GP’s Guide to Starting Private Prescribing in 2026

An increasing number of GPs are exploring private prescribing — whether as a supplement to NHS income, a portfolio career element, or a complete transition away from the partnership model. The reasons are structural: GP partnership income has declined in real terms since 2008 (BMA GP Worklife Survey, 2023), workload has increased, and the flexibility of private practice is genuinely attractive after years of 10-minute appointment pressure.

But the transition from NHS prescribing (where systems, governance, and infrastructure are provided) to private practice (where you build everything yourself) raises practical questions that medical school and GP training never addressed. This guide answers them.

Can a GP Prescribe Privately? The Legal Position

Yes. Any registered medical practitioner can issue private prescriptions. Your medical degree and GMC registration give you independent prescribing authority — there is no additional qualification required beyond your existing medical licence. This authority exists whether you work in the NHS, privately, or both.

The relevant legislation: the Human Medicines Regulations 2012, Part 12, defines who may prescribe and the requirements for prescriptions. As a registered medical practitioner, you are included without additional conditions beyond maintaining your GMC registration.

However — and this is important — legal authority does not equal competence. The GMC’s Good Medical Practice (Domain 1) requires you to work within your competence. If you have spent your career in musculoskeletal medicine, you should not suddenly start prescribing GLP-1 weight management drugs without additional training, regardless of your legal authority to do so.

Separation from NHS Work: The GMC Requirement

The GMC’s Good Practice in Prescribing guidance is explicit: private work must not compromise your NHS obligations. Key principles:

• Time separation — do not conduct private consultations during NHS contracted hours
• Resource separation — do not use NHS premises, equipment, or systems for private activity (unless you have a formal agreement with your practice/trust)
• Patient separation — do not solicit NHS patients for private services. Patients may choose to see you privately, but the initiative must be theirs
• Records separation — private clinical records must be kept separately from NHS records, though you have a professional obligation to inform the patient’s NHS GP of relevant prescriptions

Practical implication: you need your own platform, your own booking system, and your own clinical records — entirely separate from NHS systems. This is where a dedicated private prescribing platform like RxSure becomes essential.

Professional Indemnity: What You Need

Your NHS indemnity (whether through NHSR or an MDO) does not cover private practice. You need separate professional indemnity specifically covering:

• Private prescribing activity
• Online/remote consultations (some policies exclude telemedicine — check explicitly)
• The specific clinical areas you intend to practise in
• The volume of private work anticipated

Providers include Medical Protection Society (MPS), Medical Defence Union (MDU), and specialist insurers like Incision Indemnity. Costs vary by specialty and volume — typically £1,000–£5,000 annually for private prescribing services. Without adequate cover, you are personally liable for clinical negligence claims, GMC proceedings costs, and coroner’s inquest legal representation.

Defining Your Private Practice Scope

Resist the temptation to offer everything. Successful private prescribers define a clear niche aligned with their training and experience. Common GP-to-private pathways:

Setting Up: The Practical Checklist

1. Confirm GMC registration is current — annual retention, no conditions affecting private prescribing
2. Obtain private professional indemnity — covering your planned services and consultation mode
3. Register with ICO — you are a data controller for private patient data (separate from any NHS registration)
4. Choose a prescribing platform — handles booking, consultations, clinical records, and prescription generation. RxSure offers a free trial to evaluate.
5. Write your scope of practice document — which conditions you treat, your formulary, your referral pathways, your exclusion criteria
6. Develop SOPs — consultation process, prescribing protocol, safeguarding, complaints procedure
7. Set up financial infrastructure — business bank account, payment processing, accounting system, tax registration (self-employment or limited company)
8. Notify your NHS employer — if retaining NHS work, most contracts require declaration of private interests

GP Notification: Your Obligation

The GMC’s Good Practice in Prescribing and Managing Medicines and Devices (paragraph 59) states that when you prescribe for a patient, you should “inform the patient’s general practitioner or other relevant clinician of any prescription you make, unless the patient objects.” This applies whether you are prescribing as a GP privately or as any other type of prescriber.

