Setting up a private GP practice has been the most rewarding time since Dr Sibel Peck qualified. But she advises not to try and juggle the job with being an NHS GP too. Read her story here.
Here’s how I would summarise my life as a private GP: I have been able to enjoy a good work-life balance. I have been able to offer clinical care that is patient-centred. I have been able to assert more of my ideas when it comes to our business development.
Private GP work was always on my radar because my father worked as a private GP in his lunch breaks and evenings when practising full-time as an NHS GP in Tottenham back in the 1970s.
I completed my GP training scheme in 1993 and then worked as a GP locum while having a family.
For five years, I worked on the GP retainer scheme and considered what I wanted to do next professionally. Some of my medical school friends had already joined as partners in NHS practices and they regretted it. These were red flags for me.
I was also getting frustrated with the quality of care I was trying to deliver in seven-minute consultations.
Consequently, my clinics always over-ran and that further frustrated me. I always seemed to be trying to spin multiple plates and helping patients to manage crises as they awaited referrals, scans or other test results.
By the time I was ready to return to work on a more full-time basis, I had relocated to Essex as a result of my husband’s new consultant post.
In October 2000, I approached the local private hospital and met with the general manager to inquire whether they would consider a private GP practice. This was a novel idea at the time and had not been done before in this hospital, so the manager was rather sceptical.
I had also met with another local GP, Anne Squire, who was looking for a new challenge from her NHS role as a GP principal and tutor.
We had been set up as a ‘blind date’ by our husbands, who had been chatting in the operating theatre together. When we met over an egg sandwich and a cup of tea, we realised we had the same aspirations and goals in providing a patient-centred service. We immediately set to work.
It took about six months from our first meeting to open our private GP practice.
In this period, we made some big decisions that we have stuck with until the present time.
We decided we would be a paperless practice and took out a contract with Egton hardware and EMIS software to hold our patient records; we currently use EMIS web.
Our business name would be very simple – Private GP Services – and we bought the www.privategpservices.co.uk domain name.
We designed our practice leaflet and had it distributed within the hospital, informing patients throughout the waiting room areas that our practice would soon be opening.
Adverts were placed in the local press and we arranged leaflet drops in a ten-mile radius.
Our website was also designed by us and so was our own headed paper. We arranged a direct phone number through to the GP appointment line and the hospital dedicated a receptionist to support our service.
Initially, the hospital dedicated a single consulting room for us and we ran a Monday-Friday service with the two of us job-sharing a full-time role.
On our first day, 5 March 2001; we saw three patients.
Fast forward to 2020 and we now have our own dedicated GP area within the hospital with a dedicated waiting area, two full-time consulting rooms and administrative rooms. We have a team of two GP partners, six reception staff, six GP associates and one travel vaccination nurse.
There are now over 50,000 patients on our database, with appointments offered Monday to Friday from 8am-8pm. We can provide same-day appointments, so have so far avoided offering weekend appointments.
We advertise very little and most of our referrals are from word of mouth recommendations.
Back in 2001 we started with a budget of £5,000 which we spent on our PCs and software contract. There were no other private GP practices in our area, so we dominated the market early on.
In the last ten years, other private practices have begun to open – and close – in our 20-mile radius.
Many of them have folded because the GPs have tried to work in both the NHS and private sectors. Ours has survived because we were able to commit full time to private practice.
We could offer same- or next-day appointments and we could offer minimum 15-minute consultations.
Initially, many of the local GP NHS practices were sceptical and wary of us. But now, after 19 years of our practice demonstrating clinical excellence and building a good reputation, they refer patients to us for services they cannot provide.
Our business has taken off in a locality where NHS practices are struggling due to manpower shortages. Over 50% of the current GPs in mid-Essex will be retiring in the next five years. Waiting times for a routine GP appointment are around six weeks in many of the local practices.
Chelmsford and the surrounding areas are expanding at an incredible rate. The City Council/Borough Council has been granting planning permission for housing with 7,880 new dwellings built in Chelmsford alone from 2001-2016. The current proposed building rate of dwellings is 850 homes a year until 2030.
There are also a high number of commuters into London. The self-pay market is expanding and families are increasingly using their savings for private health instead of paying the rising costs of private health insurance subscriptions.
Around 25% of our appointments are new clients. We have a high loyal customer base and can continue to offer same- or next-day appointments.
Patients choose the length of their consultations. Our registered patients can request repeat prescriptions for three month supplies in most instances.
Last year, after deciding to apply for our own Care Quality Commission (CQC) registration, we had to dig deep to prepare for an imminent inspection that finally occurred in March 2019.
The team worked hard in preparation and thankfully it went well, although the CQC inspectors were not awarding gradings at this time.
We are now looking ahead to a follow-up inspection, which we have been advised will take place in the next two years, but now gradings will be awarded to the five key lines of inquiry: safe, effective, caring, responsive and well-led.
GPs starting out now in private practice should be considering platforms that allow video consultations, online bookings and online payments.
These are areas we have yet to move into. Marketing is now more sophisticated especially with social media and practices will increasingly most likely have a presence on Facebook, Instagram and Twitter. Encouraging patient reviews on Doctify, Google and other platforms will also enhance patient numbers.
So what advice would I give to someone thinking about private general practice?
I would say have a GP colleague to start in practice with because it can be isolating to work alone and a team works far better.
Have a robust system for patient records and invoicing; we used EMIS as we were already proficient in it from our NHS days. There are now many more patient/practice management packages out there now.
Commit 100% to private GP practice; don’t try to balance this with working as a GP in the NHS. You need to be available to offer daily appointments, as most of our patients book within 48 hours of their consultation.
I have found the last 19 years in private GP practice the most rewarding of my time as a doctor. I have been able to enjoy a good work-life balance and offer clinical care that is patient-centred. I have been able to assert more of my ideas when it comes to our business development.
I was blessed to meet a GP partner, Anne Squire, who retired late last year. We had 19 years of a happy ‘marriage’ and achieved a lot from our small and humble beginnings.
My partner, Dr Jo Josson McConnell, who joined us six years ago, brought her own skill set to our practice and spearheaded our success in the CQC inspection.
We have a loyal team that has become a tight-knit family. Many of our admin staff have been with us for over 15 years, our practice has grown with GP associates numbers who have joined and stayed.
You would have to ask them, but hopefully it’s a testament to the fact that, they too, find their work in private practice rewarding.