Could your specialist interest become a private practice?  

At Medical Defense Society, we are seeing a growing number of GPs explore opportunities in private practice. But this need not involve leaving NHS general practice or making an immediate transition to full-time private work.

Many GPs take a more gradual approach, developing a portfolio career that combines a limited private service with ongoing NHS sessions. An established clinical interest often provides a natural foundation for a focused and clearly defined private offering.

However, careful research and planning are essential. If you are considering incorporating private practice into your portfolio career, you need to define your service clearly and ensure that it is underpinned by genuine competence, demonstrable patient demand, robust governance and appropriate indemnity arrangements.

A growing interest in private practice

In June 2026, a poll of 500 UK GPs by financial services firm Wesleyan found that more than a quarter (27%) already undertook private work, while another third (33%) planned to start within a year. With workload issues continuing to affect general practice, a key driver of this trend was concerns about the 2026/27 NHS contract changes. GPs also perceived potential for higher earnings, improved work-life balance and greater flexibility in private work. 

If you are also considering a move to private practice, it may offer greater professional autonomy, a way to rebalance your working life, and an opportunity to reconnect with an area of medicine about which you feel genuinely passionate. But it should not be treated simply as an escape from NHS pressure or a quick route to additional income. Building a sustainable private practice requires careful planning.

Private practice does not have to be all or nothing

For GPs, ‘going private’ does not necessarily mean resigning from an NHS partnership or salaried post to launch a full-service private general practice. A strategic, phased transition into a portfolio career that includes some private work is often the more viable approach. 

For instance, you might retain several NHS sessions while working one session a week in a private clinic or piloting a small, focused private service. Starting on a limited basis avoids the need for excessive commitments of time and money at the outset. It also gives you an opportunity to understand the less visible workload generated by private care, including correspondence, results, prescribing queries, referrals and follow-up, as well as business administration.

Start with an established interest

The strongest foundation for private practice is usually an area in which you already have a sustained professional interest. Examples might include women’s health, menopause care, weight management, sports medicine, occupational health, travel medicine, dermatology, or lifestyle medicine. The RCGP’s GP+ Careers podcast and Extended Roles guidance offer some insights into the variety of special interests and career paths available within general practice. 

As well as interest in the field, you will also need relevant qualifications or training, practical experience, and insight into patients’ unmet needs. The precise opportunity will depend on your competence in the area and local demand for the service.

As your confidence, patient base and experience grow, you may choose to devote more of your working time to private practice. Your initial specialist interest may even become the foundation for a broader service. A GP beginning with weight management, for example, may subsequently introduce related areas of care that complement the original service.

Define your scope and be precise about your expertise

Before offering a private GP service, you will need to define exactly what the service will and will not provide. Important questions to ask yourself may include:

• Which patients and conditions will you accept?
• Which investigations and treatments will you offer?
• What services will fall outside your private practice?
• Will you require specialist input?

Your planning should also establish how you will demonstrate and maintain the competence required to offer the service. It may be helpful to review the RCGP’s Extended Roles guidance, which focuses on how to demonstrate competence beyond the normal scope of general practice across all clinical specialisms.

Also consider how you will promote your private service. General Medical Council (GMC) standards require doctors to be honest about their experience, qualifications and current role. Follow the Committee of Advertising Practice codes to ensure that your advertising meets the required high standards.

Information about your services, qualifications and competence should be reflected consistently across patient information, marketing, clinical and business documents.

Establish whether there is genuine patient demand

Before launching a new private service, research whether there is sufficient patient demand to make it viable. Consider unmet patient needs, local NHS waiting times and referral pathways, other private provision in the area, and whether your service would offer a clear and clinically appropriate benefit at a price patients would realistically be prepared to pay.

A small pilot may help you to establish the viability of the service. This might involve a limited number of clinic sessions within an established provider’s premises. Useful information to collect during the pilot would include enquiries, bookings, patient feedback, outcomes, unpaid workload and the true cost of delivering each consultation.

Establish robust governance 

Before starting a private service, you need to ensure that appropriate clinical governance arrangements are in place, including establishing whether Care Quality Commission (CQC) registration is required. This will depend on who provides the service, how it is structured, and which regulated activities are being carried out. Be aware that it is an offence to carry on a regulated activity without the required registration.

Governance should cover the full patient journey. Your arrangements should address contracts; premises and equipment; patient identification and consent; clinical records and information governance; prescribing and medicines management; safeguarding; test-result handling; referrals and escalation; continuity and follow-up; complaints and significant-event procedures; audit, outcome monitoring and patient feedback; emergency arrangements and cover during absence. 

Follow guidance from the CQC, British Medical Association (BMA) and GMC, and review your arrangements regularly as your service develops.

You also need to understand the requirements that apply when you work across both NHS and private practice. The boundaries between the two services should be clear in relation to funding, legal status, liability and accountability. Be explicit about which service you are providing, on what basis and where responsibility lies. If you are a GMS or PMS contractor, make sure you understand the restrictions on private work set out by the BMA.

Take time to seek appropriate financial advice when planning your private business. Establish a clear and transparent fee structure, and consider how changes to your income may affect your tax position and pension arrangements.

Make sure your indemnity follows the work

Plan your indemnity from the outset, rather than treating it as an afterthought. The GMC requires you to have insurance or indemnity appropriate to the full scope of your practice. State-backed clinical negligence schemes may cover qualifying NHS general practice, but private clinical work and other portfolio roles will usually require separate or additional protection.

Speak to us at Medical Defense Society before launching your service so we can advise on the protection you need. Your indemnity should reflect both the private nature of your work and the specific services you intend to provide.

Tell us about your planned services before you start, and let us know whenever your work changes or expands. This helps ensure that your indemnity continues to match your actual scope of practice.

Our Specialist Portfolio Membership is designed for GPs with defined specialist interests, allowing us to tailor indemnity around the services you provide.

Is your specialist interest ready to become a service?

Your specialist interest can become a rewarding private offering without requiring you to leave NHS general practice. A considered approach is to establish your competence, define a focused scope, test patient demand, put robust governance in place and expand only when your experience and the evidence support it.

Use our checklist as a guide:

1. Can you demonstrate appropriate training, experience and current competence in the field of interest? 
2. Have you clearly defined the scope of your service and its limits? 
3. Is there evidence of sustained patient demand to support a viable service? 
4. Are the regulatory and governance frameworks in place?
5. Do you have appropriate indemnity arrangements?

Contact Medical Defense Society for advice from our expert team and to arrange indemnity that reflects the service you plan to provide.