankings for a little while, and paid ads on day one usually burn budget before you have a conversion path worth sending clicks to. Get recognised, get privileges, get a functional site, then invest in visibility once you know which procedures you want more of.
What is the difference between a clinic and a private practice?
A private practice is you, the business. Legally it is usually a sole trader or a limited company through which you bill your professional fees for consultations, procedures and follow-up. A clinic is a physical facility registered with the CQC in England (or Healthcare Improvement Scotland, HIW in Wales, RQIA in Northern Ireland) to provide regulated activities on its premises.
Most consultants run a private practice without owning a clinic. A shoulder surgeon with privileges at a Spire or Nuffield Health hospital, for example, consults and operates there, and two separate bills go out: the surgeon’s professional fee from their practice, and the hospital’s facility fee covering theatre, nursing and bed. The hospital holds the CQC registration; the surgeon does not need one. That is the standard model, and it is how the surgeons in our case studies, such as shoulder surgeon Mr Andrew Chambler, structure their private work.
Opening your own clinic is a much bigger undertaking. You take on CQC registration as a provider, a registered manager, premises, staff, clinical governance and inspection. For most consultants that only makes sense at scale, typically a group of colleagues sharing rooms and overheads. If you are starting out, practising privileges at an established private hospital give you theatre access and regulatory cover without the fixed costs, and you can model what different session volumes might produce with our practice revenue calculator.
What is private practice in counselling?
In counselling and psychotherapy, private practice means a therapist seeing clients who pay directly, outside NHS Talking Therapies, usually from rented rooms or a home office. The economics are different from surgical practice: lower fees per session, no hospital privileges, and in most cases no CQC registration, because counselling by itself is not a regulated activity.
It is worth knowing because the phrase covers both worlds, and much of the advice published under it, including several of the pages ranking for this search, is written for therapists. Guidance on renting a therapy room does not help a consultant negotiating privileges, agreeing insurer fee schedules or meeting PHIN obligations. If you are a surgeon or physician researching private practice, filter what you read accordingly, and if you want an honest outside view of how findable your practice currently is, a free strategy call is a no-pitch look at your site and search presence, not a sales appointment.
Frequently asked questions
Can NHS consultants do private practice?
Yes. The 2003 NHS consultant contract permits private practice provided you declare it, it does not conflict with your job plan, and you offer the NHS additional programmed activities where the contract requires it before undertaking private work. Most UK consultants in private practice combine it with an NHS post rather than leaving the NHS entirely.
Do I need CQC registration to start a private practice?
Usually not. If you consult and operate at a private hospital under practising privileges, the hospital holds the CQC registration and you work within its governance. You only need your own registration if you provide regulated activities from premises you run yourself, such as your own clinic or day-case facility.
How do private patients find a consultant?
Insured patients typically pick from their insurer’s recognised list or follow a GP referral, then look you up online before booking. Self-pay patients mostly start with a Google search for their condition or procedure plus a location, which is why a credible consultant website and local search visibility directly affect how much self-pay work reaches you.
How much can a consultant earn in private practice?
It varies widely by specialty, location, insurer fee schedules and the balance of insured versus self-pay work, so any single figure would be a guess. Insurer fees are fixed per procedure code, while self-pay fees are yours to set. Our revenue calculator lets you model it from your own clinic sessions, conversion rates and procedure fees.
What insurance do I need for private practice?
You need indemnity that explicitly covers private work, either through a medical defence organisation such as the MDU or MPS, or a commercial insurer. NHS indemnity only covers your NHS duties. Private hospitals will ask for evidence of adequate cover before granting practising privileges, and the GMC requires appropriate indemnity as a condition of practising.