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Goodbye commuting

Is home the Best base for physios moving into private practice? Sally Priestley investigates

Setting up your own small business at home can be an attractive proposition, especially when you’re commuting long distances or coping with upheaval in the NHS. Is it a sensible move in troubled economic times? Some commercial gurus claim that there is no better time to set up a business than in a recession.

Band 6 musculoskeletal physio Anna Winstanley decided to leave her job at York Hospital last year.

‘I was struggling to see where I could go next in the NHS that would fit me and what I wanted to do,’ she says. ‘My partner and I had already decided we wanted to go travelling and this seemed like a good time to do it.’

Once back from their overseas trip, she picked up work at a friend’s private practice while she planned her own business venture.

‘I had always wanted to specialise in Pilates,’ says Ms Winstanley, who had taken a Pilates course while working for the NHS. ‘Now in my own business I run two classes a week, and go to people’s homes to provide one-to-one sessions.’


Surprise success

In less than six months Ms Winstanley has built a regular client base for both the group classes and the one-to-one sessions – which have been a surprise success.

She has now set up an office in her home for the admin and rents space at a local community centre for the group Pilates.

‘I’m still building up the business, and will continue to do the private clinic work for now, but I’m also looking to expand the Pilates to different patient groups and adopt new ideas in Pilates practice.

‘The business side of things is challenging, but I am enjoying learning new skills like marketing, and building a website,’ she says. ‘I’m loving being my own boss, managing my own time, and I feel it has reignited my enthusiasm for the profession, which passes onto my patients.’

Keeping costs down

Physios considering private practice have a number of options in terms of premises. Starting out at home is a popular route, particularly while the business is in its infancy. For a start, it’s the cheapest option.

You can also claim a proportion of mortgage or rent and utility bills against tax, depending on the amount of space used.

Other advantages include convenience, no time or costs lost to commuting (and less stress too), more time available to spend with family, flexible working hours to suit you, and the ability to adjust times of appointments to suit clients.

Of course there are also disadvantages, with home and work boundaries frequently becoming blurred. Home-workers can easily slip into working excessively long hours – or on the other hand be disrupted by family, friends and home-life going on all around.

Using a spare room as your office for admin is straightforward. But if you’re planning to carry out treatments at home, the practical requirements may be difficult to meet. You need a waiting area for clients, a separate entrance and exit to ensure privacy, and enough space for all the equipment.


Not a soft option

Carol Owen of Physio First, the organisation that represents physios working in private practice, runs a course called ‘Starting in private practice’. She warns physios not to see working from home as a soft option. One of the first things to think about – but which most people forget – is planning consent to use a treatment room on the premises, which requires a meeting with the local council.

This first step could throw a spanner in the works before the home-based practice is even off the starting blocks. ‘It depends on the area, but in a residential area you usually won’t get consent at all,’ says Mrs Owen.

Costs and equipment also present a barrier, she says. She suggests that the average start-up physio business needs to pull in around £86,000 a year to remain afloat, once all costs are accounted for.

‘Remember, in physiotherapy training,, nobody teaches you to be a business person, and there’s much to learn,’ says Mrs Owen. ‘People rarely appreciate the time needed to run a business. Running a private practice from home is definitely not a soft option.’


Losing NHS benefits

On top of that, in leaving the NHS you’re not just giving up the security of a salary. You also lose benefits such as paid holiday, occupational maternity leave and time off to attend funded CSP courses.

‘Physios are quite vulnerable to injuries, and in the NHS you can get up to six months sick leave on fully pay and six months on half pay,’ the CSP’s head of employment research, Kate Moran, adds. ‘And in private practice you’d have to make your own pension provision, without the employer’s contribution.’

Other concerns for physiotherapists working from home include being perceived as less professional by clients or colleagues, feeling isolated from peers and missing out on potential learning from colleagues.

On your own

‘Physios are social people and I miss brainstorming difficult client problems,’ admits Karen Reay, who spent nearly 20 years working in the NHS before going private.

‘Financially it’s tough, too, and I’ve had to gradually build my client list. So you need a financial buffer at the start. You need to be very entrepreneurial.’

Ms Reay ran a successful business in Winchester for two years before heading for the beautiful Spanish city of Valencia in 2010. Her love of the country, its climate, language, people and food was the main pull for this major life switch, she says. But setting up a business abroad brings a whole new set of considerations.

‘I needed to get an official translation of my physio course manuscript (available from the CSP) and physio certificates, and this had to go to the Spanish equivalent of the Health Professions Council, which took
a couple of months to process,’ she explains.

‘Only when you are recognised can you approach the regional physio society to join and be insured to practice.’

Taking the plunge

The benefits of working from home are the same at home or abroad, says Ms Reay. The lack of commuting time and expense, the cost-free use of a room (though she would like a separate space for patients to come in and out of the house) and the direct profit are what she cites as the big bonuses attached to her work choice.   

‘I’m definitely pleased I took the plunge,’ she says. And she has many plans for the development of her business.

‘I will continue to work from home, but in October I’ll move to a house nearer the metro, so I’m more accessible from the city centre,’ she says.

‘I’d also like to increase my number of Spanish clients as my Spanish improves. I don’t want to be restricted to just the expat market. And I’m going to approach some of the small local tennis and sports clubs, to see if I can offer a massage or physiotherapy for their teams.’

Like any lifestyle choice, working as a home-based physio has its pros and cons. Many physios are not just making it work, but relishing both the challenges and their success. fl


Find out more

The next ‘Starting in private practice’ course for non-members of Physio First will be on 3 October at the CSP London office. Call 01604 684960 or email

Physios interested in working abroad should call the CSP on 020 7306 6666 or find the relevant publications at


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Sally Priestley

Issue date

7 September 2011

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