We have recently looked at a range of NHS contracts for a functional medicine doctor who is just wishing to start offering consultations and treatments privately, whilst still working for an for a practice contracted to the NHS. Startups are often seen as being the most difficult businesses and we can well imagine most new functional businesses facing this challenge.
You’re a qualified doctor well into your career, you are a senior salaried doctor or maybe a partner and you have bills to pay. You can’t throw everything into the air and start a functional medicine business from scratch. So, to what extent can you migrate patients into a functional medicine business if you are “their NHS GP”?
We have weaved our way through the Standard General Medical Services Agreement (SGMSA), Standard Personal Medical Services Agreement and the Standard Alternative Medical Agreement. We have also looked at Part 4 of the NHS Act 2006 which is referenced within the agreements.
In considering your options about building your functional medicine practice out of your NHS work you will need to understand the contract by which the medical services are provided. At the heart of this is the interplay between primary medical services and private medical services. The contracts define each as the mirror image of the other. Both reference Part 4 of the 2006 Act, which provides for a bespoke list of services (called primary medical services) to be negotiated between the commissioners and the particular practice.
Assuming the NHS contract is widely worded to include a wide range of activity the standard and alternative contract will prohibit you charging existing patients. So, if you are building a functional medicine business you will have to start without anyone from your existing practice. I think that includes any patient registered with your practice even if you are not their accountable GP. This is one commercial risk that your NHS position will not be able to assist with.
Having been through hundreds of pages across the various contracts we are happy to offer what insights we can. We have one client that that a brush with NHS England over this and fortunately we were able to prevent this developing into anything significant, but this is certainly not what you want to be dealing with as well as launching a new business.