If you’re an NHS consultant

[cookingthebooks]

How much do you actually earn?
Both from the NhS and private work?
DH has 2 years left until consultancy and we are trying to forward plan financially for us and the kids but there’s just so little info or guidance (other than base salary rates) available and pretty much nothing RE private work.

Short of him flat out asking his colleagues what they earn (which he’s obviously not going to do) there’s no way for us to get an idea of this.

also, do you register as self employed for private work? I assumed as he got closer this info would be available but it’s just not.

Not a Consultant but worked with them.

Be careful of self employed as he will be liable personally should anything go wrong.

Many set up LTD company but this maybe harder and in some cases even against the rules with IR35. Professional advice is needed on this. Loads of IR35 specialists around to advise.

If he knows his colleagues names search Company House to see if they have set up a LTD company and pay for their account statements. This should give you an idea of their private revenue.

Not all consultants do private work. I know several who only work in the NHS

You don’t have to pay for accounts on companies house anymore they are free but won’t give you any idea of revenue as small companies aren’t required to file a profit and loss account only a balance sheet

why cant you look at job vacancies?

Balance sheet is a start if nothing else is available.

As previous poster said not all Consultants do private work and those that I worked with were usually very experienced and had been a Consultant for a few years.

Not sure nowadays as I don’t work in that field anymore.

Massively varies from specialty. Orthopaedics - £450k a year, easily (most join with others to make a company in this specialty), or you can get a job at a private clinic doing sessions and get paid as an employee with 2 jobs. other specialities would be far less. you can tell the orthopods in the car park as they have the best cars😂

Rather than asking colleagues about the income, ask about how the set up works.

Anaesthesia, started private work as soon as became consultant.

Use MDU for insurance, have a limited company and a specialist accountant.

Around £65k this year, gross.

No that’s not really how it works and they can negotiate salaries with hard to employ into roles paying far more than easy to fill ones. For private, he could set up a company, arrange clinic space in a private hospital or run virtual clinics and take direct payments.

It really does vary, depends on speciality and how many PAs you get allocated, on call supplement etc etc. but base salary is generally predicated on a standard 10 PA contract, you get extra PAs for extra sessions/duties and then there will be an on call allowance too. What speciality is he?

Private work - zilch. Doesn't exist for some specialties and not all people do it anyway.

NHS work - depends on if there will be waiting list initiative money. Otherwise, literally just what is on the salary scale.

If he is in a specialty that has private work then his best option is to ask a consultant that does it, how they got into it and what it involves.

It would depend wildly on the speciality. Also, it’s not common for new consultants to practice privately - most will take the time to gain experience and get on top of the workload, maybe try and get some lead roles in their department under their belts first.

Interesting, why is that?

I saw an NHS documentary years ago and the orthopaedic surgeons basically ran a production line, they must've bashed through dozens of knees a day. Literally. Whereas the facial surgery took hours. You'd think the big bucks would be in cosmetic work but perhaps it's just time consuming.

Hip and knee ops must be cost effective, low risk (no organs involved) and there’s a long wait list. The controversy was that there’s no motivation to reduce the nhs list and push there as the long list shifts clients to their private clinics. Ethically disgusting but true.

Academic urologist (so professor, paid via Uni), around £160k, plus consulting payments from industry work taking it to just shy of £200k.

Consultant in Scotland. No one I work with practices privately (hospital medicine). 10PA and paid as per the NHS pay circular which you can find online. It is more civilised than being a registrar though- pay for on call weekends etc is bundled into the PAs so actually I get a half day off a week basically in exchange for doing 1/12 weekends.
I hit year 5 next year and will hopefully apply for a discretionary point as I'm doing a lot of service improvement stuff basically in my own time.

A balance sheet tells you absolutely nothing on income it’s not worth looking at if you want to know about income even if nothing else is available. two balance sheets could look exactly the same, one where someone has had a million pounds of income and another when they have had no income

The comments here are interesting. I work in the private healthcare industry. I agree it depends on the speciality and whilst Orthopaedics is the big earner, there seems to be a shift on to more day cases such as dermatology, smaller Orthopaedic procedures, private GPs and so on.

