What do self-pay patients expect from a private practice?
More patients are choosing to fund private treatment directly. Recent PHIN figures show that self-pay admissions reached their highest recorded level in the first quarter of 2026, increasing by 7.7% compared with the same period in 2025.
But the figures only tell us how many people are entering private healthcare, not what the experience feels like once they do. Many self-pay patients are navigating private care for the first time. They may not understand what a fixed-price package includes, which organisation is responsible for each stage or whom they should contact when they need an answer.
For the first Sunday Surgery, I spoke to Gillie Atkins, MPM’s Operations and Client Services, and Nancy Dye, Client Care at MPM, about where private practices build trust during that journey and where they risk losing it.
What do first-time self-pay patients find most confusing?
Gillie began by identifying a source of confusion that practices can easily overlook:
“The first source of confusion is often not the treatment itself, but the structure surrounding it. A self-pay patient may find themselves dealing with a consultant’s practice, a hospital, a diagnostic provider and sometimes their GP. Each organisation has a different role, but the boundaries are not always obvious to somebody entering private healthcare for the first time.”
Costs can be equally difficult to navigate. Fixed-price packages vary between hospitals and may not include every consultation, investigation or follow-up. Without a clear explanation at the outset, patients can be left unsure about what they are paying for, and who they should ask when questions arise.
For Nancy, the answer is not for one person to hold every piece of information. It’s for the patient to have somebody who can help them navigate it:
“Patients need to be well informed from the beginning because that prevents problems further down the line. The PA may not hold every answer, but they should be able to guide the patient to the right place. Having one person they can rely on and return to makes the whole process less confusing.”
Gillie described this as a shared responsibility. The consultant must explain the proposed pathway clearly, while the hospital provides accurate information about its packages and charges. The Medical PA connects those elements, retaining enough context to recognise where a question belongs and what should happen next:
“The gold standard is for the consultant to be very clear about the process, how that information will be passed to the patient and what happens next. The PA also needs to be kept informed, so that when the patient comes back with questions, they know where to go. It really comes down to clear signposting.”
Practice note: Continuity does not mean the Medical PA must personally answer every question. It means the patient is never left to navigate the system alone.
What does a patient need to know at the first enquiry?
Gillie and Nancy identified several details that need to be established early: how the process is likely to unfold, when costs will be confirmed, what may fall outside a fixed-price package and what information the patient must provide. The patient should also know who will contact them next and where to direct any further questions.
Nancy drew particular attention to something practices can easily leave buried in their written terms:
“The cancellation policy needs to be clear from the beginning, especially when a patient is paying for their own treatment. It should not simply appear somewhere in the paperwork. The patient needs to be made aware of it when they first enquire or book, so everybody understands the position from the outset.”
Where appropriate, important information should be explained verbally as well as provided in writing. Frequently asked questions can also help practices address points that a first-time self-pay patient may not yet know to ask.
Gillie returned to another important part of that first interaction: speed.
“A self-pay enquiry needs to be responded to as promptly as possible. These patients are often unwell, they want an appointment and they are in a position to approach another practice if they do not hear back. If you respond promptly and make the process, costs and next steps clear, you give the rest of the journey a much better chance of running smoothly.”
Responsiveness is therefore about more than securing an appointment. It reassures the patient that their enquiry has been noticed, understood and placed into a process that somebody is actively managing.
Practice note: The initial response should answer the patient’s immediate question while making the next step unmistakably clear. Speed creates confidence; clarity helps retain it.
Where does communication most often break down?
For Nancy, the greatest risk appears when responsibility moves from one part of the patient journey to another.
A self-pay patient may be in contact with the consultant’s practice, the hospital, a pre-assessment team, a diagnostic provider and their GP. Communication can be working within each organisation while still breaking down between them:
“Communication can break down internally between the hospital, the practice and the consultant. A patient might be waiting for a result without knowing whether they should contact the hospital or the clinic. If that route has not been made clear, the patient can be left unsure about who is dealing with it.”
Pre-operative preparation is a particularly vulnerable point. Patients may receive forms and instructions from several sources, while questions about medication, fasting or additional assessments may need to be answered by different clinical professionals.
