- 24-hour Emergency Line: 0300 30 32 442
Written by: Prof Sam Shah
Reviewed by a Medico-Legal Expert
Published:
October 2026
Written by: Prof Sam Shah
Reviewed by a Medico-Legal Expert
Published:
October 2026
In a recent webinar for our members, Professor Sam Shah (a Medico-Legal Advisor and solicitor in our in-house legal team) shared his insights into the unique ethical challenges faced by healthcare practitioners when practicing privately, and the importance to maintain an ethical conduct at all times. Here’s a summary of the key themes and takeaways from the session.
If you are a MDS member and you would like to view a recording, get in touch at [email protected].
The private healthcare sector in the UK is experiencing a significant boom, bringing both substantial opportunities for practitioners and heightened regulatory scrutiny. With the market estimated at almost £14 billion and predicted to reach nearly £19 billion by 2033, clinicians are operating in an environment where ethical standards are identical to the NHS, but the context magnifies every risk.
The General Medical Council (GMC), General Dental Council (GDC), and the Competition and Markets Authority (CMA) are paying close attention to private practice conduct, confirming that more income results in more scrutiny.
Private practice introduces unique friction points that can influence clinical judgment:
All clinical decisions in the private sector must be balanced against the four pillars of medical ethics: autonomy, beneficence, non-maleficence, and justice.
Gold standard consent must be voluntary (free from commercial urgency or pressure selling), informed, and ongoing (one must be able to withdraw it at any time).
It requires disclosing all of the following:
Documentation must record the conversation with the patient, not just a signature on a form. Details must include the specific risks discussed, expectations, patient questions, alternatives offered, and the opportunity for the patient to reconsider. The use of AI scribes can be an efficient way to capture contemporaneous records of the consultation, but must be disclosed to the patient.
Clinicians are not obligated to provide treatment if they believe it is not in the patient’s best interest. The clinician must document their ethical and clinical reasoning for the refusal.
Common conflicts include the financial incentive to overtreat, undisclosed ownership interests in referral facilities (e.g., imaging or labs), and referral fee arrangements.
In the case of referral fees from testing providers, the safest option is to decline the fee and refer solely based on clinical quality and patient cost.
If you work in both NHS and private practice, NHS commitments take precedence. Clinicians cannot use NHS time or facilities for private gain unless explicitly permitted by their contract and must be transparent with their employer about their private practice.
In terms of confidentiality, in private practice this often comes to the fore when dealing with insurers. If an insurer requests clinical records, the clinician must not send the records directly. The correct protocol is to contact the patient directly, explain the request, and obtain written consent, before disclosing only the minimum necessary information. Liability for improper disclosure is a breach of confidentiality that can damage professional trust and reputation.
The general rule of no disclosure without explicit patient consent applies to requests from insurers, employers, solicitors, family, or GPs, with few exceptions for legal obligations (e.g., court orders, notifiable diseases) or public interest to prevent serious harm.
Marketing and advertising of private healthcare services are regulated by bodies including the Advertising Standards Authority (ASA), the Medicines and Healthcare products Regulatory Agency (MHRA), the GMC, GDC, and the CMA.
Two essential key points to keep in mind are:
Since 2024, holding indemnity that covers the full scope of practice is a mandatory GMC and GDC requirement. Clinicians must check that their policy covers private work, that the limits are adequate for high-damages private claims, and that all procedures they provide are included.
Ultimately, the biggest mistake is handling complaints, legal actions, ethical dilemmas, or regulatory issues or new business arrangements alone. Clinicians are encouraged to seek early advice from their insurer and Medical Defence provider whenever any of the above comes up.
Join MDS now for immediate access to expert medico-legal advice, statement & employment support.
Call us on 0300 30 32 442 or email: [email protected].
