There is a variety of factors to consider when setting up in private practice. Read about the most important below:
Recognition with private medical insurers
Registration under the Data Protection Act
Doctors who carry out private practice are required to be registered with the Information Commission under the Data Protection Act 1998.
This covers private doctors in the processing of all personal data relating to any private treatment.
It is highly unlikely that a private doctor will be a salaried member of the private hospital staff, and therefore it is hard to imagine a scenario in which private hospital’s registration would cover the private doctor's work.
Notification with the Information Commission is a statutory obligation for every organisation or individual who processes personal information electronically, unless they can rely on any of the exemptions in the Data Protection Act 1998.
What you need to do
Complete the application form, and pay the statutory annual fee on the Information Commission website or by contacting their helpline on 0303 123 1113. A register of data controllers is available for public inspection on the ICO's website.
Disclosure and Barring Service - formally Criminal Records Bureau (CRB) checks
The Disclosure and Barring Service (DBS) was established under the Protection of Freedoms Act (2012) and merges the functions previously carried out by the Criminal Records Bureau (CRB) and Independent Safeguarding Authority (ISA).
The services provided by the DBS have not changed from those provided by the CRB and ISA, they are now provided by one instead of two organisations.
With DBS's introduction, however, there has been a change to the definition of 'regulated activity' in relation to safeguarding adults as defined in the Safeguarding Vulnerable Groups Act 2006.
In this context 'regulated activity' does not have the same meaning as it does in the Health and Social Care Act of 2008. Instead for disclosure and barring purposes, a regulated activity is one involving close work with vulnerable groups including children.
Find out more about the changes
What does this mean for me?
In June 2013 the DBS introduced the Update Service to reduce the number of applications individuals have to make for a DBS check.
The DBS Update Services means that applicants will only have to apply for a DBS check once. Once this first registration has happened it is possible with the Update Service, for applicants to re-use their certificate if they require a further check of the same type.
The organisation the candidate is applying to would, with the applicant's consent, be able to check online to see whether the applicant's certificate was still up to date. To keep it up to date the applicant would have to subscribe to the Service and pay an annual subscription fee.
Use the DBS Update Service
Read The Safeguarding Vulnerable Groups Act 2006 (Miscellaneous Provisions) Regulations 2012
Be careful when entering a contract
Doctors working in private practice are not employees and as such are not covered by employment law. It is therefore extremely important that due diligence is given to any contract for the provision of services, practising privileges policy, or any other commercial agreement, before signing.
It should be remembered that contract terms can often be negotiated and amended and that it might be worth seeking independent advice from an expert to highlight any pitfalls and serious risks that might be a result of signing the contract.
If you are a BMA member, speak to one of our employment advisers.
Call 0300 123 1233
Registration with the Care Quality Commission (CQC)
The Care Quality Commission (CQC) was established by the Health and Social Care Act 2008 and its role includes regulation of the independent healthcare sector in England. Any service provider who carries out a regulated activity must register with the CQC, however, there are certain exemptions that apply to independent medical practitioners which means that some of them do not have to register.
From October 2013, to be exempt an individual medical practitioner or all those in a group of medical practitioners, must be a service provider or employed by a service provider that is registered with CQC for carrying out a regulated activity. The exemption for a group of doctors only applies to a practice of doctors not a body that employs a range of staff including doctors.
In addition, that employing service provider must be a 'designated body' or the individual medical practitioner must be on the medical performers list of a designated body.
A 'designated body' means a body prescribed by Regulation 4 of the Medical Profession (Responsible Officers) Regulations 2010.
Furthermore, the provision of treatment must be carried out in a surgery or consulting room by the service provider.
Finally, the provision of treatment must not include any of the following:
- treatment carried out under anaesthesia or intravenously administered sedation, other than:
a) nail surgery and nail bed procedures on the foot and which are carried out using local anaesthesia
b) surgical procedures involving curettage (scraping), cautery (burning) or cryocautery (freezing) of warts, verrucae or other skin lesions carried out using local anaesthesia
2. medical services provided in connection with childbirth
3. the termination of pregnancies
4. cosmetic surgery, with the exception of the following:
a) the piercing of any part of the human body or tattooing
b) subcutaneous injections to enhance appearance
5. removal of hair or minor skin blemishes by application of heat using an electric current; haemodialysis or peritoneal dialysis;
6. endoscopy other than using a device which does not have a lumen or other channel for the purpose or design of passing fluid or instruments through, or removing body tissue or fluid or any other item from, a person's body;
7. the provision of hyperbaric therapy, being the administration of oxygen (whether or not combined with one or more other gases) to a person who is in a sealed chamber which is gradually pressurised with compressed air, where such therapy is carried out by or under the supervision or direction of a medical practitioner;
8. intravenous, intrathecal or epidural administration of medicines or diagnostic agents
a) the therapeutic or diagnostic use of x-rays, radiation, protons or magnetic resonance imaging;
b) invasive cardiac physiology tests.
Need further CQC advice?
Read Scope of registration: Independent medical practitioners working in private practice (changes from October 2013). We advise that you check this guidance carefully.
To find out whether or not you will be required to register with the CQC, please contact them on 03000 616161 or visit www.cqc.org.uk
CQC advice for the nations
Regulation and Quality Improvement Authority (RQIA)
Healthcare Improvement Scotland
Health Inspectorate Wales (HIW)