In practice, this means your platform should support generating GP notification letters — a standard communication informing the patient’s registered GP what you have prescribed, for what indication, and any monitoring considerations. This protects you, the patient, and the GP from dangerous information gaps (particularly regarding drug interactions with existing NHS-prescribed medications).

Ethical Considerations

Private prescribing introduces commercial incentives that do not exist in NHS practice. The GMC expects you to manage these conflicts:

• Never prescribe to generate income — clinical need must drive every prescription. If a patient does not need treatment, do not prescribe.
• Avoid inappropriate self-referral — do not refer NHS patients to yourself privately. The patient can seek you out, but you must not solicit.
• Transparent pricing — patients must know the cost of your service before the consultation. No surprise charges.
• Right to refuse — you can decline to prescribe even when a patient requests treatment. Commercial pressure does not override clinical judgement.
• Equality of care — private patients are entitled to the same clinical standard as NHS patients. Being paid privately does not mean prescribing more liberally.

Financial Realities

Without citing specific income figures (which vary enormously by specialty, volume, and pricing), here are the structural economics:

• Consultation fees in UK private prescribing typically range from £30–£150 depending on complexity and duration
• Follow-up consultations are shorter and can be priced lower while remaining profitable
• Overhead costs for a digital-first practice are low: platform subscription (£199/month with RxSure), indemnity, ICO registration, and professional memberships
• No premises costs if working remotely (video consultations)
• No staff costs initially — you are the clinician and the business operator
• Tax efficiency is possible through limited company structure (consult a specialist medical accountant)

The breakeven point for a solo GP prescriber — platform costs covered by consultation income — is typically reached within the first month of regular practice.

Frequently Asked Questions

Do I need to leave the NHS to prescribe privately?

No. Many GPs maintain NHS work (salaried or partnership) alongside private prescribing. The key requirements are: (1) private work happens outside NHS hours, (2) NHS resources are not used for private activity, (3) your employer/partnership agreement permits outside interests, and (4) you have separate indemnity. Declare private work per your contract terms.

Can I prescribe for family members or myself?

The GMC advises against prescribing for yourself or close family and friends, particularly Controlled Drugs (Good Practice in Prescribing, paragraph 73). In exceptional circumstances (emergency, no other prescriber available), it may be acceptable — but document thoroughly. This applies equally in private practice.

What about appraisal and revalidation?

Private prescribing work contributes to your revalidation portfolio. You need a designated body for revalidation purposes — if you leave the NHS entirely, you can use an independent designated body (such as Equiniti, Seldoc, or your local HEE team). Your prescribing data, clinical audit, and patient feedback from private work all count toward revalidation evidence.

How do I handle controlled drug prescribing privately?

Private CD prescriptions must comply with the Misuse of Drugs Regulations 2001. Schedule 2 and 3 CDs require specific prescription formats (quantity in words and figures, total quantity specified). You should maintain a personal CD register if regularly prescribing Schedule 2 drugs. Your platform should support CD-specific prescription formatting and record-keeping requirements.

Is there a risk to my NHS career?

Not inherently, provided you maintain clear boundaries. The risk arises from: prescribing outside competence (GMC fitness-to-practise), inadequate governance (GPhC/GMC investigation), or allowing private work to compromise NHS duties (contractual breach). A well-run private practice, properly governed and documented, enhances rather than threatens your professional standing.

References

1. General Medical Council. Good Practice in Prescribing and Managing Medicines and Devices. 2021. gmc-uk.org
2. General Medical Council. Good Medical Practice. 2024. gmc-uk.org
3. General Medical Council. Financial and Commercial Arrangements and Conflicts of Interest. 2023. gmc-uk.org
4. British Medical Association. GP Worklife Survey. 2023.
5. Human Medicines Regulations 2012, Part 12. legislation.gov.uk