11 April 2025
In this article, Consultant Surgeon and Medmin founder Simon Radley highlights the importance of having a reliable medical secretary when establishing and managing a successful private practice. For many consultants starting out, it can be tempting to ask their NHS secretary to assist with private work. While this may seem like a practical and cost-effective solution, there are significant regulatory, efficiency, and financial factors to consider—making this approach potentially risky in the long term.
NHS organisations have clear policies about the use of NHS resources for private practice. In short: NHS staff should not be used for the delivery of private services.
As a consultant, you are required to inform your NHS employer about your private practice. The same applies to your NHS medical secretary—they must declare any private work they are undertaking.
Just as you cannot perform private work during your contracted NHS hours, your NHS secretary is equally restricted. Private work includes any administrative tasks related to a private practice, such as:
Making or receiving phone calls
Booking outpatient appointments or theatre lists
Typing letters and medico-legal reports
Sending or receiving emails, faxes, and correspondence
Moreover, NHS facilities must not be used to support private practice. This includes:
Office space
Computers and NHS email accounts
Telephone lines
Stationery, paper, or postage
Every NHS staff member, including administrative staff, is responsible for ensuring their private commitments do not conflict with NHS duties—NHS responsibilities must always take precedence.
Even if your NHS secretary is doing your private work outside NHS hours, the lack of availability during standard working hours will have a negative impact on your private practice.
For prospective patients, delays in getting a response or booking an appointment may be enough to prompt them to look elsewhere. For existing patients, poor accessibility and slow communication can reflect badly on your reputation.
There is also the risk of conflicts of interest. Just as consultants must not promote private healthcare options in NHS clinics, your secretary may find themselves in a challenging position if NHS patients enquire about private care.
And what happens if your NHS secretary goes on annual leave or is off sick? Without proper cover, your private practice could come to a standstill.
Paying your secretary fairly and legally is essential. Consultants must ensure they:
Agree appropriate remuneration, whether through hourly timesheets or a percentage of revenue
Clarify tax responsibilities—unless the secretary is directly employed, they must handle their own tax and National Insurance
Take advice from an accountant when setting up the practice to ensure all staff arrangements are legally sound
While using your NHS secretary to support your private practice might feel like a convenient and cost-saving idea, in reality it can expose you to regulatory breaches, operational inefficiencies, and financial complications.
Instead, consider using an independent medical secretary or a professional service like Medmin, which offers complete private practice management solutions—allowing you to focus on delivering excellent patient care without the risk.
Most NHS Trusts have a formal policy on private and fee-paying work. If you undertake private practice, be sure to request and review this document carefully to ensure full compliance.
