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Private GP start-up costs: a line-by-line budget

Every cost line, the published fees at the time of review, what makes the rest vary, and how to budget for working capital.

The short answer

There is no typical total, because premises, staff and your route drive most of the cost. The fixed published fees are small by comparison. For a limited company with one location in England, the regulator’s annual fee, the ICO fee, incorporation and a DBS check came to about £2,100 in the first year at the time of review. Get quotes for everything else, budget with VAT included, and hold working capital for the months before bookings cover your costs.

Key points

  • Published fees at the time of review: CQC £1,867 a year for a private doctor with one location, ICO £52 (micro tier), Companies House £100 to incorporate online, and an enhanced DBS check £49.50 (£41 from 5 October 2026).
  • Regulator fees differ by nation. HIS in Scotland charged £3,996 to register in 2026/27, and HIW in Wales £500 to apply plus £500 a year.
  • Premises, fit-out, equipment, indemnity and staff have no reliable published range. Get at least three quotes for each.
  • Most private GP care is VAT-exempt, so you usually cannot reclaim VAT on costs. Budget with VAT-inclusive prices.
  • Working capital is the line most often missed: fund the months before bookings reach break-even.

The assumptions behind this budget

  • You are setting up your own service, with your own registration, rather than working sessionally for another provider.
  • England is the default. Where Wales, Scotland or Northern Ireland differ, we say so.
  • Figures are fees published by the body that charges them, or suppliers’ own price lists, at 24 September 2026. They change, so check each one.
  • Where no reliable public figure exists, we tell you what drives the cost rather than guess.

If you would rather fill in your own figures as you go, the Private GP Launch Pack has this budget as a worksheet.

Published fees

CostFee at the time of reviewNotes
CQC annual fee (England)£1,867 a yearFor a private doctor or clinic with one location, which the CQC places in its community healthcare fee category. There is no separate application fee.
HIW (Wales)£500 to apply, then £500 a yearPlus £100 for a registered manager, unless you are a sole trader
HIS (Scotland)£3,996 to register, then from £1,372 a yearPaid in full with the application and not refundable. The annual fee is higher if you have staff.
RQIA (Northern Ireland)Set in regulationsCheck RQIA’s current registration and annual fees before you apply
ICO data protection fee£52 a year (tier 1) or £78 (tier 2)Tier 1 covers turnover up to £632,000 or up to 10 staff. There is a £5 discount by direct debit.
Company formation£100 online£124 by post. Plus £50 for each annual confirmation statement. Nothing for a sole trader.
Enhanced DBS check£49.50, falling to £41 from 5 October 2026Plus any umbrella body charge. Scotland and Northern Ireland use Disclosure Scotland and AccessNI.
Healthcode clearing service£9.20 a month plus a fee per invoiceOnly if you invoice insurers directly. See insurer billing.

For a limited company with one location in England, the first four one-off and annual fees add up to about £2,100 in the first year (£1,867 + £52 + £100 + £49.50).

One-off costs

CostWhat drives itHow to price it
Premises deposit, legal fees and fit-outSize and condition of the site, handwash basins, flooring, lighting, data cabling and signageNothing if you rent rooms by the session. Otherwise get quotes from a surveyor and contractors.
Clinical equipmentYour services, such as ECG, spirometry, a vaccine fridge or minor surgerySupplier quotes. Consider leasing expensive items. See equipment.
Emergency medicines and equipmentYour risk assessment and servicesWholesaler quotes. See the emergency drugs cabinet.
Opening stockConsumables, dressings, sharps bins, PPE and any vaccinesWholesaler price lists. See medical supplies.
IT hardwareLaptops, printer, card reader, secure Wi-FiRetail prices. Don’t forget encryption and backups.
Brand and websiteWhether you build it yourself or use an agencyTwo or three quotes. See building your website.
Policies and registration supportYour own time, templates, or a consultantFixed-price quotes from consultants, if you use one
Software set-up and data migrationThe supplier. Some charge set-up or migration fees and others do not.Ask for it in writing

Running costs

CostPublished price or rangeNotes
Rent or room hireNo reliable published rangeVaries with location and whether you rent by the session or lease. With a lease, add service charge and utilities.
Business ratesEngland: nothing if rateable value is £12,000 or lessSmall business rate relief tapers to nothing at £15,000. Wales, Scotland and Northern Ireland run their own schemes.
Medical indemnityQuote onlyMDOs price on the amount and type of work you do. See indemnity costs.
Other insuranceQuote onlyOnce you employ anyone, employers’ liability cover of at least £5 million is a legal requirement. See essential insurance.
Clinical record and practice softwareAbout £28 to £125 per user a month for suppliers that publish pricesWriteUpp Solo £27.95 excluding VAT. Hero Health £59 per user plus 0.75% per payment, alongside EMIS Web. Jump EHR £100 on an annual plan or £125 rolling. Semble and Meddbase quote on request. Check what the price includes: booking, invoicing, SMS, video, e-prescribing and lab links can each cost extra.
Private e-prescribingVariesOften charged per prescription. See private prescribing.
PathologyLab price listsLab fees, plus courier and collection costs. Many practices pass these on to patients. See pathology.
StaffNational Living Wage £12.71 an hour (21 and over) from April 2026Employer National Insurance is 15% above £5,000 a year per employee. The Employment Allowance (up to £10,500) may offset some of it. Add workplace pension contributions.
Clinical waste, consumables, cleaningContractor quotesSee medical waste
Accountant, bank and card feesQuotes and provider tariffsCard fees are usually a percentage of each payment
MarketingYour choiceSome directory listings are free. Paid search has no fixed cost. See getting your first patients.

