19 May 2025
An increasing number of doctors are choosing to supplement—or even replace—their NHS roles with private practice. This shift is influenced by a combination of systemic pressures, personal career goals, and broader healthcare trends. In this article, Consultant surgeon and Medmin founder Simon Radley explores some of the underlying reasons behind the move.
Work-life balance and flexibility
A frequently cited reason why doctors move into private practice is the greater control over their work schedules. NHS rotas can be demanding, often involving long hours, on-call duties, and high patient loads. In contrast, private practice allows doctors to set their own hours, manage fewer patients per day, and allocate more time per consultation. This can significantly improve work-life balance and reduce the risk of burnout.
Financial incentives
Private practice often provides significantly higher remuneration. While NHS salaries are banded and capped, private consultations and procedures can command premium fees. For consultants and general practitioners, private practice offers the potential to earn more in less time—particularly attractive in the face of rising living costs and student debt.
Autonomy and professional satisfaction
Doctors in private practice often enjoy greater autonomy in how they treat patients and run their clinics. They can avoid some of the bureaucratic hurdles associated with NHS policies and protocols, which many feel interfere with their ability to provide optimal care. The opportunity to build longer-term relationships with patients and offer more personalised treatment can also enhance professional satisfaction.
NHS pressures and staff shortages
Ongoing challenges within the NHS, including underfunding, staff shortages, and increasing patient demand, have led to stretched resources and longer wait times. Many doctors feel overburdened and undervalued within the public system. Private practice offers a route out of what some describe as an unsustainable working environment.
Opportunities for specialisation
Private practice allows doctors to focus on specific areas of interest or expertise without being restricted by the demands of the local NHS. This may be particularly appealing for NHS consultants in areas with long waiting lists, who find that they cannot fully develop those areas of expertise. In some regions, NHS provision of services such as dermatology or mental health may be limited, leading to higher private demand and the opportunity for doctors to develop specialist private services.
Diversification and portfolio careers
Rather than leaving the NHS altogether, many doctors engage in “portfolio careers,” combining NHS work with private practice, teaching, research, or medico-legal work. This variety can reinvigorate a doctor’s career, provide financial stability, and offer new intellectual challenges.
Conclusion
In the UK, the National Health Service (NHS) has long been the cornerstone of healthcare provision, offering free services at the point of delivery. While the NHS remains a vital and valued institution, the realities of modern healthcare are prompting many doctors to explore private practice. Whether motivated by financial considerations, a desire for greater autonomy, or simply a better quality of life, the move can offer a range of benefits.
However, it also raises important questions about equity, access, and the long-term sustainability of the NHS workforce—questions that will need addressing as private provision continues to grow.
