How do I create a business plan for my private GP practice?

Who the plan is for

First, it is for you. Writing it forces decisions about services, prices and premises, and shows whether the numbers work before you sign a lease.

It is also for others:

• Lenders. GOV.UK says you will need a business plan to get a bank loan or investment. Start Up Loans also asks for a cash-flow forecast and a personal survival budget.
• Your accountant. In England, most new providers send the CQC a financial viability statement signed by an accountant or regulated bank, and the signer may ask to see your plan.
• Partners or investors, who need to see what they are joining.

What to include

1. Summary

One page: what you will offer, to whom, where, when you will open, how much you need and when you expect to break even. Write it last.

2. Services and scope

List each service, how it is delivered (face to face, video, home visits) and any clinical interest. Note what each one needs: equipment, training, extra indemnity or a different CQC regulated activity. If you will keep NHS work, note the contract restrictions on seeing your own registered patients privately. See choosing your services and restrictions on private patients.

3. Patients and market

Describe your target patients, the local population, existing private providers and their prices, and what will make patients choose you. See choosing a location.

4. How the practice will run

• Premises, opening hours and sessions
• Staff, and who covers when you are away
• Systems for records, booking, payments, prescribing, pathology and letters to NHS GPs
• Clinical governance: policies, audit, complaints and significant events

5. Regulation and risk

Set out your registration route and timeline (CQC in England, HIS in Scotland, HIW in Wales, RQIA in Northern Ireland), indemnity, insurance and ICO registration. Add a short risk list: slower bookings, a delayed registration, losing premises, illness. For each, say what you would do. See how long CQC registration takes.

6. Finding patients

Your website, search listings, referrers, local employers and word of mouth, with a budget and the advertising rules you must follow. Booking marketplaces are another channel to cost in. A good example is Quokka Health, where patients compare named clinicians on price and live availability and book and pay online, and practices list themselves to receive bookings. See finding patients.

7. Structure and tax

Sole trader, partnership or company, and how you will pay yourself. See whether to set up a company.

8. The numbers

This is the section that matters most. Include:

1. Start-up budget. Every one-off cost with a quote or estimate. See start-up costs.
2. Monthly running costs. Fixed costs (rent, indemnity, software, insurance, staff) and variable costs per appointment (card fees, consumables, lab costs you absorb).
3. Income forecast. Sessions a week, appointments per session, the share you expect to fill in each month, and your prices. See how much to charge.
4. Cash-flow forecast. Month by month for at least 12 months, showing when money actually comes in and goes out, including the months before you open.
5. Break-even. See below.

Working out break-even

Use this simple calculation:

Appointments needed per month = monthly fixed costs ÷ (average fee − variable cost per appointment)

Compare the answer with your realistic capacity. If break-even needs most of your slots filled in the first few months, the plan is fragile. Change the price, the costs, the premises or the pace of growth before you commit.

Plan for three scenarios

Model a slow case, an expected case and a good case, changing only how quickly appointments fill. The slow case tells you how much cash you need in reserve. Treat it as a real possibility, not a formality.

For each scenario, find the month when your cash balance is lowest. That low point, plus a margin for surprises, is the funding you need to have in place before you open, whether from savings or a loan. See funding and loans.

Common mistakes

• Forgetting the months of costs before opening, while registration is pending.
• Assuming full diaries from the first month.
• Budgeting net of VAT when you cannot reclaim it.
• Leaving out your own pay, so the practice looks profitable only because you work for free.
• Adding services before the core service is paying its way.

Keep it live

Compare actual bookings and costs with the forecast every month in the first year, and rewrite the plan when something big changes, such as a new service, site or clinician. GOV.UK links to free business plan and cash-flow templates, including from Start Up Loans.