How to Set Up an NHS GP Practice
With the prospect of greater independence, more control over the way you operate, and a more established professional presence in the local community, starting a GP surgery feels like a natural next step for many experienced medical professionals.
If you’re moving from the NHS to the private healthcare sector, it also means an escape from the strict targets and rules imposed under the Quality and Outcomes Framework.
That said, it’s also a big learning curve. Private clients might be more challenging, with higher expectations of your service than the clients you’ve worked with before. What’s more, setting out on your own means you’ll be taking on an entirely new role – that of a business owner, and managing private work.
Your surgery needs not only to cover its costs but make a profit too, and you’ll be responsible for making sure it does, from creating a business plan and measuring progress to keeping on top of your cashflow and finances.
Understanding the Basics
Starting a private GP practice in the UK can be a rewarding venture, offering the opportunity to provide direct and personal patient care. Unlike NHS practices, a private GP practice operates independently, often catering to patients on an ad-hoc basis or through private medical insurance. This independence allows for greater flexibility in how you manage your practice and interact with patients. However, it also requires a solid understanding of the business aspects involved, from initial setup to ongoing management. You’ll need to consider your qualifications, the financial investment required, and the logistics of setting up your practice to ensure it meets all necessary standards and regulations.
What’s your plan?
First of all, it’s a good idea to spend some time thinking about what you want to get out of running your own private practice, and weighing up the pros and cons.
There’s the benefit of being able to make your own decisions about how you run it, as well as the value you could build up by establishing your surgery over time. You might plan to sell it eventually and retire on the proceeds, or maybe you’re thinking of turning it into a family business and handing ownership over to the next generation.
Either way, don’t put off thinking about this until closer to the time. Having an exit plan even when you’re just starting up will help you to set goals and understand what you’re working towards.
Don’t forget to consider your personal financial circumstances, too, and how they’ll change when you set up your own surgery.
For example, you might not be able to continue with your NHS superannuated pension and will need to consider private options.
With that in mind, you’ll need to create a business plan much as you would with any other kind of business.
That includes doing your research on the market for healthcare services where you are, drawing up financial forecasts, setting out operational plans, and so on.
Skills and Qualifications Needed
To embark on the journey of starting a private GP practice, you must be a fully registered medical practitioner with the General Medical Council (GMC). This registration ensures that you meet the professional standards required to practice medicine in the UK. Additionally, you must hold a recognized medical degree from an accredited medical school and have completed any necessary foundation or internship programs. Depending on your area of focus, you may also need to obtain specialist registration, particularly if you plan to concentrate on a specific facet of general practice. These qualifications are crucial for establishing credibility and trust with your patients.
Choosing a structure for setting up a private medical practice
Structuring your business as a GP can be complicated, with several options to choose from depending on how you’d prefer to operate and how many people you’ll be working with.
If you’re going to be practising on your own, without any partners, you might decide to set up as a sole trader – also known as a ‘single-handed GP’.
If you prefer the flexibility of working by yourself, this could be a good option, but bear in mind that it means you’ll be solely responsible for providing appropriate premises, bookkeeping, and if you decide to take on staff, managing them and meeting your obligations as an employer. Additionally, maintaining a separate business bank account is crucial for managing your finances effectively.
There’s been a downward trend in the number of single-handed GPs in recent years, which nearly halved between 2002 and 2013.
This is in part because many GPs have found it more efficient and profitable to work in partnership with other professionals.
If you are planning to start your surgery with partners, you might choose to do so by forming a limited liability partnership (LLP).
This structure is similar in some ways to a traditional partnership and in others to a limited company – both of which you can read about in our blog post on choosing a business structure – but in summary, it means each partner will pay tax on their share of the business profits, but has limited liability for any debts.
And if you want to join up with even more GP organisations, the ‘super partnership’ structure has become increasingly popular, which allows multiple partners and practices to work within the same entity.
Your other options include forming a cooperative, a not-for-profit organisation, or a community interest company. Whichever route you go down, it’s always best to take professional advice and make sure your choice of structure meets your needs.
Regulation for how to open a GP practice
All new practices must register with the Care Quality Commission (CQC) before opening. In some cases, you may also need to seek approval from the hospital’s medical advisory committee for certain privileges and practices. This can be a lengthy process, with various pieces of preparation work and interviews required, which can take three months or more to complete.
Once you’re registered, you’ll be subject to regular inspections, and the CQC will review information it holds about your practice annually.
One of the CQC’s fundamental standards requires practices to ensure any complaints are appropriately investigated and appropriate action taken is taken in response, so you’ll need to set up a complaints policy.
Setting Up Your Practice
Setting up a private GP practice involves several critical steps, starting with choosing the right location. Your practice should be easily accessible to patients and ideally have adequate parking facilities. The premises must meet stringent health and safety standards to ensure a safe environment for both patients and staff. Equipping your practice with the necessary medical equipment is another essential aspect. This includes everything from basic diagnostic tools to more specialized equipment, depending on the services you plan to offer. Ensuring that your practice is well-equipped and meets all regulatory requirements is key to providing high-quality patient care.
Staff Management
Running a successful private GP practice often requires a team of support staff, including receptionists, nurses, and administrative personnel. Hiring the right staff is crucial, as they play a significant role in the day-to-day operations and overall patient experience. It’s important to ensure that all staff members are properly trained and qualified to provide high-quality care. Additionally, you’ll need to consider staffing levels, shift patterns, and employee benefits to maintain a motivated and efficient team. Effective staff management is essential for creating a positive and professional environment within your practice.
Technology and Operations
Investing in modern technology is vital for the efficient operation of a private GP practice. This includes practice management software that can streamline administrative tasks, electronic health records (EHR) for accurate and secure patient information, and secure communication systems to maintain patient confidentiality. Data protection is a critical concern, and you must ensure that all patient data is handled in compliance with relevant regulations. Implementing the right technology can enhance the efficiency of your practice, improve patient care, and ensure that you meet all legal and regulatory requirements.
Growing Your Practice
Once your private GP practice is up and running, you may start thinking about ways to grow and expand. This could involve appointing new partners to bring in additional expertise, expanding your premises to accommodate more patients, or even acquiring another practice. Each of these options comes with its own set of financial implications and requires careful planning. You’ll need to ensure that you have the necessary funding and resources to support your growth plans. Strategic growth can help you enhance the services you offer, increase your patient base, and ultimately achieve greater success in your private GP practice.
By following these steps and considering each aspect carefully, you can successfully navigate the process of starting and growing a private GP practice in the UK.
Managing your finances with a separate business bank account
To return to our earlier point, setting up your own surgery means becoming a business owner, and a big part of that is making sure your books are balanced.
You can do this before you start with a financial forecast. Consider the role of private medical insurance policies in your income, as many patients may use these to cover their costs.
Estimate as best you can the cost of your premises, tax, and any staff you hire, as well as your own salary, and compare that total to the income you expect to get from client fees. Does your income cover your expenditure?
You might need to be prepared to invest in the business to begin with, either with external finance or your own money, if it won’t be possible to cover your costs right away.
And make sure you have a system in place right from the start for recording your financial data and keeping accurate accounts.
You’ll need to do this to meet your tax and reporting obligations, but it’s also valuable for keeping an eye on your cashflow and staying on track to meet your goals.
As specialist accountants for medical professionals, we can help you to start and grow your GP surgery.
