How do private GP consultations differ from NHS consultations?

At a glance

	Typical NHS consultation	Typical private consultation
Length	Often 10 minutes, with the BMA recommending 15	Set by you, and usually longer
Access	Depends on practice capacity	Often same or next day
Continuity	Varies	Usually the same doctor
Patient record	Full NHS GP record	Your own record, plus whatever the patient can show you
Prescribing	NHS prescriptions through EPS	Private prescriptions, paper or private e-prescribing
Referrals	e-RS and local pathways	Letters to NHS trusts, or private referrals
Tests	NHS pathology, often at a separate appointment	Often done in the consultation, paid for by the patient
Payment	None for the consultation	A fee, plus any extras

Time

Time is the difference most GPs notice first. The BMA says many NHS practices still work to 10-minute appointments and strongly recommends moving to an average of 15 minutes. In private practice you set the length yourself. Look at the appointment lengths other private services near you publish, and decide what your patients need. Many private GPs offer a standard appointment and a longer one for complex problems or health checks, with shorter slots for simple follow-ups.

That time is not only for listening. Without the NHS record, you often need longer to take a full history, check medicines and allergies, and write a letter to the NHS GP afterwards. Build that into your appointment length and fees.

Access and continuity

Patients usually choose private care for speed and for seeing the same doctor. Continuity is one of the real pleasures of private work: you can order a test, give the result yourself and review the patient at follow-up. It also means patients may expect you personally, so be clear about your availability and cover.

Doing more in one appointment

Private GPs often take blood, test urine or record an ECG in the same consultation rather than booking the patient back. That is efficient and popular, but each test has a cost, and each result is yours to act on. BMA guidance for NHS practices says private providers should arrange the tests they think are needed and deal with the results themselves.

Working without the NHS systems

• Records. You cannot usually see the NHS record directly. Patients can often show you theirs in the NHS App. See accessing the NHS record.
• Prescribing. Private prescriptions cannot go through NHS EPS, and the patient pays the pharmacy’s private price for the medicine. See private prescribing and EPS.
• Referrals. You can refer to NHS services, but not through e-RS. See NHS referrals from private GPs.
• Communication. With consent, you send a summary to the NHS GP after each episode. See sending notes to the NHS GP.

Money in the consultation

In the NHS you rarely discuss cost with patients. In private practice it is part of informed consent. Before you order tests, refer privately or prescribe an expensive medicine, the patient should know what it will cost and what the alternatives are, including the NHS. In England, registered providers must give paying patients written terms, including fees, before care starts where practicable.

Money can also create pressure to do things. GMC guidance on decision making and consent is clear: if a patient asks for treatment you do not think serves their needs, explore why, explain your reasons, and do not provide it. See managing patient expectations.

Responsibility for what you start

In the NHS, the practice is responsible for a registered patient’s ongoing care. In private practice, you are responsible for what you take on, and no more, unless you agree otherwise. That cuts both ways. You must follow up your own results and prescriptions, because NHS GPs are not obliged to continue private tests, prescribing or shared care. But you also need to be clear when your involvement ends, so the patient knows to return to their NHS GP.

What stays the same

Good medical practice, NICE guidance, safeguarding duties, the law on consent and confidentiality, and your duty to act in the patient’s interests apply exactly as they do in the NHS. Many GPs find that private work lets them practise the medicine they trained for, with the time to do it. For the wider picture, see why become a private GP and the different types of private GP work.