Going solo: a practical checklist for your first private practice

The clinical part of going solo is the part you are already qualified for. It is everything else that eats the first three months.

This is the list in roughly the order it needs doing, with honest notes on which items are quick and which are genuinely worth paying somebody for.

Written by a software person who has watched several physios do this, not by an accountant or a lawyer. Where money or law is involved, take proper advice.

Before you see anyone

HCPC registration. Non-negotiable and you already have it, but check the renewal date now rather than discovering it in a busy month. Practising while lapsed is a serious problem, not an admin slip.

Professional indemnity insurance. A legal requirement for HCPC registration. If you are moving from employment, your employer's cover almost certainly does not follow you. Get your own before your first private patient, not before your tenth. CSP membership includes cover for many members; check the limits against what you are actually going to do, particularly if you plan acupuncture, home visits or anything else the standard policy treats separately.

Public liability insurance. Separate from indemnity. If someone trips over your treatment couch, indemnity does not cover it.

Decide your legal structure. Sole trader is simpler and cheaper to run; a limited company gives you liability separation and can be more tax-efficient above a certain income. This is a genuine accountant question and one of the few places where an hour of paid advice reliably pays for itself.

Register with HMRC. Self-assessment as a sole trader, or Corporation Tax if you incorporate. Deadlines are unforgiving and the penalties are automatic.

Register with the ICO. £52 a year, about fifteen minutes. You process health data, which is the most sensitive category there is. We wrote a whole piece on this because it is the item most often missed.

The money decisions

Set your prices before you are asked. The worst time to work out what you charge is while a patient is waiting for an answer. Look at what comparable practices in your area charge, then decide deliberately whether you are at, above or below that, and be able to say why.

Decide your appointment types up front. New patient assessment, standard follow-up, extended follow-up, and anything specialist. Each with a duration and a price. This sounds trivial and it structures your entire week, because it determines what can be booked and how your diary fills.

Decide your cancellation and no-show policy, and write it down. Not because you will enforce it rigidly (you mostly will not), but because having a stated policy makes the awkward conversation a reference to a rule rather than a personal judgement. Then tell patients about it before they need it, not after.

Decide when you take payment. At booking, at the appointment, or on an account. Prepayment dramatically reduces no-shows and is the single highest-leverage admin decision most new practices make. It also feels uncomfortable at first, which is why people skip it and then spend two years chasing money.

Open a separate bank account. Even as a sole trader, where it is not strictly required. Mixing practice and personal money makes your tax return miserable and your finances illegible.

The bit about patients

Your privacy notice and patient information. What you collect, why, how long you keep it, who you share it with. This needs to exist before your first patient, and they need to be able to see it.

Your consent and terms. What treatment involves, what you are agreeing to do, what happens with their data. Capturing this at intake rather than verbally means it exists in the record if it is ever questioned.

How you take referrals, and how you refer on. Know before you need it who you send someone to when it is not musculoskeletal, and how you write to a GP.

Retention. Eight years after the conclusion of treatment for adults, longer for children. That duty is yours and it outlives your practice, your software and your subscription. Plan for how you will still have those records in eight years if you stop practising.

The software decision

I am not neutral, so take the specifics with appropriate scepticism, but the structural advice holds regardless of what you choose.

Do not assemble it from parts. The default path is a diary app, a notes system, a spreadsheet for invoices, a separate exercise-prescription subscription, your personal mobile as the practice number, and WhatsApp on your own phone. It works for about forty patients. Then the joins start failing: the note that never got written because it was in a different tab, the invoice nobody raised, the enquiry that arrived while you were treating.

Count the real total. Practice management software is rarely the whole bill. Add the exercise platform, the call answering, the payment processing, and any per-user or tier upgrades. Compare totals rather than headline prices. This is where the all-in-one argument either wins or does not.

Check the exit before the entrance. Can you export everything, in a usable format, without asking permission? If that answer is unclear during the sales conversation it will not improve later, and you have an eight-year duty riding on it.

Ask where the data lives, specifically. Not "is it secure": everyone says yes. Ask which company, which country, and can you see the sub-processor list. A supplier who can answer immediately has thought about it.

Use the trial properly. Put ten real patients in, write real notes, send a real exercise programme to your own phone, take a test payment. A demo shows you the happy path; a trial shows you the Tuesday.

The order that actually works

1. Insurance and HCPC: you cannot practise without them.
2. Legal structure and HMRC: before money moves.
3. ICO registration: fifteen minutes, do it the same week.
4. Prices, appointment types, payment and cancellation policy: before the first booking.
5. Software: trial two, pick one, get your records in.
6. Privacy notice, consent, patient information: before patient one.
7. Marketing: last, deliberately.

That last one is contentious, so to be explicit: the most common failure in a new practice is not too few enquiries, it is enquiries arriving before there is anything to catch them with. Get the machinery working, then tell people you exist.

The one thing worth over-investing in

Your notes.

Not your website, not your branding, not your equipment. In five years the only thing you will still be relying on from your first month of practice is the clinical record, and the moment it matters most is the moment you least want to discover it is thin, late or unamendable.

Everything else you can change your mind about.