How to Start an Osteopathy or Chiropractic Practice in the UK

Osteopathy and chiropractic are both statutorily regulated healthcare professions in the UK, meaning you must be registered before you can practise. Both offer strong demand for private practice and the potential for a rewarding career in musculoskeletal health.

Statutory Registration

Osteopaths

Must register with the General Osteopathic Council (GOsC). Only GOsC-registered practitioners can use the title "osteopath". Annual registration is around £750. You must hold a GOsC-recognised qualification (typically a 4–5 year degree).

Chiropractors

Must register with the General Chiropractic Council (GCC). Only GCC-registered practitioners can use the title "chiropractor". Annual registration is around £800. You must hold a GCC-recognised degree.

Both professions have mandatory CPD requirements.

Sole Trader or Limited Company?

Most practitioners start as sole traders, especially if practising from a rented treatment room. As your practice grows and you take on associates or open your own clinic, a limited company may become more appropriate.

Registering with HMRC

Register for Self Assessment within three months. VAT: both osteopathy and chiropractic services are exempt from VAT as regulated healthcare professions.

Insurance

• Professional indemnity and malpractice — mandatory. Available through professional bodies or specialist insurers.
• Public liability — for clinic premises
• Employers' liability — if you employ staff
• Contents and equipment — treatment tables, diagnostic equipment, clinic fixtures

Professional body membership often includes insurance. Otherwise, budget £500–£1,500 per year.

Claimable Expenses

• GOsC or GCC registration fees
• Professional memberships — Institute of Osteopathy, British Chiropractic Association, etc.
• Clinic room hire — your biggest ongoing cost if renting
• Equipment — treatment tables, X-ray viewing equipment, diagnostic tools, rehabilitation equipment
• Consumables — couch rolls, pillows, tape, exercise bands
• CPD and training — courses, conferences, supervision
• Marketing — website, Google Ads, local advertising, patient leaflets
• Software — practice management, clinical records, online booking
• Home office costs — for admin if you do not have a dedicated office
• Travel — if you work at multiple locations
• Phone and broadband
• Insurance premiums
• Laundry — clinic towels and linens
• Accountancy fees

Accounted handles expense tracking and receipt matching automatically.

Pricing

• Initial consultation (45–60 min) — £50–£90
• Follow-up treatment (30 min) — £40–£65
• Extended treatment (45 min) — £55–£80
• Package of treatments — discount for block bookings

Prices vary by location — London practitioners typically charge 30–50% more than those outside the capital.

Building Your Practice

• GP referrals — build relationships with local doctors
• Location — a visible, accessible clinic location with good footfall
• Online reviews — Google reviews are essential
• Local SEO — optimise your website for local search
• Health insurance panels — register with BUPA, AXA PPP, Aviva, and other insurers to receive insured patients
• Corporate wellness — ergonomic assessments and treatment for local businesses
• Partnerships — personal trainers, sports clubs, yoga studios

Bookkeeping Tips

• Separate business and personal finances
• Track patient numbers and revenue per session
• Record all clinic costs — rent, equipment, supplies
• Monitor cash flow — clinic overheads create fixed costs
• Set aside 25–30% of profits for tax

Accounted connects to your bank and categorises transactions with AI. Designed for UK healthcare professionals.

Key Deadlines

• 31 January — Self Assessment and payment
• 31 July — second payment on account
• Annually — GOsC/GCC renewal, insurance renewal, CPD compliance

Getting Started

Opening your own practice requires careful planning, but the demand for musculoskeletal healthcare is strong and growing. Ensure your registration is current, get proper insurance, and keep your finances well-managed.

Ready to straighten out your practice finances? Sign up for Accounted and let Penny handle the bookkeeping while you look after your patients.