I suggest contacting a local private hospital to you and enquiring about the process as well as the fees (hospital fees and consultant fees so you get the breakdown). They will guide you.

What is his speciality? as that is the key for private practice - eg dermatology/orthopaedics are massive earners as waiting lists are so long on the NHS, care of the elderly and psychiatry less so. It can be slow to build up a private practice and also requires additional hours. The pay can be good but it's a lot of work on top of the day job.

Where are you located - London is best for private practice but the cost of living is also very expensive

NHS earnings can be well above above the published rates if he does extra ie extra sessions, weekend working/evenings, waiting list initiatives, takes a leadership role, clinical impact awards etc . All of these take time and effort.

If he has a colleague he gets on with he could ask them for a ball park figure or eg how much they earned when starting.

You can work privately independently or as a business - he needs to speak to an accountant to see which would work best. Some private consultants pay their partners or a family member to do their secretarial work and that can be financially efficient but needs to be done above board. He will also need to pay out for secretarial staff, rooms, higher insurance premiums etc so sometimes at the beginning doing in house waiting lists etc is easier as there is no extra outlay up front.

Who is ethically disgusting? The Trusts /managers are free to fund more consultant time to shorten waiting lists. But they've chosen not to.

Orthopaedics also has high demand for medico legal work which can be a good earner.

Though worth looking into for other specialisms too but might take longer to break in. A lawyer dealing with a brain injury, spinal injury or mesothelioma case wants an experienced consultant they know, but they are more likely to take a punt on a newbie for a broken wrist.

Locally all (it seems), consultants work for the NHS hospital, plus for one or both of the private hospitals, we have two. Lots band together and set up clinics for particular specialities. It's very common here to switch between the two. Start private, then transfer into NHS.

We can’t magic up bed spaces and nursing staff, nor HDU bed availability.

Quite a lot of our routine ortho work is already done under contract with private providers.

@Kungfoopanda
@freetradedeal

Hes an anaesthetist.
I understand the 10 pa and the new pay deal and the 3% availability uplift but with the loss of the on call uplifts he currently gets I think he’s likely to only increase a couple of thousand between what he’s getting now at ST6 and what he will get in consultancy.

I also don’t understand the private side of it. They have a group in our city so all private work is shared out equally and I understand it’s relatively available as every surgery needs an anaesthetist.

Id just be interested to know

is that £65k all in or just private? I’m confused as DH earns more than that now.

There’s reports saying some consultants deliberately reduce the number of nhs operations they do as there’s no incentive to do extra. In other specialties they are running weekend clinics to catch up whereas orthopaedics (in my trust) were the only ones who refused. I find that ethically wrong.

Hi OP.

The basic starting salary for a 10 PA consultant job is around 105k, presuming no allowance for additional years completed in research, which some Trusts honour. I’m not sure how much the on call supplement would work out as in anaesthetics, but I’m sure your husband’s colleagues would be able to volunteer this without him needing to be too nosy! He must have trained with people who are now consultants and would be able to tell him?

I think the private question is a case of “how long is a piece of string?” None of my friends (medical specialties mainly) do any private work as consultants. On the other hand, through my PhD I’ve met people who do a lot of work or solely work in the private sector and they earn a lot. There is a very broad scope depending on what you do. If all the anaesthetists tend to work together for private practice in your city, it really would be best if your husband can speak to a trusted colleague about how this works and what his earning potential may be!

FWIW, as you mention that you have children, be aware that the consultant pay rise may put you in the position where you lose tax free childcare and funded nursery hours, but don’t earn enough to make up for the loss of these benefits. In which case, your husband might consider increasing pension contributions to avoid a pay cut in real terms from senior reg level. I really appreciate that this is an extremely fortunate “issue” to have, before anyone points this out!