Setting Up the Admin Side of a New UK Private Practice

What this article is and is not

This is an operational checklist — the day-to-day machinery of running a private practice once you have decided to start one. It is deliberately not a guide to your professional, regulatory, insurance or tax obligations, because those are specific to you, to your specialty, to what you intend to provide and to where in the UK you practise, and getting them from an article is the wrong way to get them.

REVIEW: Before seeing a single private patient, resolve the following with the actual authorities, not with a blog: your registration and any specialist registration with the GMC; whether the services you intend to provide require registration with the Care Quality Commission in England, or Healthcare Improvement Scotland, Healthcare Inspectorate Wales, or the RQIA in Northern Ireland; your indemnity or insurance cover for private work; your registration with the Information Commissioner's Office and your data-protection responsibilities as a controller; and your tax and company structure with an accountant. This article does not tell you what any of those require of you.

With that said — here is the operational side.

1. Decide what you are actually selling

Before any software decision, write down your appointment types. For each: what it is, how long it takes, whether it can be remote, what it costs, and what a follow-up costs. This one page determines your diary structure, your website, your booking flow and your invoicing. Practices that skip it end up rebuilding their configuration three times.

Be honest about appointment length. A new patient consultation that genuinely takes fifty minutes booked as thirty will make you late every single day.

2. Booking

The decisions that matter:

• Can patients book themselves, or must they ring? Self-booking captures people who look for a clinician outside office hours, which is a large share of them. Some practices deliberately gatekeep first appointments by phone; that is a legitimate choice, but know you are trading volume for control.
• How is availability actually maintained? The most common failure in a new practice is a booking page showing slots that are not really free because the real diary lives somewhere else. One source of truth, always.
• Do you take payment at booking? It reduces non-attendance and removes an awkward conversation at reception.
• Can patients reschedule themselves? If not, they will not attend instead.

3. Fees and getting paid

• Publish your consultation fee. Patients searching for private care compare on price and will pass over a listing that does not state one.
• Be explicit about what the fee includes and what is charged separately — tests, follow-ups, reports, letters.
• Decide your position on private medical insurance early: whether you will seek recognition from insurers, and whether you will invoice them directly or ask patients to claim back. This shapes your admin load substantially.
• Have a written cancellation policy that patients see before they book.

4. Records and correspondence

• You need a proper clinical record system. Not a folder of documents.
• Decide your default on writing to the patient's NHS GP, and how you obtain and record the patient's consent to do so.
• Decide how you handle results — who chases them, who tells the patient, and what happens when a result arrives while you are away. This is the process most likely to cause a serious problem in a new practice, and it needs to exist before you need it, not after.
• Decide how patients contact you between appointments and what your response time is, then tell them. Unmanaged expectations here consume enormous amounts of time.

5. The bits people forget

• A working telephone route. Even a self-booking practice needs one, and it needs to be answered or clearly signposted.
• A safety-netting message on every outbound communication, telling patients what to do if they get worse and where to go in an emergency. You are not an emergency service and your patients need to know it.
• An out-of-hours position. What your voicemail and auto-reply say when you are not available.
• Cover for absence. Who handles results and urgent correspondence when you are on leave.

6. Start narrow

New practices consistently over-configure. Start with a small number of appointment types, one site, one payment method and one reminder schedule. Add complexity when a real patient problem demands it. Configuration you built for a scenario that has not happened yet is configuration you will get wrong.

How Roshtah fits

Roshtah covers the operational layer described above: a bookable page with live availability, appointment types and fees, reminders, self-service rescheduling, patient records, invoicing in GBP, remote consultations and multi-site rotas as you grow. It does not cover your regulatory, indemnity or tax obligations — see the review note at the top.