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Placements in private practice: student guidance

This guidance will help students gain knowledge and understanding of private practice and what going on placement in the independent sector entails. It is specifically aimed at placements in smaller clinics or with sole trader physiotherapists.

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Students at table

Physiotherapy students require 1000 hours of practice-based learning to gain HCPC registration. At university, when we consider practice, much of the focus is on the NHS.

However, placements don’t just take place in the NHS, as qualified physiotherapists work in multiple settings. Placements in private practice settings are still relatively rare; a recent survey of student physiotherapists showed that 75% of current students had not had a placement in this setting.

The learning environment and experience to be gained in the private sector is unique. You can gain skills in areas such as the running of a business or in marketing. You may have more access to different equipment and potentially seeing patients in different environments.

How this guidance can help you

This guidance can help you:

  • be more prepared for undertaking private practice placement, knowing what is involved and the breadth of knowledge you can gain.
  • feel more confident about what your day might involve and the new experiences you may be exposed to.
  • prepare prior to starting my placement and understand the different pressures that private practitioners face. 

What is private practice?

Private practitioner physiotherapists are those who works for themselves, i.e., are self-employed, or who are employed within a private practice or private hospital setting.

However, there is a huge spectrum. Some physiotherapists choose to work for larger private healthcare providers such as the Nuffield or Spire Health. In these instances, the physiotherapists are usually employed and may have similar employment terms and conditions of employment to NHS employees.   

At the other end of the spectrum, there are sole trader physiotherapists. A sole trader is a physiotherapist who sets up and owns their own business. Some practitioners are self-employed, choosing to carry out work contracted to them by the owner of a private practice. Others may go into partnership with another physiotherapist and employ others, therefore working as a small business.

It's this group of physiotherapists that we would like to focus on as this is a sector where there may be potential for more quality practice placements opportunities. It’s also a sector where traditional models of placements may be challenging. Therefore, it’s essential that students consider some of these challenges so that they can be fully prepared.

What is involved in placements within the private sector?

Have you ever thought about what it may be like to go on placement in the private sector? Have you ever considered how the private sector differs to the NHS? This is something that may not have been discussed in university. 

A placement in private practice will still give you the opportunity to practice clinical skills, shadow physiotherapists, treat patients but will also introduce you to the business, legal and financial considerations that those working in this sector must address, that are not so clearly required when starting out in NHS practice.

Some students may have the idea that being on placement in the private sector is not dissimilar to the NHS. After all, patients are patients and physiotherapists are there to help them regain function or reduce pain or increase independence.

However, there are differences that must be considered to ensure the experience is a positive one for all involved.  

Top tips for students

  • Get involved – You may just be working alongside one physiotherapist…. Get involved, ask questions, consider your strengths and weaknesses to gain as much out of it as possible!
  • Say yes – You may have chance to use specialist equipment and technology that won’t be available in the NHS so be bold and grasp every opportunity.
  • Prepare yourself – Read up around different business considerations, what kind of business the placement is that you’re going to, what specialism they offer (MSK, Neuro, Women’s Health etc), what uniform is required, how the sessions are going to run e.g., half an hour/hour long session.
  • Ask for an informal visit – Asking for an informal visit to the practice prior to your placement may be beneficial and help calm your nerves.
  • Have fun – Private placement opportunities aren’t as common as NHS, so take it all in and have fun!

What are the additional considerations?

There are many issues private practitioners must consider if they are to run a successful business. Challenges and benefits of the private sector include:

Business considerations

Other than finding and paying for appropriate premises, private practitioners must consider insurance costs, tax implications, paying wages, and other bills.

If they are off sick, there is no sick pay or readily available cover and ultimately patients need to be cancelled. Additionally, when patients fail to attend there is often no payment.

Marketing

Physiotherapists who run their own business are in competition with other providers and may need to market their service in order that they can build up a case load of patients to enable a viable business. There are many private clinics so making sure their clinic stands out, has a good reputation and offers the very best patient experience is imperative. 

Private practitioners must therefore strive to give their patients the very best experience, ensuring they choose to return. They must also build and maintain relationships with those who may potentially refer into their clinic and other local stakeholders.

Patient expectations

I saw a patient having access to and benefitting from a Moollii suit while with a private neurological physiotherapist. This was being used to control pain and improve function. Such interventions are rarely available in the NHS.

Second-year physiotherapy student

Patient’s perceptions of private physiotherapy may be different to that of NHS physiotherapy. As they are paying, they may feel that are able to ask for specific interventions or feel they are entitled to more that they would get on the NHS. Managing such expectations can be challenging.

What can students bring to a private practice placement?

As current students, your knowledge is up to date. You are being taught new treatments, approaches and techniques that some qualified physiotherapists may find interesting to discuss or explore.

You may also bring a fresh perspective with good IT, and social media skills that could help private practitioners market and promote their business.

This guidance was created by two student physiotherapists while on placement at the CSP and with Physio First. It has been written by students for students, and has been written following conversations with private practitioners, students who have been on placement in this sector and other stakeholders.

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