If you’re either thinking about starting a private practice, of if you’re expanding and need extra hands, getting good legal advice is a really good idea.
Why is this?
Well, frankly, it’s all too easy to fall into a legal trap you weren’t expecting.
I recently had a good natter with healthcare legal expert, Tania Francis, about where clinicians sometimes go wrong, and how getting the right advice can prevent you getting into hot water.
Here’s a few key areas to consider:
Mixing up your NHS and Private Practice time and systems:
It’s tempting, particularly when you’re starting out, to keep costs down, but your NHS life and your Private Practice life needs to be very separate.
For instance: It’s a real no-no to use your NHS email address for Private Practice correspondence. Whilst it may seem an easy choice (it’s accessible and secure), the NHS won’t take kindly to this, and it can lead to a disciplinary event.
It’s really important to know exactly what is in your NHS contract so that you know when you can and can’t work.
SPA and ‘admin time’ should not be used to see private patients, unless it is explicitly stated in your contract that this is permitted. Whilst NHS employers may be prepared to accept the very occasional late arrival at an NHS session (e.g. because of private practice patient emergency), they’ll likely take umbrage at it being an every-week occurrence.
Be very careful about using your NHS secretary for your private practice work.
It’s very hard to separate out NHS time from private time. If you’re thinking that he or she can answer your private patient enquiry phone calls in their lunch time, you’ll quickly learn that private patients don’t like being kept waiting for an answer, or, they’ll be tempted to pick up the phone regardless.
Never store Private Practice correspondence or imaging on a NHS computer.
If you’re doing ‘extra’ sessions for the NHS (e.g. an additional operating list), you need to ensure you’re not being paid double for your time (i.e. time operating plus time you were supposed to being doing admin). It doesn’t matter that you’re being paid by the NHS, it still means you’re being paid twice.
Make sure you’re not trying to creep up your earnings with ‘over billing’. Unbundling procedures that should be grouped together can land you in big trouble, so always get expert medical billings advice. If the insurers catch you out, they’ll be after you to re-coup the money, and you can be reported to the GMC for dishonesty.
Is it really worth the risk?
Partnerships and employment:
It’s possible to be in a partnership and not know that you are.
Why does this matter?
Well partnerships share risks, as well as benefits of scale, but it also means you can be held jointly and severally liable for each other. That means, if someone in your partnership defaults on their indemnity or finds themselves in a legal mess, it’s theoretically possible that an angry party could come after you for compensation.
It’s far better to get a formal partnership arrangement drawn up by a legal expert. That way you’ll all be very much in the clear about what happens if the partnership breaks down, if someone wants to sell a premises or equipment, and whether there are any ‘restriction of practice’ clauses should someone want to leave and set up a practice next door.
How might you inadvertently be in a partnership and not realise it?
If you’re sharing premises and a receptionist greets all of your combined patients and books appointment, it’s a sign to get a formal partnership agreement drawn up. Make sure that indemnity and clinic costs are paid by direct debit whenever possible.
Don’t forget your working arrangements with your medical secretary.
Even if he or she is paying their own tax and national insurance, it’s not a guarantee that they are truly self-employed.
If your secretary works regular hours for you, and you mandate the nuts and bolts of how they work, chances are you’re in an employer/employee arrangement. That means they have legal rights, such as sick leave, maternity leave, holiday allowance, flexible working and statutory rights relating to dismissal. This makes it far harder to ‘let someone go’, and you’ll need pay national insurance contributions for them, as well consider pensions arrangements.
Get advice from the outset, so everyone is clear on where they stand.
‘Get in touch now, and let’s make sure you grow your private practice, you won’t regret it.’
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