Setting up health screening in private general practice: a playbook

Setting up health screening in private general practice means more than choosing a blood panel. You need a clear rationale for every test, a UKAS-accredited laboratory, competent phlebotomy, a written process for acting on every result, the right registration for your nation, and advertising that does not overstate what a health check can do. This playbook takes a GP or small practice through each step, from the UK National Screening Committee’s position to a launch checklist.

If you are still deciding whether to offer health checks at all, start with the benefits and pitfalls of health screening packages. This guide is the operational version.

The short answer: what it takes to launch health screening

Decide who the service is for (people without symptoms) and design two or three packages where each test has a written purpose and a plan for an abnormal result. Open an account with a UKAS ISO 15189-accredited laboratory, set up courier collection, and train and sign off whoever takes blood. Write a results protocol that names who reviews each result, how quickly, how patients are told and what happens out of hours. Check your CQC registration (or HIW, HIS or RQIA registration) covers what you will do, then price the package to include the results consultation and a realistic allowance for follow-up.

Service models: health checks, well man checks and private blood tests

Most private GP screening services use one or more of these models:

Model	What the patient gets	Points to watch
GP-led health check (well man or well woman check)	A questionnaire, examination, bloods and a results consultation with a doctor	The highest value to patients and the most clinician time
Phlebotomy service with GP review	Private blood tests taken in clinic, with a GP reviewing and explaining results	Volume work. Every result still needs a named reviewer.
Phlebotomy for other clinicians	Blood taken on behalf of another doctor, who requested the tests	Agree in writing who receives and acts on the results
Home sample kits	A finger-prick or venous kit posted to the lab, with results online	Fewer suitable tests, and a higher rate of unusable samples (see home kits)
Annual review in a membership	A yearly check as part of a subscription	Steady recall work. Be clear what the membership covers.
Corporate health checks	Checks for staff, paid by the employer	Confidentiality and who pays for follow-up (see corporate contracts)

Know what the NHS already offers, because many patients are eligible and the tests are free. In England, the NHS Health Check is offered every five years to people aged 40 to 74 without existing heart disease, diabetes, high blood pressure or stroke. It covers height, weight, waist, blood pressure, cholesterol and sometimes blood sugar. NHS screening in England includes cervical screening (25 to 64), breast screening (women 50 to 70), bowel screening (home test kit every two years, 50 to 74), abdominal aortic aneurysm screening for men at 65, and lung screening for people aged 55 to 74 who have ever smoked in some areas. A good private check reminds patients to take up these invitations rather than duplicating them.

What the UK National Screening Committee says

The UK National Screening Committee (UK NSC) advises ministers and the NHS in all four nations. Its public guidance on NHS and commercial screening tests makes points every private screening service should build into its design and patient information:

• Screening is not for people with symptoms. Anyone with symptoms needs a consultation and investigation, not a package.
• False positives are inevitable. They cause worry and lead to follow-up tests that can carry their own risks.
• False negatives are inevitable too. A normal result can falsely reassure and delay diagnosis.
• Overdiagnosis happens. Screening can find conditions that would never have caused harm, leading to unnecessary treatment.

It suggests patients ask any provider: what the benefits are, whether the test is free on the NHS, whether the company is properly regulated, what the fees cover, whether the test can do more harm than good, and what happens if it picks something up. Answer each of those questions in your own patient information.

Tests the UK NSC does not recommend for everyone

• PSA. In March 2026 the UK NSC confirmed it recommends against population screening for prostate cancer. It recommends targeted PSA screening every two years only for men aged 45 to 61 with a pathogenic BRCA2 variant and a family history of breast, ovarian, pancreatic or prostate cancer. It cited false positives and negatives, overtreatment of low-risk cancers and the side effects of treatment. The NHS says anyone with a prostate can ask a GP about a PSA test after a discussion of benefits and risks. If you include PSA in a well man check, make it an informed choice with written information, not a default line on a panel.
• Ovarian cancer. The UK NSC does not recommend screening, after UKCTOCS showed no reduction in deaths. Do not sell CA125 to women without symptoms as a cancer check.
• Whole-body CT. The Committee on Medical Aspects of Radiation in the Environment (COMARE) recommended in its twelfth report that services offering whole-body CT scanning of asymptomatic people should stop. It also said CT lung scanning of asymptomatic individuals could not be justified, and that commercial scanning services should explain false positives and the further tests that may follow.

