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Innovative ways to boost your practice income

Thinking outside the box can identify new income streams, explains Dr Una Coales

Practices experiencing a fall in income need to be on the lookout for new ways to boost earnings. Often the most successful people are those who have taken an unorthodox idea and made it work for them – and have been able to profit from it.

This article outlines some innovative ideas you might not be aware of and explains how practices can turn them into a useful income stream.

Take over a failing practice

Hostile takeovers are not just for investment bankers. Contact your PCT and offer to take over a local failing single-handed practice. It may be hard work at first, but those additional patients are a ready-made source of income. Many GP-led companies and consortia have started this way – for instance, DMC Healthcare has so far acquired nine NHS practices in London and Kent and is growing.

Rent out your consulting rooms

You own a building. When it is not in use, you can make it generate income. In my area, Balham Park Surgery rents out rooms for evening yoga classes, RCGP faculty board meetings and so on. They charge £90.50 for two hours’ room hire and get additional brownie points for their surgery by being publicised as a healthy-living centre.

Form a local property consortium

Take advantage of local building developments to add to your practice list and boost your income. GPs can already buy into their surgery and take a proportion of the appreciation when they leave – this can be expanded on a larger scale.

In our area, the US embassy will be relocating to Nine Elms, Wandsworth, with 5,000 employees. All those people will need to be housed, and I know of 10 surgeries that each have a £20,000 stake in a local new-build development and are hoping for a handsome return on this investment.

This kind of speculation may not be to every GP’s taste, but be aware of any local developments and be prepared to expand to meet additional demand. Those extra people have to be on somebody’s list – why not yours?

Offer a premium service

Patients will pay to get a faster service than they can get on the NHS. This philosophy is behind the success of, set up by Dr Laurence Gerlis, a GP in central London. Dr Gerlis has established a group of eight same-day clinics across the UK offering occupational health checks, STI screens, HIV testing, steroid joint injections, podiatry and travel vaccines. Have a look at his website, go for a consultation and learn how he has created a lucrative empire.

Offer simple cosmetic procedures

GPs may use their NHS patient lists to offer private services, so start thinking. You could easily train one of your GPs and start providing non-surgical cosmetic treatments such as dermal fillers, Botox, Vaser liposuction or other services. offers accredited training on how to administer Botox and fillers for around £650. Privately, you can charge £250 for an injection at one facial site and £350 for three – with a profit margin of 100-200%.

Look at – a website set up by a newly qualified GP in south-east London. She is now a GP partner. What a bonus to have a partner with such entrepreneurial talents.

Set up your own locum agency

When I sat on my LMC, I often heard GP partners moan about the £110 an hour they had to pay to locum agencies to cover a two-hour session, but there are ways to reduce your costs.

If you are having problems getting value for money, it is likely that other practices in your area are as well. Newly qualified GP Dr Asghar Jaffery set up his own agency R&R medical services ( in Essex and now supplies locums to local practices and hospitals – and he gets to keep the profits.

Alternatively, you can cut out the middle man and pay a local locum directly. Contact your primary care organisation for a list of locums on their supplementary list. This typically reduces the cost from £110 an hour with an agency to around £80 an hour.

Some PCOs support local locum groups

to ensure they keep up with annual appraisals, so find out who the facilitator of this group is, and get your practice on their email cascade.

Sell old equipment on Ebay

No, you can’t put your old senior partner on Ebay, but you will be amazed what you can get rid of. I put my broken television up and someone paid me £100 for it.

Have everyone in your practice become a GP trainer

You get £8,000 a year for each trainee you take on and your practice may even apply for an expansion grant from your PCT – a great way to boost income and contribute to the next generation of GPs.

You can enrol on your local deanery’s trainer’s course – this costs £475 and your practice nurse can attend for free as part of an ‘interprofessional pair’. The course is normally 13 classes over nine months, so it should not interfere with practice work.

Don’t stop at GP trainees. Ask to take on foundation-year students, medical students, and even work-experience teenagers. Practices should receive around £8,000 a year for each foundation-year student they accept from their deanery.

Dr Una Coales is a GP in Stockwell, south London, and the author of Dr Una Coales’s MRCGP AKT Hot Topics and Dr Una Coales’s MRCGP CSA, available from

The content of this article was taken from a presentation made at the Pulse seminar ‘How to become a high-income practice’

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