As a private GP, what can I treat?

The principle: your competence sets the limit

There is no list of conditions a private GP may or may not treat. Acute illness, long-term conditions, mental health, women’s and men’s health, minor injuries: if you would manage it competently as an NHS GP, you can manage it privately. Good medical practice says you must recognise and work within the limits of your competence, and that applies in every setting.

Private practice also lets you do things the NHS GP contract does not pay for, such as extended health checks, travel clinics or procedures. For each one, check four things: your competence, your registration, the prescribing rules and your indemnity.

Your registration must cover it

In England, the CQC regulates activities rather than conditions. Most GP consultations fall under treatment of disease, disorder or injury. Several services you might add are separate regulated activities:

Service	Regulated activity it may fall under
Blood tests sent to a lab, ECGs, ultrasound	Diagnostic and screening procedures
Minor surgery, some skin procedures	Surgical procedures
Coils, implants and other contraception	Family planning services
Weight-loss services	Services in slimming clinics
Telephone or online advice	Transport services, triage and medical advice provided remotely

Some minor procedures are excepted from some of these activities, so check the CQC’s guidance on each one before you launch. See CQC registration by service. Scotland, Wales and Northern Ireland have their own regulators and definitions.

Prescribing

You can prescribe privately for almost anything you would prescribe in the NHS, on a paper prescription or through a private e-prescribing service. The patient pays for the medicine. Some areas need more care:

• Controlled drugs. Private prescriptions for Schedule 2 and 3 drugs need the special private form and your private prescriber code, and cannot be sent electronically. See private prescribing and EPS.
• Remote prescribing. GMC guidance applies the same standards as face to face. Be especially cautious with medicines open to misuse or that need monitoring.
• Long-term treatments. If you start something that needs monitoring, plan to continue it yourself. NHS GPs are not obliged to take over private prescribing or enter shared care.

Services with their own rules

• Cosmetic injectables. GMC guidance for doctors offering cosmetic interventions says you must not prescribe injectable cosmetic medicines, such as botulinum toxin, by telephone, video link or online, or at the request of others for patients you have not examined. The government has also said it will introduce licensing for non-surgical cosmetic procedures in England through secondary legislation, so check the current position before offering them.
• Travel vaccines. You can offer vaccines the NHS does not fund, such as rabies or Japanese encephalitis. Yellow fever vaccine can only be given at a centre designated by NaTHNaC, which has its own conditions and training. See ordering private immunisations.
• Special interests. Menopause, weight management, minor surgery, contraception and similar services usually need training beyond core general practice. Keep evidence of it and cover the work in your appraisal. See appraisal and revalidation for private GPs.

Investigations and results

Treating privately usually means investigating privately too. You can order blood tests, imaging and other investigations through private laboratories and imaging providers, and the patient pays for them. Whatever you order, you are responsible for reviewing and acting on the result. BMA guidance for NHS practices says private providers should arrange and deal with the tests they think are needed, rather than asking the NHS GP to do so. Before you order, tell the patient the cost and what happens if something abnormal is found. See where to get pathology done.

Indemnity

Your medical defence organisation needs to know what you do. Cover for general practice does not automatically include cosmetic work, procedures, remote consultations or patients abroad. Tell them before you add a service, not after. See indemnity for private GPs.

What to send elsewhere

Some things are better handled outside a private GP service:

• emergencies, which belong in A&E or with 999
• problems needing hospital investigation or specialist care, which you refer on. See NHS referrals from private GPs
• ongoing care that needs NHS monitoring when you cannot share information with the NHS GP
• NHS screening and vaccination programmes, which run through the patient’s NHS practice

Choosing what to offer

What you can treat and what you should offer are different questions. For which patients you can see, see who can I see as a private GP? For shaping your service around demand, see deciding the range of services to offer.