Starting off in private practice: I'm a GP, but what next?

This is one of the questions we are asked most often by GPs. There has never been so much interest among UK GPs in working, in some way, in the independent or private sector.

GPs are rightly valued. They work hard, and their impact is real and happens at scale. But working conditions in NHS general practice have become harder over the last 15 years. Many GPs now leave the NHS early in their careers, fewer want partnership, and few newly qualified GPs see a nine or ten session week as viable.

So many GPs are looking at portfolio careers, with a foot in the NHS that trained them and a foot in private practice. The appeal is better balance, and the time and resources to practise the way they hoped to when they chose general practice.

Why good GPs stall

Given the pressures and the opportunities, you might expect far more GPs to make the move. Instead, we keep meeting excellent doctors for whom regulation, documentation, indemnity and the commercial side have seemed too daunting. They put it off, or do a little remote work for an online provider.

That work has its place, but it is not a good picture of what private general practice can be when a good clinician, or a group of them, runs a service with a strong business and patient wellbeing as shared aims. So let us look at each of those worries in turn. They are manageable tasks.

GMC licence, appraisal and revalidation

You need to be registered with a licence to practise, and you need to revalidate, which rests on an annual appraisal. Private work does not change that.

• If you keep some NHS GP work and stay on the performers list, your NHS appraisal covers your private work too. Bring evidence from your private sessions to it.
• If you go fully private, you need a new route. That may be a private provider that is a designated body, the Independent Doctors Federation, a GMC-approved suitable person, or revalidating directly with the GMC under extra requirements.

An earlier version of this post said fully private GPs must either pay for a private appraisal or keep enough NHS work to qualify for a free one. The options are wider than that. We explain each route in how to get your appraisal and revalidation as a private GP. Whichever route you take, build its cost into your yearly budget.

Indemnity

NHS general practice work in England is covered by the state-backed Clinical Negligence Scheme for General Practice (CNSGP). Private work is not. NHS Resolution says any treatment you provide privately, where the patient pays you for services outside the NHS, is not covered.

So you need your own indemnity for private work, and it is a significant cost. Tell your provider exactly what you will do, including remote consultations and any procedures, and get a quote before you commit. See do I need different indemnity to practise as a private GP?

With a licence, an appraisal route and the right indemnity, you can start work as a private GP for an existing clinic or group, for example as a sessional GP or under practising privileges.

Running your own service: the CQC

If you want to set up your own practice in England, you will need to register with the Care Quality Commission. Scotland, Wales and Northern Ireland have their own regulators and rules.

Few people look forward to it, but it is a defined process. CQC says registration can take a few months, and that it is an offence to carry on a regulated activity without being registered. Before you apply you will need a DBS check for your main point of contact, which CQC says can take up to 60 days. You will also need registered manager details where they apply, your supporting documents, and premises ready for a site visit.

How CQC assesses services is also changing. Its single assessment framework, introduced from late 2023, drew heavy criticism. After a consultation that closed in December 2025, CQC planned to publish new sector-specific frameworks in summer 2026 and start using them from the end of 2026. It has also recruited more registration inspectors to speed up applications. Check CQC's website for the framework in force when you apply.

The principle has not changed. Keep good systems, policies and records from day one, and you will be ready both for registration and for later inspections. Our guides on whether you need CQC registration and how to register your service walk through the detail.

What next?

So you are licensed, you have an appraisal route, your indemnity covers private work and, if you are running your own service, your CQC application is under way. The next decision is how you will keep clinical records. See how private GPs store their consultation notes, and for the full sequence, how to start a private GP practice.