Can I practise as a private GP from any residential or commercial premises?

Your options

As a private GP you may practise from home, a purpose-built surgery, rooms rented by the session, or consulting rooms in a private hospital. Each has different costs and rules.

Option	Who registers the site	Suits	Watch for
Consulting rooms in a private hospital or clinic, under practising privileges	Usually the host	Starting out, and access to diagnostics and staff	Room fees and the host's rules. See practising privileges.
Room rented by the session in another provider's clinic	You, for your own service, unless you work under the host's registration	Testing an area cheaply	Agreeing who provides and checks shared equipment, emergency kit and waste
Your own leased or owned premises	You	An established or growing service	Cost, fit-out and a long commitment. See leasing versus buying.
Your home	You	Low overheads and a small list	Planning, insurance, safety and privacy. See seeing patients from your home.
Remote only	You, at the address you run the service from	Video and phone services	You still need a base and a plan for patients who need examining

For choosing the area and the building, see choosing a location.

Registration of the site

In England, your CQC registration lists the locations where you carry on regulated activities. A new site means adding a location before you use it. If you work within another provider's service under practising privileges, the host's registration usually covers you, but confirm this with the host and the CQC. See whether you need CQC registration.

When you apply, the CQC asks all providers for a building control final certificate if any location needed building regulations approval. It may also ask to see your health and safety risk assessment and your list of risk assessments, so have them ready.

What the premises must provide

Regulation 15 requires premises and equipment to be clean, secure, suitable for their purpose, properly used, properly maintained and appropriately located. The CQC's guidance says that includes:

• a layout big enough for the number of people using it, with adequate toilets, waiting space and storage
• privacy, dignity and confidentiality, so conversations cannot be overheard
• easy access in and out, with reasonable adjustments under the Equality Act 2010
• regular health and safety risk assessments of the premises
• arrangements for maintenance, repair and replacement.

For general practice, the CQC's infection control guidance adds adequate handwashing facilities, clinical rooms without carpets, and a secure area for waste awaiting collection. NHS England's Health Building Note 11-01 on facilities for primary and community care is the usual design reference if you are fitting out new rooms.

Planning

In England, "the provision of medical or health services, principally to visiting members of the public" falls within Use Class E(e), but not premises attached to the residence of the practitioner. So:

• many shops, offices and other Class E units can become a clinic without planning permission for change of use, although other consents such as signage may still be needed
• seeing patients at home may or may not be a material change of use, depending on its scale and effect. See seeing patients from your home.

Scotland, Wales and Northern Ireland have their own use classes, so check with the local planning authority.

Legal and practical checks before you commit

• Lease or deeds. The permitted use must allow clinical services, and you need consent for alterations such as basins, signage and cabling.
• Building control. Any works that need approval must be signed off, and you will need the certificate.
• Fire safety. In England and Wales the responsible person must carry out and record a fire risk assessment for non-domestic premises. In shared buildings, coordinate with the landlord.
• Business rates. Most non-domestic property pays business rates, and small business rate relief may apply.
• Accessibility. See accessibility requirements.
• Insurance. Buildings, contents and public liability cover must reflect clinical use. See essential insurance.
• Practicalities. Reliable broadband, courier access for samples, safe access for evening clinics, and somewhere to store clinical waste.

Moving or adding a site later

Many GPs start in rented rooms or at home and move as the practice grows. In England, tell the CQC before you move or add a location, and update your statement of purpose, website and patient information. Allow time, because a change of location is an application, not a notification.

Scotland, Wales and Northern Ireland

Healthcare Improvement Scotland, Healthcare Inspectorate Wales and RQIA register independent healthcare services and each has its own premises standards. Planning, fire safety and business rates are devolved, so the details differ in each nation.