Can I run a private practice by myself?

Ways to work alone

• Your own registered service, as a sole trader or through your own company. You hold the regulator registration and run everything.
• Consulting in someone else’s clinic, renting a room by the session or under practising privileges. You work independently, but the host usually holds the registration, premises and support staff.
• A remote service, run from a registered base, which in England may count as online primary care for CQC purposes.

The second route is the lightest way to work solo. The first gives the most control and the most responsibility. For the full set-up sequence, see how to start a private GP practice.

Registering as an individual

The CQC (Registration) Regulations 2009 impose a registered manager condition on any company or partnership, and on an individual provider who is not fit to manage the service or is not in full-time day-to-day charge of it. So:

• as a sole trader who runs the service, you are usually the registered provider with no separate manager
• as a one-GP company, the company is the provider and needs a registered manager, who can be you

See whether to set up a company. In Scotland, Wales and Northern Ireland, check the equivalent rules with HIS, HIW or RQIA.

What you carry alone

Area	What it means for a solo GP
Governance	Policies, audit, significant events, complaints and learning, all led and evidenced by you
Safeguarding and infection control	You are the lead for both, with training to match
Results and messages	Every result and patient message needs a named person to act on it, every working day
Emergencies	Responding alone, with the drugs and equipment your risk assessment requires
Chaperones	A plan for offering one when you have no staff
Data protection	ICO registration, privacy notice and security, as the data controller
Business	Bookings, invoicing, accounts, marketing and suppliers

Making a solo practice safe

Cover when you are away

Illness and holidays are the main weakness of a one-person service. Arrange a buddy: another private GP who will review your urgent results, respond to urgent messages and see patients if needed, with access to the records and a written agreement. Offer the same in return. The CQC may ask a GP applicant for a business continuity plan, so write this down.

The agreement should cover how your buddy accesses records, what they will and will not do, how they are paid, and how you both confirm with your indemnity providers that the cover work is included.

Clear expectations for patients

Tell patients when you are available, how quickly you reply to messages, and where to go when you are not available, such as NHS 111, their NHS GP or 999. Put this on your website, in booking confirmations and on your voicemail. See whether to give patients your phone number.

Lone working

If you see patients alone, think about personal safety: who knows where you are, a panic alarm or app, and a policy for home visits and late appointments.

Systems that do the admin

Online booking with payment at booking, automatic reminders, invoicing linked to your accounts, and results that arrive in the record all save hours a week. Look for software priced per user, so a solo GP pays for one seat. See how to choose a record system.

Peer support

Working alone can be isolating, and you still need an appraisal that covers all your work. Join a peer group, discuss cases with colleagues and keep your CPD current. See keeping in touch with peers and appraisal and revalidation.

Insurance when you work alone

You need personal medical indemnity. HSE says a company whose only employee also owns 50% or more of its shares is exempt from employers’ liability insurance, but the exemption ends when you employ anyone, even part-time. Public liability is still expected, and the CQC asks to see it. See insurance for a practice.

When to bring others in

• Your diary is full and you are turning patients away.
• Admin is eating clinical time. A part-time receptionist or virtual reception service may pay for itself.
• You want to add services that need a nurse or healthcare assistant.
• You want reliable cover without relying on goodwill.

See what staff you need.