Gillie highlighted the importance of explaining those responsibilities before a question becomes urgent:
“If the patient journey has not been made clear from the outset, the patient will not know where to go for each piece of information. Sometimes they need to speak to the hospital, sometimes the consultant and sometimes their GP. The PA’s role is to recognise where the question belongs, guide the patient to the right person and make sure it does not simply get lost between them.”
This does not mean the Medical PA should answer clinical questions outside their remit. It means they need enough understanding of the pathway to recognise the nature of the question, direct it appropriately and follow through until the patient receives an answer.
The patient should never become the person responsible for joining the system together.
Practice note: Good coordination comes from clear ownership of responsibilities and ensuring that no question is lost during handover.
What makes a patient feel that their journey is being managed?
Gillie’s answer was simple: the patient should not have to chase the practice or repeatedly explain their situation.
“For me, a well-managed journey is one where the patient is not constantly chasing or having to repeat themselves. Their main point of contact should know where they are in the process, what has already happened and what needs to happen next.”
This requires more than responsiveness. The person supporting the patient needs visibility across the pathway, from the initial enquiry and consultation through to investigations, treatment and follow-up.
Nancy explained that this continuity should remain intact even when the patient’s usual contact is unavailable:
“The patient should not feel as though the process starts again because somebody is away. If the practice-management system is kept up to date and the notes contain the right information, another member of the team should be able to understand the history, see the outstanding actions and respond consistently.”
The technology holds the record, but its usefulness depends on the quality of the information entered. Clear notes, documented actions and an accurate account of previous conversations give another informed team member the context they need to help without asking the patient to begin again.
Practice note: Patients feel supported when the practice remembers their journey, even when a different person answers the phone.
If a practice reviewed one part of its self-pay journey, where should it begin?
Gillie and Nancy agreed that the initial enquiry is the most valuable place to start.
That first interaction sets expectations for everything that follows. It tells the patient whether the practice is responsive, organised and prepared to guide them through a process they may never have experienced before. Gillie explained:
“I would start with the initial enquiry and look at exactly what the patient receives. Does it explain the process clearly? Do they understand the next step, when costs will be confirmed and who they should contact if they have a question? That first response should give them confidence that somebody is managing the journey.”
Practices should also consider what may remain unclear. Are possible exclusions from a fixed-price package explained transparently? Is the cancellation policy easy to find and understand? Has somebody taken ownership of following the enquiry through, or could it remain unanswered once the initial information has been sent?
Nancy emphasised the value of looking at the experience from the patient’s perspective:
“It is worth going through the process as though you were a new patient. Look at the information they receive, how long they wait for a response and whether the next step is obvious. If you have to search for the answer internally, the patient is unlikely to find it any easier.”
This review does not need to begin with a large operational overhaul. Small improvements to response times, written information and ownership can make the journey feel considerably more coherent.
Nancy concluded: “Efficiency is also one of a private practice’s strongest promotional tools. A patient who feels informed and supported is more likely to trust the practice and to recommend it to somebody else.”
Practice note: Begin where the patient begins. A prompt, clear and well-owned initial enquiry creates confidence in the journey that follows.
Annabel’s assessment
What struck me during this conversation was how easily we use the phrase “patient journey” while still expecting the patient to navigate much of it themselves.
For a self-pay patient, the quality of clinical care is only one part of the experience. They are also judging whether the practice responds, explains, remembers and follows through.
Technology can provide reminders and make information visible. It cannot, by itself, recognise that a patient is confused, adapt the way something is explained or notice that an apparently routine action has stalled between two organisations.
That is where experienced people remain essential.
The strongest private practices do not leave patients to work out who owns the next step. They make that ownership visible from the beginning.
Three questions for your practice
- Would a first-time self-pay patient understand your process after their initial enquiry?
- Does every patient know who owns their next step?
- Can your team see the whole journey without asking the patient to repeat it?
About Sunday Surgery
Sunday Surgery is MPM’s regular conversation about the realities of running a modern private practice.
Hosted by MPM founder Annabel Veysey, each edition brings together people with direct sector experience to examine one current issue and share practical insight for consultants and practice teams.
