The landscape of general practice in England is changing. A growing number of General Practitioners are choosing to work outside the National Health Service, either fully or part time, prompting important questions about the future of primary care. Why are more GPs moving into private practice? What does this mean for patients? And how is the government responding?
Recent reporting from BBC News highlights a sharp rise in doctors registering as independent practitioners outside the NHS. Behind the statistics lie complex issues involving workload pressures, patient demand, funding constraints, and professional wellbeing.
In this in depth analysis, we explore the factors driving this trend and what it signals for the future of healthcare in England.
According to analysis of data from the Care Quality Commission, there has been a significant increase in doctors registering as independent consulting practitioners in England.
Between 2021 and 2025, the CQC received 1,238 new registrations for independent consulting doctors. This compares with 396 registrations in the previous five year period, representing a 212 percent increase. From 2024 to 2025 alone, new registrations rose by 58 percent.
Independent consulting doctors operate outside the NHS framework. They may provide services in person or online and span various specialties including general practice, dermatology, women’s health, and aesthetics.
While there is no specific category that isolates private GP registrations, the trend is clear. The structure of primary care is gradually diversifying.
For context, the Royal College of General Practitioners reports that 6,229 NHS GP practices were active as of September 2025. Against that backdrop, even a modest shift of practitioners toward private models can have ripple effects across the system.
Many GPs describe overwhelming daily workloads within the NHS.
Dr Yvonne Girgis Hanna, who splits her week between NHS and private patients, describes days filled with 30 face to face consultations, additional phone calls, and extensive paperwork. She says she feels exhausted after NHS sessions and struggles to sustain that pace full time.
This reflects a broader issue. Rising patient demand, workforce shortages, and administrative complexity have created a high pressure environment for primary care doctors.
Burnout among GPs has been widely documented. Long working hours, emotional strain, and insufficient recovery time contribute to declining job satisfaction. For some, moving into private practice offers greater control over schedules and patient volume.
In private practice, appointment lengths often differ significantly from standard NHS consultations.
Some private GPs offer 20 minute sessions starting at around £129, with options for appointments lasting up to an hour. Longer consultations allow for deeper exploration of symptoms, preventative care, and continuity of treatment.
By contrast, NHS appointments are typically shorter due to funding limitations and demand pressures. Patients frequently report feeling rushed.
This difference in consultation time is a major factor for both doctors and patients. GPs working privately often describe greater professional fulfillment when they can spend adequate time addressing underlying causes rather than managing immediate symptoms alone.
General practice within the NHS operates under tight budget constraints.
Some GPs point out that the annual funding per patient is approximately £120. If a patient visits 20 or more times a year, that funding stretches thinly across all consultations, administrative support, and overhead costs.
The British Medical Association has argued that general practice requires substantial additional investment. It previously lobbied for a £2.5 billion increase in the core GP contract. In response, the government announced a £485 million uplift for 2026 to 2027, including £292 million ringfenced to recruit more GPs.
Amanda Doyle of NHS England stated that these funds aim to strengthen care provision and improve access. Meanwhile, Health Secretary Wes Streeting has said the government is focused on fixing the front door of the NHS by improving appointment access.
Despite these measures, many clinicians argue that the funding gap remains substantial.
The shift is not solely doctor driven. Patient demand plays a crucial role.
A 2024 report by LaingBuisson estimated that 13 percent of GP consultations were private, compared with just 3 percent two decades earlier. This indicates a significant cultural shift in how primary care is accessed.
Several key factors explain why patients are willing to pay.
Many patients report difficulty securing timely NHS appointments. Long phone queues and delays can cause anxiety, especially when symptoms worsen during the wait.
Private consultations often provide same week or even same day availability, offering reassurance and speed.
Seeing the same GP consistently is another attraction. Patients often value familiarity and the ability to build an ongoing therapeutic relationship.
In private settings, doctors frequently manage smaller patient lists, enabling greater continuity. This recalls the traditional cradle to grave model of family medicine that many older patients remember.
Patients appreciate the opportunity to discuss multiple concerns in one visit. Longer sessions can feel more thorough and less transactional.
However, cost remains a barrier. Not all patients can afford repeated private appointments, and many still rely on NHS referrals for specialist treatment.
Many GPs express mixed feelings about working privately.
On one hand, private practice may protect wellbeing and reduce burnout. On the other, some worry about widening health inequalities.
If more doctors shift part time into private care, access disparities may grow. Patients with financial means can secure faster consultations, while others remain within an overstretched public system.
Dr Diana Hunter, an NHS GP in Cambridgeshire and BMA representative, suggests that increasing private uptake signals deeper systemic issues within NHS general practice.
She argues that what patients are paying for is not necessarily superior medicine, but access and time. In her view, this highlights unmet needs within publicly funded care.
Despite the rise in private consultations, the NHS remains the dominant provider of primary care in England.
The independent sector still accounts for a minority of total GP appointments. Most GPs continue to work primarily within NHS practices, and many who offer private services do so alongside NHS roles.
This hybrid model may become more common. Doctors may divide their time to balance financial sustainability, professional satisfaction, and public service commitment.
The key question is whether this trend stabilizes or accelerates.
If current patterns continue, several outcomes are possible:
Policymakers will need to address core drivers such as workload, recruitment, and funding structures to ensure NHS general practice remains viable and attractive.
The government has introduced measures aimed at improving access, including requirements for practices to keep online consultation systems open throughout the working day.
Phone system upgrades and digital request forms are intended to streamline communication and free up urgent lines.
However, many GPs argue that technology alone cannot solve structural workforce and funding challenges.
Recruitment initiatives and contract reforms may help, but restoring morale and long term sustainability will likely require deeper investment and systemic redesign.
The rise in private GP registrations is not merely a trend. It reflects broader pressures facing the NHS and evolving expectations from both doctors and patients.
For some GPs, private practice offers manageable workloads and meaningful patient interaction. For some patients, it offers speed, familiarity, and time.
Yet the growth of private general practice also raises questions about equity, funding priorities, and the long term identity of British healthcare.
The NHS remains a cornerstone of public life. Ensuring its resilience in primary care will require balancing access, quality, workforce wellbeing, and sustainable funding.
As this shift continues, the debate over the future of general practice in England is likely to intensify.
BBC News, 1 March 2026.
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