What to Consider When Moving Into Private Practice for the First Time
Quick answer: When you start private practice for the first time, you’ll need to arrange your own medical malpractice cover, since your NHS indemnity is not applicable for private work. Key things to get right early include: giving your broker a realistic estimate of your expected private earnings, understanding whether your cover is claims-made or claims-occurrence, checking your limit against what your hospital or group requires, and making sure any limited company structure (and staff working under it) is properly noted on your policy. A good broker should also check in with you partway through your first year to make sure your cover still matches reality.
Starting private practice is an exciting step, but it also comes with a set of insurance decisions that can feel unfamiliar if you’ve spent your career under NHS indemnity. Here’s what to think about before you take out your first policy.
- You’re now responsible for your own cover
Once you start seeing private patients, NHS indemnity no longer applies to that work, you need your own medical malpractice insurance in place before you start. This is the first and most important thing to sort out, and it’s worth doing before you take on any private patients, not after.
- Estimating your cover in year one is genuinely difficult – that’s normal
Your premium is based partly on your expected private earnings, but if you’re new to private practice, you won’t have a track record to base that on. Unlike an established practice, where earnings are relatively easy to predict, a first-year estimate is by nature a bit of a best guess.
This is exactly where a good broker earns their keep. Look for one who will check in with you around the halfway point of your first year to compare your actual earnings against the original estimate and adjust your cover accordingly. That way, you’re not left under-covered if your practice grows faster than expected, or overpaying if it grows more slowly.
- Understand claims-made cover from day one
Most insurance-backed medical malpractice policies are claims-made, meaning the policy in force when a claim is made, not when the incident happened, is the one that responds. This matters for your entire career, including decisions you’ll eventually make about run-off cover at retirement. It’s worth asking your broker to walk you through this clearly at the outset, including pointing you to the specific parts of your policy wording worth reading yourself, rather than assuming it’ll make sense later.
- Check your limit matches what’s required of you
Hospitals and private groups often have specific requirements for the limit of indemnity you must hold – commonly £10 million for surgeons, though this varies. Don’t assume a standard limit automatically meets your requirements; check with your hospital or group directly and make sure your policy matches.
- If you’re trading through a limited company, flag it early
Many consultants set up a limited company for tax purposes when they move into private practice. If that applies to you, tell your broker so your company name is properly noted on your policy. It’s also worth checking whether any staff working under that company (such as a PA or admin support) are covered, since this varies by insurer. This is important because a claim or invoice could arrive in your company’s name rather than your own, so your policy needs to reflect that structure from the start.
A quick-start checklist for your first policy
- Have you arranged cover before seeing your first private patient?
- Have you given your broker a realistic estimate of expected private earnings?
- Do you understand whether your cover is claims-made or claims-occurrence, and what that means long-term?
- Does your limit of indemnity match what your hospital or private group requires?
- If you trade through a limited company, is it (and any staff under it) noted on your policy?
- Will your broker proactively check in with you during your first year as your practice takes shape?
Frequently asked questions
Do I need separate insurance when I start private practice?
Yes. NHS indemnity doesn’t cover private work, so you’ll need your own medical malpractice insurance in place before you see private patients.
How is my premium calculated if I have no private practice earnings history yet? Your broker will typically base your first-year premium on an estimate of your expected private earnings. Because this is a genuine estimate rather than a track record, a good broker will check in partway through the year to compare it against your actual earnings and adjust your cover if needed.
What does “claims-made” mean for a new consultant?
It means your policy responds based on when a claim is made against you, not when the treatment took place. This is worth understanding from the outset, since it affects decisions throughout your career, including run-off cover when you eventually retire.
Do I need to tell my broker if I trade through a limited company?
Yes. Your limited company name, and any staff working under it, should be recorded on your policy so cover responds correctly if a claim or invoice is made in the company’s name rather than your own.
How do I know if my limit of indemnity is high enough?
Check with your hospital or private group, as they’ll often specify a minimum limit you’re required to hold – commonly £10 million for surgeons, though this can vary.
Starting out? We’ll make sure you’re set up properly
Starting private practice brings enough new decisions without your insurance being one more thing to worry about. At Practition, we’re on your side from the very first policy: our specialist healthcare team will help you arrive at a sensible estimate for year one, explain your cover in plain English rather than jargon, and check in with you as your practice grows so your protection keeps pace with reality. If questions come up along the way – and they usually do – our in-house team is a friendly, familiar voice at the end of the phone, not a call centre queue.
Get a quote to get your first policy sorted, or request a call back if you’d rather talk it through with our team first.
If you’re also weighing up an MDO against insurance-backed cover, take a look at our comparison of insurance-backed indemnity vs. MDO cover, or read our broader guide on what to look for in a medical malpractice policy and broker service. You can also browse more on our blog or check our FAQs for quick answers.