Ethics of testing the worried well

A patient paying for reassurance is still a patient. GMC guidance on decision making and consent expects you to discuss the potential benefits and harms of each option, including the option of doing nothing, and to tailor that discussion to the person. For screening, that means explaining before the test that results can be abnormal in healthy people, what you will do if they are, and what is not included. Record that conversation. See informed consent in private practice.

The RCGP does not support screening that is not approved by the UK NSC or NICE. It says organisations offering such screening should not assume NHS GPs will deal with the results, and must organise and fund follow-up. That is the principle the rest of this playbook is built on.

Regulation: CQC registration and the devolved regulators

England: diagnostic and screening procedures

Diagnostic and screening procedures is a regulated activity under paragraph 7 of Schedule 1 to the Regulated Activities Regulations 2014. Whether you need it depends on what you do and what you are already registered for:

Activity	Regulated activity position
Taking venous blood that is sent to a laboratory	In scope of diagnostic and screening procedures, unless you are already registered for another regulated activity (for example treatment of disease, disorder or injury). In that case, taking blood and urine samples is excepted.
Pin-prick or venous blood tested on the spot, not sent to a lab	Excepted
12-lead ECG, non-ambulatory blood pressure, peak flow, spot pulse oximetry	Excepted
Spirometry	Excepted when for screening, non-diagnostic or monitoring purposes
Ultrasound, X-ray or MRI, and ambulatory physiological monitoring	In scope

So a private GP practice already registered for treatment of disease, disorder or injury may not need a new activity for a bloods-based health check. A screening-only service that does not treat, or a practice adding ultrasound or ambulatory monitoring, will. Adding a regulated activity needs a variation to your registration before you start, and any new service must be described in your statement of purpose. See CQC registration for different services.

Wales, Scotland and Northern Ireland

• Wales: Healthcare Inspectorate Wales (HIW) registers independent clinics, defined as establishments where private-only medical services are provided regularly by GMC-registered doctors. HIW’s registration team will confirm whether a new service needs registering.
• Scotland: Healthcare Improvement Scotland (HIS) registers independent clinics where doctors and other listed professionals provide services.
• Northern Ireland: the RQIA registers independent clinics and independent medical agencies.

The devolved regulators do not use England’s list of regulated activities, so ask your regulator before you add screening, and update your registration documents if needed.

Clinical governance: designing packages that are safe

Write a short screening protocol that lists each package, who it is for, the tests, the rationale for each, the action thresholds and who reviews results. Use NICE guidance and UK NSC recommendations as your reference points, and record why you have included anything they do not recommend.

Element	Rationale	Limits to explain
Pre-appointment questionnaire	Family history, smoking, alcohol, activity, medicines and symptoms. Flags anyone who needs a consultation instead.	Only as good as the answers. Review it before the appointment.
Blood pressure, BMI and waist	Cheap, repeatable and linked to clear action	Confirm raised clinic readings before diagnosing hypertension
Lipids and HbA1c	Inputs to cardiovascular risk and diabetes detection	Borderline results need repeating, not labelling
Cardiovascular risk (QRISK3)	NICE NG238 says use QRISK3 for people aged 25 to 84 without CVD	Do not use a risk tool for people already at high risk, including type 1 diabetes, eGFR under 60 or albuminuria, and familial hypercholesterolaemia
Kidney, liver, thyroid function and full blood count	Common in packages. Include only with a reason.	Mildly abnormal results in well people are common and generate follow-up
12-lead ECG	Patients often expect it	Limited value in people without symptoms, and someone competent must report it. See where to get ECGs interpreted.
PSA	Informed choice for men who ask	Not recommended as population screening (see above)
Tumour markers and whole-body imaging	Usually requested for reassurance	Not recommended for screening. Leave them out of standard packages.

