Private practice setup · step 2 of 7
Company structure and asset protection
The structure you incorporate at the start determines whether a future clinical claim can reach the assets you spent a career building. Getting it right costs very little at incorporation and is expensive or impossible to unwind later.
What this involves
- Design the operating and property structure so that the trading entity carrying clinical risk is not the same entity holding the valuable assets.
- Position any existing family or personal company as a covenant behind the venture rather than inside it, so its balance sheet supports the borrowing without being exposed to the trading risk.
- VAT planning at incorporation, including registration and whether to opt to tax, which frequently matters because commercial landlords have often opted to tax already.
- Coordinate the accountant, the solicitor and the lender so the structure they each assume is the same one.
The mistake that costs the most
Letting the lender design your structure. A broker or underwriter will sometimes push for the entity that is simplest to underwrite, which is often the one holding the existing assets and track record. That is rational from their side and can be the wrong answer for you, because it collapses the separation between the family balance sheet and the venture. The right response is not to refuse, it is to ask which specific underwriting concern the request solves and to solve it another way, usually with a guarantee rather than by moving the assets inside the borrowing entity.
Why this workstream matters
A clinician's personal and family wealth is usually the largest asset in the picture and the one nobody thinks about until something goes wrong. Structure is the cheapest insurance available and it has to be bought before you trade.
Common questions
Should I use one company or two for a private practice?
Two is common and often right where property, fit-out or significant equipment is involved: an operating company that trades and carries the clinical risk, and a separate entity holding the lease and the assets. The point is that a claim against the trading company cannot reach the assets. One company is simpler and can be adequate for a low-capital consulting-room practice, but the decision should be deliberate rather than a default.
Does the structure affect whether I can get funding?
It affects how the lender sees the covenant, not usually whether funding is available at all. What matters is that the underwriter can see the same total covenant either way. Where a lender asks for the structure to change, the underlying concern can almost always be met with a guarantee from the stronger entity rather than by placing the valuable assets inside the borrowing company.
When should I decide the structure?
Before you incorporate, sign a lease or apply for funding. All three lock in assumptions that are awkward and costly to reverse, and a lease signed by the wrong entity is a particularly difficult one to unpick once the landlord has taken the covenant into account.
Reviewed 22 August 2026. Nothing on this page is legal, tax or financial advice, and regulatory requirements change. We work alongside your solicitor and accountant rather than in place of them.
The rest of the programme
These overlap heavily. Running them in sequence rather than in parallel is what adds months to an opening date.
See the full practice setup overview, or our CQC and Ofsted registration support and Provider Selection Regime guide.
Where are you up to?
A director replies, and the first conversation is about sequencing rather than fees.
Company structure and asset protection
What is your specialty, do you have premises or partners in mind, and what stage are you at?