How to build a solid specialist practice

Some great practical tips for consultants considering a private practice venture are shared here by Sue O’Gorman.

The opportunity to set up in private practice is something most newly appointed substantive consultants will consider.  

Whenever the ‘right time’ presents itself, setting up in private practice should involve very careful planning and navigation of multiple fundamental elements and factors.  

Following my extensive industry background in supporting consultants across all specialties with practice growth, here are my tips for ensuring a successful practice set up to provide you with the foundations for long term sustainability.

Location, location, location

Chose a facility location accessible to your target market population. This may be in central London or another large city with a critical mass of potential patients likely to utilise your services.  

Consider the proximity of the competition. Is the market already overprovided for or is there an opportunity to create something new to attract patients to your clinic?  

Your second practice location ideally should be one close to home, within your local community perhaps. 

Many newly substantive consultants will have young families and today share the responsibilities of all that goes with it, so the benefit of having a clinic close to home should not be underestimated. 

Do not be tempted to gather practising privileges at multiple locations. You will spend more time travelling from A to B to C, for which you are not earning, are likely to run late for clinic and frustrate the hospital staff who may have to pacify agitated patients on your behalf.

Ultimately, you will be treated as a ‘splitter’ rather than someone who is loyal to their facility.  

Top tip: You may be asked to meet with the facility chief executive ahead of your application, so be prepared to discuss your plans for growth and how you see yourself attracting patients to your clinic.

Discuss your opportunities for cross-referrals to other specialists in the hospital. The hospitals are there to help support your practice, but they will expect a collaborative approach.  

Civica Medical Billing

Solid credentials

Ensure you have the necessary credentials and documentation required to support your practising privileges application close to hand. 

Many, but not all, private hospitals will only accept applications from consultants who are a minimum of 12 months in a substantive NHS post.  

There may sometimes be exceptions to this on a case by case basis. The application process can be an onerous task and one you will need to perform for each hospital you apply to.  

Top tip: Allow a few hours to complete the application pack and do chase up your referees. Lack of full and complete references is the number-one reason why packs get rejected. 

If you have consultant colleagues at your chosen location well known to you, ask them to provide a reference to support your application and act as your ambassador.

Prepare to be prepared

It is important from the outset to carve out ‘admin time’ into your schedule, so that you can prepare talks, interview staff, develop a website – or appoint a marketing agency who can – and network with potential referrers and organisations who may be able to direct referrals into your clinic.  

The hospital facilities will provide you with opportunities to present to GPs and allied health professionals, so be prepared with those PowerPoint slides and have a selection of topics ready to showcase your expertise.  

Top tip: Keep information relevant to your audience.  

If you are invited to speak at an event, establish who the audience will be. A group of GPs may want to learn more about red flags and when to refer, as opposed to a group of physios who may expect a more interactive and detailed hands-on session.

The money shots

Ensure you register with the private medical insurers as soon as possible. 

This can be a lengthy process, so utilise your admin time to do this. A robust Bupa Finder profile will boost your online footprint and serve to better inform the insurers of your areas of specialty and contact details.  

Does your specialty lend itself to self-pay work? If so, think about your fee structure and how your services could be packaged to attract greater market share.  

Consider how you will bill your patients and the methodology used to collect fees. Some clinicians will do this in-house via their medical secretary, but there are good external agencies who can provide this service too.

Top tip: Ensure you verify your Bupa profile annually. Include a professional, high-resolution image of yourself and place semi-colons between each of the key specialty words – the Bupa Finder profile works on an algorithm and all of these will help get your profile listed on the first page.

The back office

The success of your practice ultimately will be underpinned by having an efficient back office function, at the helm of which will be your medical secretary or practice manager.  

The most successful consultants I have worked with have understood the value of this from day one and have invested in ensuring their phone is answered promptly, emails are responded to efficiently and the patients are well informed at all times.  

In the early stages of practice development, cost is likely to be a consideration, but there are hospitals and agencies who can provide this service remotely and will charge based on hours used. It’s a cost-effective short-term solution until your practice builds.

If you do decide to invest in employing a medical secretary, you will need practice management software to manage all of your patient data, correspondence and billing.   

These software solutions are usually operated on a licence basis and there are many providers in the market, so use your admin time to look into what platform will work best for you.

Top tip: Make regular time to meet with your medical secretary or practice manager. They are a fountain of knowledge and are the ‘shop window’ to your practice.  

Patients often develop a rapport with them, as will the insurers. So their support and feedback will prove invaluable in helping you identify any issues or opportunities early on. 

PHIN and the CMA

In 2014, the Competition and Markets Authority (CMA) issued a legally binding Private Healthcare Order requiring providers to submit key data to the Private Healthcare Information Network (PHIN).  

As a consultant who will be working in the private sector for the first time, you are required to register with PHIN, a repository of unbiased information on all private hospitals and consultants in the UK for all to access.  

Top tip: Be aware of Article 22 – a CMA order issued to all consultants six years ago that requires:

  • Outpatient letters to all patients to include your initial and follow-up consultation fees – insured and self-pay; 
  • Details of any financial interests you may have in the facilities and equipment used at the hospital;
  • A list of insurers that recognise you.  

You can set up your template letters on the practice management software. Adhere to compliance around privacy regulations (GDPR).

Create a roadmap

Private practice is a journey and one that can take several years to become established. It should continue to grow and evolve over the lifetime of the practice.  

Having a set of clear goals from the outset will help identify the key elements required to support your vision. 

Some initial aspects to consider might include, for example, understanding the demand for your service in your chosen location. Think about ‘niching’ in your clinical specialty to attract the right patients and position yourself as an expert in your field. 

Include projected costs in the plan, such as operational expenses and revenue projections. Outline time-frames for each of the objectives and note the actions you need to take to achieve them.  

This will help you have a good understanding of how you see your practice growing, allow you to remain commercially agile throughout the process and keep you on track with your business priorities for continued private practice success.

Top tip: Mystery-shop your competitors as part of this process.

What do they do well or is there a gap in the market that you can fill? It may be clinical, location or the customer service you provide that sets you apart from others.  

This is known as your ‘point of differentiation’ and will be helpful in attracting patients and referrers.

In summary, establishing a private practice requires a comprehensive approach and advice from legal, financial and other business professionals should always be sought, as it will be invaluable during the planning process.

Sue O’Gorman (right) of Medici Healthcare Consultancy provides services to help healthcare professionals think and act commercially. Website: