Established practice
Practice overheads are rising and eating into your earnings
Indemnity, secretary costs, room hire, software. Everything has gone up. Most consultants have not reviewed their cost structure since they started, and the margin erosion is gradual enough that it goes unnoticed.
- steps
- 8
- steps
- to start
- 2 to 3 hours
- to start
The short answer
Overheads creep because each rise is small and nothing forces a review. Once a year, list every recurring cost, compare it with last year and with two alternatives, and act on notice dates before contracts renew automatically. Most consultants who do this properly recover a few thousand pounds a year without touching the quality of care.
8 steps
Do it yourself: step by step
0 of 8 done
Export 12 months of bank and card statements and list every recurring cost: room or session hire, secretary or PA, indemnity, practice management software, phone, card processing, accountant, website, directory listings, GMC, royal college and BMA subscriptions.
- Time
- 2 to 3 hours
- Typical cost
- Free
- Who does it
- You or secretary
Done when: Every recurring cost has a line with annual amount, supplier and renewal date
This problem is Solvable.
Copy this table
Annual overhead review table
Free to copy, adapt and use. No sign-up.
Copy this into a spreadsheet. Fill one row per recurring cost.
| Cost | Supplier | Last year (£) | This year (£) | Change (%) | Renewal date | Notice date | Alternative quote (£) | Action |
|---|---|---|---|---|---|---|---|---|
| Consulting room or session hire | [Hospital or rooms provider] | Keep / renegotiate / reduce sessions | ||||||
| Secretary or PA | [Name or supplier] | |||||||
| Medical indemnity | [Provider] | Get 2 like-for-like quotes | ||||||
| Practice management software | [System] | |||||||
| Insurer e-billing | [Service] | |||||||
| Card processing | [Provider] | Check rate per transaction | ||||||
| Phone and call handling | [Provider] | |||||||
| Website and hosting | [Supplier] | |||||||
| Directory listings | [Platforms] | Cancel if no enquiries | ||||||
| Accountant | [Firm] | |||||||
| GMC annual retention fee | GMC | Claim as expense | ||||||
| Royal college, BMA and society subscriptions | [Bodies] | Check on HMRC approved list | ||||||
| Other | ||||||||
| Total | ||||||||
| Private income | ||||||||
| Overheads as % of income |
Rules for the review
- Act on notice dates, not renewal dates.
- Compare indemnity only like for like, including run-off.
- Never let any cover lapse while switching.
- Any cost over £1,000 a year gets an alternative quote before it renews.
Avoid these
Common mistakes
- Diarising renewal dates instead of notice dates, so the chance to switch has passed.
- Comparing indemnity quotes that do not cover the same procedures, income band and run-off.
- Paying for room sessions that are regularly half empty.
- Cutting secretarial support to save money, then losing more in late or unsent invoices.
- Raising fees in one large jump after years of no change, instead of small annual steps.
Free personal check
Done by Paul Robinson, not software
I'll sense-check your overheads against your income and show you where to look first
What I need from you
- Your calculator inputs
- Your three biggest costs and what each costs a year
- Your annual private income, roughly
What you get
- How your costs compare with your income
- The three costs I would challenge first
- The notice dates to diarise
Within 2 working days
No sign-in, no sales call. I read every request myself and reply on WhatsApp.
Free tools
Check where you stand
Benchmarks
Overheads of 25% to 40% of private income
Typical range for a solo consultant with consulting rooms, part-time secretarial support, indemnity and software; much lower if you use a hospital outpatient suite and a remote secretary
Solvable estimate
Paul Robinson
14 years in UK private healthcare
I solve this one for consultants
Want a hand? I'll look at your situation and tell you the three things I'd tackle first.
A few quick questions, about two minutes. I read every one myself and usually reply the same day.
No sales call unless you ask for one. Just a straight answer from me.
I reply personally, usually the same day.
Questions
Frequently asked questions
What is a normal overhead percentage?
It varies widely by specialty and set-up. A consultant with rooms, a full-time PA and procedural indemnity runs much higher than one using a hospital outpatient suite with a part-time secretary. Track your own trend first.
Can I negotiate room hire?
Often, yes, especially if you bring inpatient, day case or diagnostic work to the hospital. Ask for a sessional review, half-session rates or pay per use.
Should I switch indemnity to save money?
Only if the cover is genuinely equivalent, including run-off and every procedure you do. Never let cover lapse during a switch. Ask an indemnity broker or your current provider to compare like for like.
Is a doctor-specialist accountant worth the fee?
Usually. They know which costs are allowable, how NHS and private income interact, and what similar consultants spend. This page is general information, not tax advice.
How often should I do this?
A full review once a year, plus a check before any contract over £1,000 renews.
Last reviewed:
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