Set eligibility and exclusion criteria: adults without relevant symptoms, with a route to a same-day or routine consultation for anyone the questionnaire flags. Include safeguarding (for example, chaperones, and what to do if you identify a concern), consent for each test, and a plan for incidental findings. Audit a sample of records each quarter for: time from result to review, time to patient contact, abnormal results with a documented plan, and letters sent to the NHS GP. See how to run a clinical audit.

Pathology partners, sample logistics and home kits

Private GPs usually open a clinician account with a private laboratory. Examples include Nationwide Pathology, Randox and The Doctors Laboratory (TDL), and some NHS trust pathology services sell tests to private providers. No single lab suits every practice. Compare at least two on test menu, turnaround from your postcode, courier days and cut-off times, how results reach your record system, who they phone with a critical result out of hours, and price. Our guide to where to get pathology done covers the options in detail.

Whichever you choose, check its UKAS accreditation to ISO 15189, the standard for medical laboratories. UKAS’s directory shows the scope, so you can confirm the specific tests you order are covered.

Sample logistics

• Packaging. Diagnostic samples travel as UN3373, Biological Substance, Category B, in triple packaging: a leak-proof primary tube, leak-proof secondary packaging with absorbent material, and a rigid outer pack with the UN3373 mark. Most labs supply compliant packs.
• Timing. Ask the lab for sample stability limits and plan clinic times around the last courier collection. Some tests are affected by delay, so do not book phlebotomy late on a Friday unless the lab can receive the samples in time.
• Tracking. Log each sample sent and reconcile against results received. A missing result is a safety event, not an admin task.

Home kits versus venous samples

Postal finger-prick kits are convenient and remove the need for a phlebotomy appointment, but not every test is validated on capillary blood, and some samples arrive haemolysed or too small to test. Ask your lab which tests it accepts on capillary samples, its rejection rate, and how you will be told about an unusable sample. For anything that may change management, a venous sample taken in clinic is usually the more reliable choice. Whatever the route, the requesting clinician remains responsible for the result.

Staff, phlebotomy training and indemnity

A phlebotomy service can be run by a GP, a practice nurse, a healthcare assistant or a trained phlebotomist. There is no statutory registration for phlebotomists, so the practice must assure competence. A widely used benchmark is the national occupational standard for obtaining venous blood samples (Skills for Health CHS132), which covers infection prevention and control, giving information and gaining valid consent, selecting the site and equipment, use of the tourniquet, and correct labelling and handling of samples.

• Training and sign-off. A recognised course, then supervised practice and a documented competency sign-off by a clinician before working alone. Reassess periodically.
• Delegation. The GP who requests a test remains responsible for it. Delegate tasks, not accountability.
• Sharps safety. HSE guidance under the sharps regulations expects a risk assessment, safer sharps devices where practical, disposal at the point of use, training, and a clear procedure after a needlestick injury.
• Immunisation. Staff exposed to blood should be offered hepatitis B vaccination. See immunisations your staff need.
• Indemnity. Tell your medical defence organisation or insurer about the new service, including any work by non-doctors and any corporate contracts, and check it is covered. See indemnity for private GPs.

