One of the key roles for any consultant who wants to have a successful and profitable private practice is the medical secretary. Many doctors chose to use their NHS secretary to administer their private practice. Whilst using your NHS secretary when starting out in private practice might seem an appealing solution to a problem, there are important considerations you need to make before going down that route.
These considerations fall into 3 major categories:
Regulatory
The NHS has a strict working policy relating to the use of NHS resources for private practice. In short, consultants should not use NHS staff for the provision of private services.
Just as you are expected to inform your NHS employer about your private practice, your medical secretary is bound by the same rule.
Similarly, just as you are not allowed to do private work during contracted NHS hours, the exact same rule applies to your NHS secretary. Private work includes any work undertaken in relation to a private practice. Such activities may include but are not limited to:
- Making and receiving phone calls
- Booking appointments & theatre lists
- Typing letters and reports including medico-legal
- Receiving and sending email, faxes and letters
Unless you and your secretary have an explicit agreement with the NHS organisation, they should not be using NHS facilities to carry out that work. Such ‘facilities’ may include but are not limited to:
- Office space
- IT facilities
- Paper and stationery
- Postage
All staff, including administrative staff, are responsible for ensuring that private commitments do not conflict with their NHS commitments, which must take precedence.
Efficiency
As well as the regulation around the use of your NHS secretary to carry out your private work, if they are doing this work in their own time, i.e. outside contracted working hours, they must—or they cannot—answer phone calls, emails, respond to queries from patients, etc., nor can they undertake any private bookings for outpatient appointments.
The lack of availability of your secretary during the normal working day means it’s inevitable that your practice will suffer. For a prospective patient, the lack of immediate availability might mean that they go elsewhere.
Similarly, for existing patients, a lack of accessibility to your secretary can reflect poorly on you and your practice.
There are also potential conflicts of interest that need careful navigation. In the same way that consultants may not discuss private healthcare options with their NHS patients in the outpatient clinic, your medical secretary—if they are undertaking both NHS and private practice work—could be put in a very difficult situation should those conversations arise.
Finally, if your NHS secretary takes annual leave or is away for other reasons, who will cover your work in their absence?
Financial
Paying your secretary appropriately is important. Consultants must ensure that they pay their staff appropriately—this may be based on timesheets or as a percentage of revenue. Unless directly employed, consultants should ensure that their secretaries are responsible for their own tax and national insurance contributions. Consultants should specifically discuss payments to staff with their accountant when setting up their practice.
In summary
Whilst using your NHS secretary to undertake your private work might seem a simple, easy solution for a new consultant starting up, this article highlights the reasons why this is not a good idea for most consultants. At Medmin, we offer a Total Practice Management package.
Most NHS organisations have a policy covering private practice and fee-paying work. If you undertake any private fee-paying activity, you should obtain a copy of your organisation’s policy documents and read it carefully.
Get in touch today to find out how we can make private practice easier for you