Private HealthcareConsultant-Led Private Practice: From Decision to Registered Provider
Private Healthcare
Ongoing, 2026

Consultant-Led Private Practice: From Decision to Registered Provider

A hospital consultant and their partner decided to move from NHS-only practice into their own multi-room clinic. What they needed was not clinical help, it was a property negotiator, a borrower, a company structurer, a regulatory applicant and a construction client, all at once, while still holding a clinic list. Glaxtons ran all of it under one engagement.

Seven-figure capital programme
Contract Value
12 months to opening
Duration
Private Healthcare
Sector
Consultant
Client Type

The Challenge

The clinical proposition was never in doubt. The risk was everywhere else. A commercial lease negotiated against an agent who does it full time. A funding application that had to satisfy a credit committee rather than describe an ambition. A company structure that would determine, permanently, whether a future clinical claim could reach the family assets built over a career. CQC registration with a lead time long enough to decide the opening date. And a fit-out programme where every week of slippage after lease completion burns rent against no income. Each of those has its own professional, none of them owns the programme, and the failures in these projects are almost always the dependencies between them rather than mistakes inside any one.

Our Approach

Fixed the corporate structure before anything else was signed, separating the entity that trades and carries clinical risk from the entity holding the lease and the assets, so a claim against the operating company cannot reach what sits behind it

Held that structure when the lender proposed a simpler one, by identifying the specific underwriting concern behind the request and satisfying it with a guarantee from the stronger entity rather than by moving the valuable assets inside the borrowing company

Built the funding submission to the lender's own template rather than a generic format, with the capital requirement broken down line by line and the forecasts modelled at a pessimistic case, because underwriters price the downside rather than buying the upside

Drafted a full shareholders' agreement across both entities, covering the provisions founders avoid discussing: illness, a partner ceasing to practise, loss of registration, deadlock, valuation and exit

Negotiated the lease on the terms that carry the long-run value rather than the headline rent, including the uplift basis, the repairing obligation, service charge and reinstatement, and handled landlord works approval and the fees attached to it

Confirmed the VAT position at incorporation, including the option to tax, because the landlord had already opted and that changes what the tenant entity must do from day one

Sequenced CQC registration alongside the fit-out rather than after it, so regulatory approval was not the reason the doors stayed shut on a building that was ready

Coordinated the accountant, the solicitor, the broker and the letting agent so that all four were working to the same structure and the same timetable

Outstanding Results

Measurable success across every key performance indicator

7
Workstreams
Structure, funding, shareholders' agreement, lease, CQC registration, fit-out programme and NHS contracting, delivered under a single engagement
2
Entities Structured
An operating company and a separate asset-holding company, so clinical risk and family assets sit on opposite sides of a legal boundary
4
Advisers Coordinated
Accountant, solicitor, finance broker and letting agent, aligned to one structure and one programme rather than four assumptions
Clinic list intact
Founder Time Protected
Lender queries, agent negotiations and consents handled directly, so the programme did not run through clinical sessions

Key Achievements

Asset protection settled before incorporation, when it is cheap, rather than after trading begins, when it is not
Lender's proposed restructure resisted without losing the facility, keeping the family balance sheet outside the borrowing entity
Lease negotiated on uplift basis, repairing obligation and service charge, not just headline rent
CQC registration run in parallel with the fit-out rather than after it
One accountable adviser across all seven workstreams, so the dependencies between them had an owner

Project Deliverables

Corporate structure design, with the operating and asset-holding split and the covenant position behind it
Business plan and integrated financial forecasts built to the lender's template
Capital requirement schedule covering fit-out, equipment, working capital to breakeven, fees and contingency
Full shareholders' agreement across both entities, including reserved matters, deadlock, valuation and exit
Lease heads of terms negotiation and landlord works approval
VAT and option to tax position at incorporation
CQC provider and registered manager applications, statement of purpose and supporting governance framework
Fit-out programme management and critical path tracking across consents, contractor and equipment lead times
NHS contracting route assessment, covering Patient Choice and ICB commissioned work

Ready to Achieve Similar Results?

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