Results governance: you own every result

Missed and delayed results are a well-recognised safety risk in primary care, and in a screening service most results arrive for people who feel well and are not expecting bad news. The CQC’s GP mythbuster on managing test results describes what a safe system covers, and it applies equally to private services:

1. Request. Record every test requested and by whom.
2. Track. Check results come back, and chase those that do not.
3. Review. A named clinician reviews each result within a set timescale, with cover when they are away or when a locum made the request. Clinicians are responsible for acting on results that alter management.
4. Act. Use a written abnormal result pathway: for example, critical results (the lab phones; you act the same day), significant results (contact the patient within an agreed number of working days and arrange follow-up), and minor results (explain and repeat or monitor).
5. Tell the patient. Contact the patient when results need action, even if you told them to get in touch. Do not rely on them calling you.
6. Record and audit. Record what was communicated and how, and audit the system regularly.

No national rule sets a timescale for private results, so set your own in the protocol and tell patients when and how they will hear. Agree with the lab who it phones with a critical result out of hours, and make sure that person can act. Safety-net clearly: tell patients which symptoms should prompt them to seek help before the results are back. If a check raises suspicion of cancer, you can refer directly; see urgent suspected cancer referrals from private GPs.

Prescribing after an abnormal result

Most screening is diagnostic, but some results lead to treatment, such as a statin after a QRISK3 discussion or antihypertensives after confirmed raised blood pressure. Decide in advance whether you will start and monitor treatment yourself, or write to the NHS GP with your findings and a recommendation. If you prescribe, you take on monitoring and review, so price that into a follow-up plan. If you recommend, be explicit that the NHS GP will decide; they are not obliged to take over private prescribing. See the private prescribing checklist.

Systems: results import, patient portal and letters to the NHS GP

Paper and email results are where screening services lose track. Look for a record system that can:

• receive results from your lab electronically into the patient record, linked to the request
• show outstanding requests and results awaiting review
• send a pre-appointment questionnaire and take online booking and payment for packages
• recall patients for repeat tests and annual checks
• release results and an explanation to the patient securely, rather than by plain email
• send a summary to the patient’s NHS GP, with consent

A good example is Jump EHR, a newer system on the market. It brings lab results (for example from TDL) into the record, has online booking, invoicing and payments, automatic clinical registers with recalls, and sends letters to the patient’s NHS GP via MESH. See how Jump handles results. Alternatives include Semble, Hero Health, Meddbase and EMIS. Whichever you consider, ask the supplier which laboratories it receives results from electronically, and test it with a dummy patient before launch.

Premises and equipment

• A clinical room with a hand basin, and a couch or reclining phlebotomy chair so a patient who faints can lie down
• Phlebotomy consumables from your lab, safer sharps devices, sharps bins and a spill kit
• A validated blood pressure monitor with appropriate cuff sizes, calibrated scales, a height measure and a tape for waist circumference
• An ECG machine if you offer ECGs, with a reporting arrangement
• Secure, temperature-appropriate storage for samples awaiting collection, as your lab advises
• Clinical waste contracts for sharps and blood-contaminated waste; see medical waste

Check the equipment list in what equipment a private GP needs, and service and calibrate devices on a schedule.

Pricing and unit economics

The figures below are illustrative only. They are not market rates or any lab’s prices. Replace each line with your own lab price list, staff costs and overheads.

Illustrative well man check	Per patient
Price to patient	£249
Laboratory panel (lipids, HbA1c, renal, liver, thyroid, FBC)	£55
Consumables, sample packs and courier share	£8
Phlebotomy by a healthcare assistant (15 minutes)	£6
GP time: 30-minute check plus 15 minutes for review and letters	£75
Allowance for follow-up (say 1 in 5 patients needs a 15-minute review)	£5
Card fees	£4
Share of room, systems, indemnity and marketing	£25
Contribution	£71 (about 29%)

What drives margin:

• Test choice. Each extra test adds cost and, more importantly, adds abnormal results you must follow up.
• Follow-up rate. Track how many patients need repeat tests or reviews, and price for it. Say before purchase what the package includes and what is charged separately; see charging separately for tests.
• Clinician time. A good questionnaire and templated letters save the most time.
• Lab pricing tier. Lab prices usually depend on volume, so revisit them as you grow.
• No-shows. Take payment at booking and keep a clear cancellation policy.

