How should I communicate with patients as a private GP?

What changes in private practice

The clinical skills are the same as in NHS general practice. What changes is that patients are paying, often expect to reach you directly, and may use you alongside their NHS GP. In our experience, many problems in private practice come from communication rather than clinical care: unclear costs, results that were never explained, or a message that went unanswered.

So think of communication as a system, not just a consultation skill. Decide how patients reach you, how quickly you reply, how results reach them, and what goes in writing.

In the consultation

Longer appointments are one of the main reasons patients choose private care, so use the time well.

• Agree the agenda early. Ask what the patient hopes to leave with. Private patients often bring several problems and a specific request.
• Talk about cost before you act. If you suggest tests, a follow-up or a referral, say what it costs and whether there are NHS alternatives, before the patient agrees.
• Explain options, including doing nothing. Give information in a way the patient can understand, and check it has landed.
• Be clear about who does what next. You, the patient or their NHS GP. Don’t assume the NHS GP will take over prescribing or tests you started. The BMA advises NHS GPs that they are not obliged to act on private recommendations they do not agree with.

Put the plan in writing

A short written summary after each consultation prevents most misunderstandings. It needs only a few lines:

• what you found and what you think is going on
• what you prescribed or arranged, and what it costs
• when and how the patient will get results
• safety-netting: which symptoms mean they should contact you, NHS 111 or 999
• whether you are writing to their NHS GP, with their agreement.

Send it through a secure channel and keep a copy in the record. For the letter to the NHS GP, see sending notes to the NHS GP.

Choosing your channels

Channel	Good for	Watch out for
Phone	Urgent issues, anxious patients, explaining results	Calls at all hours and no written record unless you make one
Secure messaging or portal	Questions, documents, results, follow-up	Patients need to log in; set response times
Encrypted email	Letters, summaries and results	Wrong recipients; check the address every time
Ordinary email or text	Reminders and “please log in” notices	Keep confidential detail out
Video	Follow-up and consultations that do not need examination	Identity, privacy and when to see in person
Post	Patients who prefer it; formal documents	Slow

NHS England’s guidance on messaging patients is a sensible model. You do not need consent to message patients about their own care, but you should record and respect their preferences, keep confidential information out of unencrypted messages, use only approved tools and keep a copy or summary of each message in the record. See secure email and video appointments.

Response times and out of hours

Patients who pay reasonably expect a reply. They do not need an instant one, but they need to know when it will come.

• Publish your response times for messages and calls, for example “by the end of the next working day”.
• Say clearly what patients should do when you are not available, and repeat it in auto-replies and voicemail: NHS 111 for urgent advice, 999 for emergencies.
• Make sure messages are read when you are on leave, or switch the channel off and say so.

Whether to give out a direct phone number is a separate decision. See should I give patients my phone number? and professional boundaries.

Results

Results are where communication most often fails. Agree at the time of the test how the patient will hear, and who is responsible for acting on it. Tell patients about normal results as well as abnormal ones, so silence never has to be interpreted. Explain abnormal results by phone or in a consultation rather than a bare message, and record what you said.

Accessible communication

The NHS Accessible Information Standard applies to NHS and publicly funded adult social care, so it does not strictly cover a purely private service. The Equality Act 2010 does. You must make reasonable adjustments for disabled patients, including providing information in an accessible format, and you cannot charge the patient for the cost of the adjustment. Following the standard’s steps is an easy way to do this: ask about communication needs, record them, flag them, share them when you refer, and meet them.

For patients who do not speak English well, use a professional interpreter for anything clinical rather than a family member.

Keep care messages and marketing separate

Messages about a patient’s own care are not marketing. Newsletters, offers and promotions are, and they need consent or a valid soft opt-in, with an easy way to unsubscribe in every message. Keep the two separate so a patient who opts out of marketing still gets their reminders and results.

Ask how you are doing

Ask for feedback after appointments and read it. Patterns such as unclear costs or slow replies show where your system needs fixing. See getting feedback from patients.