Which lines apply to your route

Cost lineRooms by the sessionOwn leased clinicRemote only
Regulator fees and ICOYesYesYes
Fit-out and depositNoYesNo
Business ratesUsually included in room hireYesNo
Clinical equipment and emergency kitSome (check what the host provides)YesMinimal
Software and indemnityYesYesYes
StaffOften none at firstUsually reception at leastOften none at first

Costs that are easy to miss

  • Your GMC annual retention fee, appraisal costs and any professional memberships
  • Equipment servicing, calibration and electrical safety testing
  • Card terminal rental, SMS reminder credits and paid add-ons in your software
  • Membership of an independent complaints review scheme such as ISCAS, if you choose one
  • Training for you and any staff, such as safeguarding, basic life support and infection control
  • Your own sick pay and holiday cover, which the practice has to absorb
  • Professional fees for your lease, contracts and employment paperwork

Add each one to the worksheet, even if the amount is small. Together they add up.

VAT: budget gross, not net

Medical care by a registered doctor is exempt from VAT when its main purpose is the patient’s health. A practice that makes only exempt supplies does not charge VAT and cannot reclaim the VAT on its costs. So a £1,000 piece of equipment plus VAT costs you £1,200. Some reports and medicals are standard-rated. If you make some taxable supplies as well, the partial exemption rules usually limit how much VAT you can recover. See VAT for private GPs.

Working capital

You pay rent, indemnity, software and insurance from the first month, and some costs come before you can see a patient at all. To size the buffer:

  1. Add up your monthly running costs.
  2. Estimate how many months it will take to reach break-even, using a slow case as well as your expected one. See pricing and break-even.
  3. Multiply the two, add your one-off costs, and add a contingency you are comfortable with.

That total is what you need from savings, a loan or investors. Once you open, compare actual spending with the budget every month and update your break-even figure, so you spot a shortfall while there is still time to act. See funding a new practice.

Keeping costs down

  • Start in rooms hired by the session, or under practising privileges, and move once demand is proven.
  • Launch with a focused set of services. Each new service can add equipment, training, indemnity and registration cost.
  • Prefer software with published prices, no set-up fee and monthly terms, so a slow start costs less.
  • Get three quotes for insurance, waste, fit-out and equipment.

For the full sequence of set-up steps, see how to start a private GP practice.

Tools that can help

Frequently asked questions

Is there a CQC application fee?

No separate one. The CQC’s annual fee covers registration and ongoing regulation, and was £1,867 for a private doctor with one location at the time of review.

What is the cheapest way to start?

Renting a consulting room by the session in an existing clinic, or working under practising privileges, avoids fit-out, rates and most equipment costs.

Can I claim start-up costs against tax?

Many business costs are allowable, and some costs incurred before you start trading can be claimed. Ask your accountant how this works for your structure.

Why is Scotland more expensive to register in?

Each regulator sets its own fees. HIS charges a registration fee up front as well as an annual fee, while the CQC charges only an annual fee.

How long before a new practice covers its costs?

It depends on your prices, sessions and how quickly patients find you. Model a slow start as well as a realistic one, and keep enough cash for the slow case.

Sources

  1. Provider fees payable: independent healthcareCare Quality Commission · cqc.org.uk · Accessed
  2. Independent healthcare feesHealthcare Inspectorate Wales · hiw.org.uk · Accessed
  3. Independent healthcare fees 2026-27Healthcare Improvement Scotland · healthcareimprovementscotland.scot · Accessed
  4. Data protection feeInformation Commissioner’s Office · ico.org.uk · Accessed
  5. Companies House feesCompanies House · gov.uk · Accessed
  6. DBS reduces fees for checks and Update Service from 5 October 2026GOV.UK · gov.uk · Accessed
  7. Small business rate reliefGOV.UK · gov.uk · Accessed
  8. Employers’ liability insuranceGOV.UK · gov.uk · Accessed
  9. Rates and thresholds for employers 2026 to 2027GOV.UK · gov.uk · Accessed
  10. PricingWriteUpp · writeupp.com · Accessed
  11. Changes to the data protection feeInformation Commissioner’s Office · ico.org.uk · Accessed
  12. Check someone’s criminal record as an employerGOV.UK · gov.uk · Accessed
  13. FeesCare Quality Commission · cqc.org.uk · Accessed
  14. Services within our fees categoriesCare Quality Commission · cqc.org.uk · Accessed
  15. Partial exemption (VAT Notice 706)HM Revenue and Customs · gov.uk · Accessed
  16. Employers’ Liability (Compulsory Insurance) Act 1969: a brief guide for employers (HSE40)Health and Safety Executive · hse.gov.uk · Accessed
  17. Who needs to register with us?Healthcare Inspectorate Wales · hiw.org.uk · Accessed
  18. Regulation of independent healthcareHealthcare Improvement Scotland · healthcareimprovementscotland.scot · Accessed
  19. Registration guidanceRQIA · rqia.org.uk · Accessed