How to Start a Physiotherapy Practice in the UK

Private physiotherapy is in strong demand, driven by long NHS waiting lists, growing awareness of musculoskeletal health, and the sports and fitness market. If you are HCPC-registered, starting your own practice offers clinical autonomy and excellent earning potential.

HCPC Registration

Physiotherapist is a protected title. You must be registered with the HCPC (Health and Care Professions Council). Annual registration is around £106. You must hold an HCPC-approved degree in physiotherapy.

Professional Memberships

• CSP (Chartered Society of Physiotherapy) — the professional body. Membership provides insurance, CPD resources, and professional support.
• Specialist interest groups within CSP — for specific practice areas (sports, musculoskeletal, respiratory, etc.)

Sole Trader or Limited Company?

Most private physiotherapists start as sole traders. A limited company becomes relevant if you grow into a multi-therapist practice.

Registering with HMRC

Register for Self Assessment within three months. VAT: physiotherapy provided by an HCPC-registered practitioner is exempt from VAT. You do not charge VAT but cannot reclaim it on expenses.

Insurance

• Professional indemnity and malpractice — essential. CSP membership includes an insurance option. Otherwise, specialist policies cost £300–£800 per year.
• Public liability — for clinic premises and home visits
• Employers' liability — if you employ staff
• Contents and equipment — treatment tables, ultrasound machines, exercise equipment

Claimable Expenses

• HCPC registration fees
• CSP membership
• Clinic room hire — often your largest ongoing cost
• Equipment — treatment tables, ultrasound, TENS, exercise equipment, resistance bands
• Consumables — tape, couch rolls, ice packs, exercise sheets
• CPD and training — specialist courses, conferences, supervision
• Marketing — website, Google Ads, patient leaflets, professional directories
• Software — practice management, clinical records, online booking, exercise prescription platforms
• Home office costs — for admin
• Travel — to clinic, home visits, sports events, at 45p per mile
• Phone and broadband
• Insurance premiums
• Accountancy fees

Accounted tracks expenses automatically and keeps your records organised.

Pricing

• Initial assessment (45–60 min) — £55–£95
• Follow-up treatment (30 min) — £40–£65
• Extended session (45 min) — £55–£80
• Sports massage (as part of physio) — £40–£60
• Home visit surcharge — £10–£30 extra

Register with health insurance panels (BUPA, AXA, Aviva, Vitality) to access insured patients. Insurance companies set maximum fees for insured treatments.

Building Your Practice

• GP referrals — build relationships with local doctors
• Sports clubs — provide pitch-side physio and build your reputation
• Health insurance panels — a major source of patients
• Online presence — Google My Business, website with SEO
• Local gyms and fitness centres — referral partnerships
• Corporate contracts — workplace health and ergonomic assessments

Bookkeeping Tips

• Separate business and personal finances
• Track income by source — private, insurance, sports, corporate
• Monitor treatment numbers and revenue per session
• Keep equipment purchase records
• Set aside 25–30% of profits for tax

Accounted connects to your bank and categorises transactions with AI.

Key Deadlines

• 31 January — Self Assessment and payment
• 31 July — second payment on account
• Every 2 years — HCPC renewal

Getting Started

Private physiotherapy is a thriving market with strong demand. Ensure your HCPC registration is current, arrange proper insurance, and keep your finances well-managed from your first patient.

Ready to keep your physio practice finances healthy? Sign up for Accounted and let Penny handle the bookkeeping while you focus on rehabilitation.