Making the leap to private practice

This month, Independent Practitioner Today’s troubleshooters Sue O’Gorman and Hannah Browning tackle a very common question they are increasingly asked by consultants.

QI have been a substantive consultant for almost three years and have been considering transitioning from the NHS to focus solely on private practice, due to the growing demand for self-pay procedures in the on-going current climate.  

What do I need to consider before making the leap?

AMoving a surgical or medical practice over fully from the NHS into the private sector requires careful consideration and there are multiple key factors to take into account before making the decision.  

1Plan ahead 

Unless the switch is to one of an employment model contract offer with a hospital group, then a phased approach is usually the least risk-orientated approach.

It provides a safety net in the event of the private practice taking longer to develop than anticipated.  

Create a transition plan addressing demand, financial stability and personal readiness, such as financial commitments to support a young family or other individual circumstances.

2Consider a phased approach

It is common practice among consultants to initially reduce programmed activities (PAs) within their NHS base and replace those sessions within private practice.  

This gives them time and space to focus on developing a private practice, with the assurance of an income from the NHS until such time that a further reduction in PAs becomes a more viable option.  

3Financial considerations

When a consultant does decide to fully transition, it is essential to analyse the financial implications of leaving the NHS and relying solely on private practice income.  

Consider revenue potential and operational overheads to run a private practice, in particular professional medical indemnity costs. 

It may well take more time than anticipated to establish a steady patient base in the private sector, so ensure the practice is financially viable and capable of supporting income needs without the stability afforded by NHS sessions.

4Legal and regulatory considerations

Review contractual obligations with the NHS, licensing requirements, insurance and compliance with healthcare laws and regulations.  

Ensure you are prepared to navigate the complexities of operating in a private practice, which can be onerous and financially challenging. 

5Patient demand

Evaluate the demand for self-pay procedures in the specialist area. Assess the competition, patient demographics and local market trends.  

Is there a sustainable demand for this service and how prepared and well-positioned is the practice to capture and divert a significant share of the market?


Develop a detailed plan that includes steps for notifying patients, managing referrals, updating contracts and securing necessary resources for private practice.   

Set aside a budget to support these objectives in addition to protecting time in the diary on a regular basis to enable and revise the plan.

7Mitigate risk factors

Transitioning from the NHS to private practice will present a level of risk, so it is important to consider not only financial risks, but reputational and regulatory risk factors too. 

Include these risks and plans to mitigate challenges and uncertainties associated with the transition.

8Professional satisfaction and ethical considerations

Consider the impact of your decision on patient continuity of care and access.

Does this decision align with long-term goals and personal values and ethics?  

Will private practice continue to deliver the acuity of mix and diversity of patients? 

Take time to reflect on your professional satisfaction and fulfilment of working in the NHS versus the private sector.

The decision to transition from the NHS to the big leap of being solely focused on private practice should be based on a careful consideration of all the factors.  

Evaluate options, seek advice from trusted colleagues and make a decision that aligns with your personal goals and values.

Sue O’Gorman (left) is director of Medici Healthcare Consultancy. Email: 

Hannah Browning (right) is director of Beyond Excellence Healthcare Consultancy. Email: