Who can I see as a private GP?

The short answer

Private general practice is not restricted to a list or a catchment area. Anyone can book, and patients can see you whether or not they are registered with an NHS practice. The limits come from five places: NHS contract rules, your own registration and indemnity, the law on consent, GMC guidance, and the rules of any clinic you work in.

Your NHS practice’s registered patients

This is the limit most likely to catch out an NHS GP starting private work. Under regulation 24 of the GMS Contracts Regulations 2015, and the equivalent PMS rules, an NHS practice must not charge its own registered patients for any treatment, whether or not the NHS contract covers it, except for a short list of permitted fees. The rule applies whether the practice charges directly or through another person.

So if you are a partner in an NHS practice, do not see that practice’s patients privately. If you are a salaried GP, the position is less clear-cut, but it raises contract and conflict-of-interest problems. Most GPs avoid it. See the restrictions on seeing private patients in NHS practices and which private services you can offer your own practice’s patients.

Your registration and indemnity

In England, your CQC statement of purpose must describe the kinds of services you provide and the range of service users’ needs they are meant to meet. If you register to see adults and later want to see children, or start remote consultations, update your statement of purpose and check whether you need to notify the CQC.

Your indemnity works the same way. Tell your medical defence organisation which patient groups you will see, which settings you will work in and whether you will consult remotely. Cover for children, remote consultations and patients outside the UK is not automatic. See indemnity for private GPs.

Children and young people

You can see children privately, but plan for it:

• Consent. GMC guidance on 0 to 18 year olds says you can treat with the consent of a competent child, one person with parental responsibility, or the court, provided treatment is in the child’s best interests. Young people aged 16 and 17 are presumed to have capacity. Under 16s may consent if they are competent to understand the decision.
• Who is with the child. Check that the adult accompanying a child has parental responsibility, especially for anything beyond simple advice.
• Safeguarding. You need up-to-date children’s safeguarding training at the right level, and a clear route to local safeguarding teams.
• Clinical scope. Be honest about your paediatric experience, and about equipment such as child-sized cuffs and appropriate emergency drugs.

People close to you

Good medical practice says you must, wherever possible, avoid providing medical care to yourself or anyone with whom you have a close personal relationship. That includes family and close friends, and can include colleagues. Private practice makes it easy to drift into, because friends ask to book. See professional boundaries in private practice.

Patients who are abroad

Remote consultations mean patients may contact you from outside the UK. Medical Protection’s guidance says you must be aware of local laws, including any requirement to be registered in the country where the patient is, and must check that your indemnity covers the consultation. Prescribing to a patient abroad also depends on the rules where the medicine will be dispensed. Many services limit remote care to patients who are in the UK at the time of the consultation.

Patients without an NHS GP

You can see patients who are not registered with an NHS practice, including visitors. Take extra care: you have no NHS record to check and no NHS GP to share information with. Encourage them to register if they live in England, which they can do without ID or proof of address.

If you work for someone else

With practising privileges or sessional work, the host organisation decides which patients and services you can see under its registration. Its rules may be narrower than yours, for example excluding children or certain treatments. See practising privileges.

Choosing your patients fairly

You can decide what your service offers, such as adults only, women’s health or remote consultations. What you cannot do is turn away an individual for discriminatory reasons. Good medical practice says you must not unfairly discriminate against patients, and as a service provider you have duties under the Equality Act 2010, including making reasonable adjustments for disabled patients. If you decline someone because their needs are outside your competence or service, explain why and suggest where they can go.

Scotland, Wales and Northern Ireland

The NHS contract rules and CQC requirements above apply in England. Wales, Scotland and Northern Ireland have their own GP contract regulations, and independent services there are registered by Healthcare Inspectorate Wales, Healthcare Improvement Scotland or the RQIA. Check the rules for the nation you work in. GMC guidance applies across the UK.

For what you can treat once a patient is in front of you, see what can a private GP treat?