Setting up a private GP practice: where to start

Starting a private GP practice is one of the most rewarding - and daunting - career moves a doctor can make. You gain clinical autonomy, control over your working patterns, and the ability to practise medicine the way you were trained to. But the administrative side can feel overwhelming if you have not done it before.

This is the first in a five-part series covering everything you need to know about setting up and running a private GP practice in the UK. We will keep it practical and honest - no fluff, just the things we wish someone had told us.

Start with a business plan

Before anything else, write a business plan. It does not need to be a 50-page document - a clear, honest assessment of your market, your costs, and your revenue model is enough.

Your plan should cover:

• Target patient demographic and catchment area
• Estimated patient volumes in year one, two, and three
• Pricing model - per consultation, membership, or hybrid
• Monthly fixed costs - rent, staff, insurance, technology
• Break-even timeline and cash reserve requirements

Most private GPs underestimate how long it takes to build a full patient list. Budget for 12-18 months before you reach steady state. Having a financial cushion is not optional.

CQC registration

In England, any independent clinic providing regulated activities must register with the Care Quality Commission. This is non-negotiable and takes longer than most people expect - typically 12-16 weeks from application to approval, sometimes longer.

You will need to demonstrate:

• A registered manager (often you, initially)
• A statement of purpose describing your services
• Policies covering safeguarding, infection control, complaints, and clinical governance
• Evidence of appropriate clinical systems and record-keeping
• DBS checks for all staff

Start this process early. You cannot see patients until registration is granted, so every week of delay costs you revenue.

Choosing your premises

Your premises need to meet CQC standards, be accessible to patients, and work financially. The main options are:

• Renting rooms in an existing clinic or hospital - lowest risk, shared overheads, but less control
• Leasing dedicated premises - more control but higher fixed costs and fit-out requirements
• Starting from a home consultation room - possible for initial patients but limits scalability

Whichever route you choose, ensure the space meets infection control standards, has adequate patient waiting areas, and has reliable internet connectivity. Your clinical system, communication tools, and payment processing all depend on a stable connection.

Professional indemnity and insurance

You will need medical indemnity cover for private practice. The MDU, MPS, and MDDUS all offer private practice policies, as do commercial insurers. Check that your cover includes:

• All services you plan to offer (some policies exclude certain procedures)
• Locum and employed clinician cover if applicable
• Good Samaritan cover
• Run-off cover if you change providers

Beyond medical indemnity, you need public liability insurance, employers liability if you have staff, and cyber insurance. The last one is increasingly important - you are holding sensitive patient data and regulators take breaches seriously.

Building your founding team

Even a solo GP practice needs support. At minimum, you will likely need:

• A practice manager or administrator (even part-time initially)
• An accountant familiar with healthcare businesses
• A solicitor for contracts and lease review
• An IT provider or clinical system vendor who understands primary care

Hiring a good practice manager early is one of the highest-return investments you can make. They handle the operational complexity that would otherwise consume your clinical time.

What is next

In part two of this series, we cover the technology and clinical systems you need to run a safe, efficient private practice - from EHR software to payment processing and patient communication tools.