Established practice
Not ready to stop, but ready to slow down?
Many consultants step back gradually: fewer clinics, advisory roles or medicolegal work. Here is how to plan it.
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- steps
- 7
- steps
- to start
- 2 hours
- to start
The short answer
Decide first whether any of your future work needs a licence to practise, because that sets everything else: revalidation, appraisal, indemnity and practising privileges. Then reshape in stages, telling hospitals, insurers and referrers what you still do. Plan for 6 to 12 months, and sort indemnity run-off before you stop anything.
What good looks like
Where you stand, before and after
Mr Sam Patel, Consultant Orthopaedic surgery
- Two clinics a week · medicolegal work
- Profiles updated · licence plan agreed
Illustrative sample, not a real person or result.
7 steps
Do it yourself: step by step
0 of 7 done
List every type of work you do now: operating, outpatients, on-call, NHS sessions, teaching, medicolegal, advisory. Mark each keep, reduce or stop, with a target date
- Time
- 2 hours
- Typical cost
- Free
- Who does it
- You
Done when: A one-page plan with a date against each change
This problem is Solvable.
Copy this checklist
Stepping-back plan and referrer letter
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Stepping-back plan
| Work type | Keep, reduce or stop | Target date | Needs licence? | Who to tell |
|---|---|---|---|---|
| Operating | Yes | Hospitals, insurers, indemnity | ||
| Outpatient clinics | Yes | Hospitals, insurers, referrers | ||
| NHS sessions | Yes | Trust, responsible officer | ||
| On-call | Yes | Hospital, colleagues | ||
| Medicolegal reports | Check with instructing parties | Indemnity, appraiser | ||
| Teaching | Often not | Appraiser | ||
| Advisory or company work | Often not | Appraiser, indemnity |
Before you change anything
- Read GMC guidance on licence and registration
- Agree revalidation plan with responsible officer
- Written indemnity confirmation, including run-off for past work
- Checked each hospital's minimum activity rules
- Pension advice taken if you are in the NHS Pension Scheme
- Handover arrangements for patients on your list
Letter to referrers
Dear [GP name],
I am writing to let you know about changes to my practice from [date].
I will continue to see patients for [conditions or procedures you keep] at [hospital], on [days].
From [date] I will no longer be [operating / seeing new patients for X]. For [those patients], I recommend [colleague name], who I have worked with for [years] and who I trust.
Patients currently under my care will be [completed by me / handed over to colleague], and we will write to each of them.
Thank you for your referrals over the years. My secretary [name] remains the best contact on [number] or [email].
With best wishes, [Your name] [GMC number]
Avoid these
Common mistakes
- Giving up the licence before checking whether new roles need one.
- Stopping work without arranging run-off indemnity for past cases.
- Leaving old procedures on insurer and directory listings, so referrals keep arriving for work you no longer do.
- Forgetting that appraisal must cover medicolegal and advisory work too.
- Telling nobody, so referrers assume you have retired altogether.
Free personal check
Done by Paul Robinson, not software
I'll check your plan to reduce clinical work and flag what could catch you out
What I need from you
- What you want to keep and what you want to stop
- Answers to eight tap questions
What you get
- Whether you are likely to need a licence to practise
- The indemnity and appraisal steps in order
- Who to tell, and when
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
6 to 12 months
Realistic time to reshape a practice in stages, including insurer and hospital updates
Solvable estimate
3 to 12 months
Time to build a steady flow of medicolegal instructions after training
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
Can I keep my GMC registration but give up my licence?
Yes. You stay on the register without a licence. You can no longer do things that need a licence, such as prescribing or signing statutory certificates, and you no longer need to revalidate. The GMC guidance explains the difference.
Do I need a licence for medicolegal work?
It depends on the work and who instructs you. Ask your instructing solicitors and any agency you work with before you give up your licence.
Will my hospitals let me keep practising privileges with less activity?
Some set a minimum activity level and review it at renewal. Ask the medical director's office what reduced scope they accept.
What happens to my indemnity for past patients?
Claims can arrive years later. Make sure past work is covered, either through occurrence-based membership or run-off cover on a claims-made policy.
Can I draw my NHS pension and keep working?
The NHS Pension Scheme offers partial retirement. From minimum pension age you can take 20% to 100% of your pension and keep working, if you reduce your pensionable pay by at least 10% for 12 months. The rules are detailed, so take advice from NHS Pensions or an independent financial adviser before changing your sessions.
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