Private Practice Success: How Consultants Can Build a Practice That Works

The simplest model involves delivering private work inside an existing facility, often an NHS private patient unit or an independent hospital, on a room rental basis. “Consultants arrive to a fully operational environment – staff, systems and equipment already in place”. The host organisation provides the infrastructure, governance and operational support, allowing clinicians to focus on clinical delivery.

Advantages 

• No capital outlay: No need for premises or equipment investment.
• Operational cover: Bookings, payments, governance and clinical systems are provided by the host.
• Low risk: Consultants can build experience in private practice without major exposure.

Pitfalls

• Limited autonomy: Consultants must adapt to the host’s systems and processes.
• Revenue generation: Consultants can only bill their own fees, with all provider fees going to the facility.
• Patient ownership: The facility, not the consultant, often “owns” the patient journey.
  

Best Practice and Consultant Actions

• Protect brand and continuity: Look at using the hospital to start building your brand and awareness in the market.
• Test the waters: Use this model to establish private practice demand before scaling up.

Inspired by the barristers’ chambers system, consultants pool resources, share a branded “front door” and jointly fund back-office infrastructure such as reception, billing and marketing with a practice manager in place.

Advantages

• Economies of scale: shared facilities and staff reduce costs.
• Professional environment: offers patients a polished experience beyond ad hoc consulting.
• Collaboration: encourages peer support and multidisciplinary pathways.
  

Pitfalls

• Governance risks: without clear agreements, disputes between consultants can destabilise operations.
• Variable commitment: consultants may differ in their willingness to invest time and resources.
• Booking and capacity clashes: shared rooms require transparent scheduling systems.
  

Best Practice and Consultant Actions

• Formalise governance: Create shareholder agreements, role definitions and conflict-resolution processes. “Often there’s a lead consultant who runs the books and oversees the shared services.” “Get agreements in place, work out who handles costs, who has a say on major purchases, what happens when someone wants to leave.”
• Invest in systems: Robust CRM/EPR and booking platforms prevent disputes.
• Define the offer: Keep the scope narrow; do a handful of things brilliantly, then expand.

A management company delivers the facility to specification, provides operational services under service-level agreements (SLAs) and leaves consultants to focus on clinical work.

Advantages

• Professional engine room: administrative, regulatory and operational tasks are outsourced.
• Predictable costs: service charges and SLAs provide transparency.
• Focus on clinical excellence: consultants concentrate on patients, not back-office burdens.
  

Pitfalls

• Scope creep: management partners may add services or costs beyond initial agreements.
• Reduced control: consultants rely on third parties for governance and brand integrity.
• Dependency risk: if the partner underperforms, clinical reputation suffers.

Best Practice and Consultant Actions

• Negotiate watertight SLAs: Include performance metrics and escalation processes.
• Retain oversight: Create joint committees for quality, finance and patient experience.
• Plan succession: Avoid dependence on a single management partner by building in review points.

Consultants form a joint venture (JV) with a hospital group, gaining access to theatres, wards and diagnostics while holding limited equity. Under Competition and Markets Authority (CMA) rules, consultant equity is capped (typically at 5%).

Advantages

• Full clinical pathway: from consultation through to surgery and recovery.
• Shared governance: hospital committees provide oversight.
• Scale and brand association: alignment with an established hospital builds patient trust.

Pitfalls

• Equity cap: limits consultants’ ability to realise long-term value.
• Higher regulatory burden: hospitals face greater scrutiny than outpatient centres.
• Design pinch points: theatre sizing, sterile services and recovery flows can constrain operations.

Best Practice and Consultant Actions

• Understand the governance structure: clarify representation on boards and committees.
• Model patient flows: Anticipate pinch points in theatres and wards.
• Plan for exit: recognise equity caps and plan how to realise value elsewhere. “There are a lot of variables.” “Do they want out in 10 years, and if so, what do they want to have achieved by then? Over that time, do they want to deliver a particular standard of patient care, make a certain level of income and establish themselves in the market?”

At the highest-risk, highest-control end of the spectrum, consultants own and operate a facility outright, funded by debt or external investors. They control brand, patient journey and strategic direction.

Advantages

• Total autonomy: full control over pathways, operations and growth.
• Asset ownership: potential to build long-term equity.
• Strategic freedom: ability to innovate in design, services and branding.
  

Pitfalls

• Financial exposure: consultants carry debt, overheads and operational risk.
• Complex operations: phones, payments, electronic patient registration (EPR), insurance contracts, marketing, and compliance all fall to the owners.
• Regulatory scrutiny: full accountability for safety, governance and planning.

Best Practice and Consultant Actions

• Secure professional expertise: Invest in finance, operations, compliance and marketing from the outset.
• Future-proof design: Plan for robotics, AI, digital records, and same-day surgery trends.
• Start narrow: Focus on one speciality or service line, then scale gradually.