What makes a good private GP?

The same standards, more time

Being a good private GP starts with being a good GP. GMC standards, clinical guidelines and your duties to patients do not change because the patient pays. See how private consultations differ.

What changes is what patients expect around the clinical care. They are paying for time, access and a service that works. The GPs who do well privately tend to get five things right.

1. Use the extra time well

Longer appointments are the main reason many patients choose a private GP. Use them to listen properly, examine thoroughly and explain your thinking.

• Let the patient finish their story before you narrow it down.
• Explain the options, including doing nothing or waiting, and the likely costs of each.
• Agree a plan together and write it down for them, with what to do if things change.
• Check that they understood, and that you have answered the question they came with.

More time is not a reason to do more. Order tests and prescribe because they will help the patient, not because the time or the fee seems to call for it.

2. Own everything you start

In the NHS, a practice team catches results and loose ends. In private practice it is usually you. Patients judge you on the follow-up as much as the consultation.

• Results. Tell patients when and how they will hear, and make sure every result is reviewed, acted on and communicated, including when you are away. See managing pathology results.
• Safety-netting. Give clear advice on what to watch for and who to contact out of hours, and record it.
• Referrals. Chase what you send, and tell the patient what happens next.
• The NHS GP. With consent, send a summary so that the patient’s NHS record is complete and their GP can act on your findings. See sending notes to the NHS GP.

3. Be honest about money and limits

Trust is harder to rebuild than to keep, and money is where private patients most often feel let down.

• Publish your fees and tell patients about extra costs, such as tests, before you incur them. The GMC expects you to be clear about what patients will pay for each investigation or treatment, and when.
• Tell patients if a treatment or test would be free on the NHS, when you have reason to think they do not know.
• Be open about any financial interest in a service you recommend.
• Say no when a request would not help the patient, and explain why. Payment does not change your clinical judgement. See managing patient expectations.
• Know the limits of your competence and refer on when a problem needs someone else.

4. Know who to send patients to

A private GP’s value often lies in knowing where to go next. Build a list of local consultants, physiotherapists, imaging providers and mental health services you trust, and know their prices and waiting times. Know the NHS routes too, and what you can and cannot refer into. See finding local private clinicians and making NHS referrals.

5. Make the service easy to use

Much of what patients remember happens outside the consulting room.

• Booking that shows real availability and the price before they commit.
• Clear information before the appointment: where to go, how long it lasts, what it includes and your cancellation terms.
• Response times that you state and keep, for messages, results and repeat prescriptions.
• Continuity. Patients often choose a private GP to see the same doctor. When you are away, say who covers and make sure they can see the record.
• Accessibility. Premises, forms and communication that work for disabled patients and those who need an interpreter.
• Communication boundaries. Clear rules on how patients can contact you, so availability does not turn into burnout. See sharing your phone number.

Keep improving

Good private GPs check that they are as good as they think they are.

• Ask for feedback after appointments, and act on patterns rather than single comments. See getting patient feedback.
• Audit your own work, for example prescribing, results turnaround or referral outcomes. See clinical audit.
• Handle complaints well. Have a clear procedure and tell patients about independent adjudication. ISCAS, a voluntary subscriber scheme, offers this for many independent healthcare providers. See managing complaints.
• Stay connected. Private GPs can be isolated. Peer review, CPD and a full-scope appraisal keep your practice sharp. See keeping in touch with peers.

A simple self-check

In England the CQC assesses services against five key questions: are they safe, effective, caring, responsive and well-led? They make a useful test of your own service, whether or not an inspection is due:

1. Safe: would every abnormal result be caught if you were ill tomorrow?
2. Effective: do you follow current guidance, and can you show it?
3. Caring: do patients feel listened to, and do they know what their care will cost?
4. Responsive: can patients get an appointment and a reply when you say they can?
5. Well-led: do you learn from feedback, complaints and audit, and change things as a result?

Regulators in Scotland, Wales and Northern Ireland use their own frameworks, but the questions work anywhere.