Check VAT treatment with your accountant; see do private GPs need to charge VAT. For wider pricing, see private GP pricing and break-even.

Corporate health contracts

Employers buy health checks for staff, which brings volume and predictable dates. Before you sign:

• Confidentiality. Your clinical relationship is with the employee. Health information is special category data under UK GDPR, and the ICO has specific guidance on workers’ health information. As a rule, give the employer only anonymised, aggregated reports, and share anything individual only with the employee’s explicit consent.
• Follow-up. Agree who pays for repeat tests and follow-up consultations. The employee should not be left with an abnormal result and no plan.
• Scope. Be clear this is a health check, not an occupational health or fitness-for-work assessment, unless you are competent and contracted for that.
• Logistics. On-site clinics need a private room, sharps disposal, sample transport and a way to collect questionnaires and consent before the day.

Marketing and advertising rules for health screening

Advertising for health services falls under the CAP Code, enforced by the ASA. Objective claims, such as “detects cancer early”, need evidence (rule 12.1), and ads must not discourage people from seeking essential treatment for conditions that need medical supervision (rule 12.2). Two ASA rulings show where screening ads go wrong:

• In 2023 the ASA upheld complaints about a blood test advertised as “FREE if we don’t find anything”. It ruled that a result outside the reference range does not necessarily mean something is medically wrong, noting that 90% of users had at least one such result.
• In December 2025 it ruled that ads for an at-home PSA test misleadingly implied the test could diagnose prostate cancer and failed to make its limitations clear.

In practice: describe what each package includes, not what it will find; avoid promising peace of mind or early detection of cancer; state the price and what follow-up costs extra; and do not use the NHS logo or imply NHS endorsement. GMC guidance also expects information you publish about your services to be factual and verifiable. See advertising rules for private GPs.

For local visibility, list the service where patients search. Find A Private GP is a patient-facing directory where patients search by service type, including blood tests and annual medicals, and by location; listing is free at the time of review. List your practice on Find A Private GP. Your own website and Google Business Profile matter too.

The NHS interface

• NHS GPs do not have to act on your results. BMA guidance says complying with private providers’ requests to arrange tests is outside NHS primary medical services, and that GPs should not interpret or act on investigations they lack the knowledge or capacity to manage. Shared care with private providers is not recommended.
• Do write to them, with consent. A clear summary keeps the NHS record complete. Say what you found, what you have done, and whether you are asking them to do anything. See sending notes to the NHS GP.
• Keep NHS screening in view. Remind eligible patients to take up NHS screening and NHS Health Check invitations.
• Refer properly. If a result needs specialist care, refer directly where you can, or write to the NHS GP with the urgency stated, rather than telling the patient to “see your GP”.

Launch checklist

1. Decide the service model and who it is for, and confirm it is for people without symptoms.
2. Write the screening protocol: packages, test rationale, exclusions, action thresholds and reviewers.
3. Check your registration (CQC, HIW, HIS or RQIA) covers the new activity, apply for a variation if needed, and update your statement of purpose.
4. Choose a UKAS ISO 15189-accredited lab after comparing at least two, and agree courier times and critical-result phone-out.
5. Set up UN3373 packaging, sample tracking and a reconciliation routine.
6. Train and sign off phlebotomy staff, confirm hepatitis B immunisation, and complete a sharps risk assessment.
7. Tell your indemnity provider and confirm cover, including corporate work.
8. Configure your record system for electronic results, requests, questionnaires, recalls and NHS GP letters, and test it end to end.
9. Write the results protocol with timescales, cover arrangements and safety-netting wording.
10. Write patient information covering benefits, limits, false positives, PSA choice and what is included in the price.
11. Set prices with an allowance for follow-up, and decide what is charged separately.
12. Check website and ad copy against the CAP Code.
13. Run a pilot with a few patients, then audit the first month of results.