Dr Oliver Large
February 24, 2026
Primary care in the UK is under significant pressure. Demand has grown, expectations have evolved, and accessing timely GP appointments can sometimes feel harder than it once did. That is not really anyone’s fault - it reflects how healthcare needs and systems have changed over time.
For many people, this has prompted a simple question: would having a private GP involved in their care make life easier?
Often, by the time patients come to see us, they have already answered that question for themselves. They are not usually debating whether private GP care has a role - they are thinking about how best to use it.
Some simply want quicker access when something crops up. Others are looking for more time with a doctor, better continuity, or a more proactive approach to their health. Many simply want flexibility alongside their NHS care rather than instead of it.
That naturally leads to the next question:
Should you book appointments as needed on a pay-as-you-go basis? Or does a membership model make more sense?
There is no universal answer. It depends largely on how you expect to use healthcare over time, what level of continuity you value, and how involved you want your GP to be in your ongoing care.
Episodic Care vs Ongoing Care
Pay-as-you-go works extremely well for episodic problems. A chest infection. A new symptom you want checked quickly. Travel advice. A second opinion. A one-off prescription or referral. You book when you need help, the issue is addressed, and life moves on. For many patients, that is entirely sufficient.
Where things begin to shift is when care becomes ongoing rather than occasional. Hormone therapy, weight management, mental health support, cardiovascular risk work, chronic skin conditions and preventative planning all tend to require monitoring, periodic review and sometimes ongoing prescribing. At that point, the structure around care becomes more important.
Why Continuity Changes Things
Membership tends to build relationships. And in medicine, relationships reduce friction.
When I know a patient well over time, I understand their baseline health, how they respond to treatment, and what tends to happen when things fluctuate. Decisions are usually quicker and more proportionate. Reviews are often shorter because the context is already there. Monitoring becomes proactive rather than reactive.
The success of membership is not about how many appointments you use. Appointment numbers play a part, but the real value is simplicity and familiarity. Knowing who to contact. Knowing someone understands your history. Knowing there is a plan in place.
Quite often, that continuity reduces appointments rather than increasing them.
What That Looks Like in Practice
Take recurrent UTIs. If we have already discussed the pattern, agreed when antibiotics are appropriate, and put a plan in place, then when symptoms recur - even if you happen to be elsewhere in the country - support can often be seamless because the groundwork has already been done.
Or longstanding eczema. Many patients have predictable flare-ups and know what works. If there is an agreed management plan with a GP who understands their history, accessing the right treatment becomes straightforward rather than starting from scratch each time.
The same applies to mental health. Some people recognise when low mood or anxiety is returning. They often know what helps, but value having a safety framework around them - someone who understands their history, can adjust treatment if needed, and is quietly keeping an eye on things.
That is relationship-based care. It is not about volume. It is about familiarity.
Situations where Pay-As-You-Go Becomes Less suitable
When ongoing care is managed purely on a pay-as-you-go basis, we often see a gradual shift in the conversation. It moves from booking appointments to requests for “just a prescription”. That is completely understandable, especially when each consultation carries a cost.
But from a prescribing perspective, it is rarely that simple.
Safe prescribing involves asking whether anything has changed, whether monitoring is up to date, whether side effects have crept in, whether the dose remains appropriate, and whether a review or examination would add useful information. It also involves asking a more subtle question: do I know this patient well enough to feel comfortable continuing to support this condition without seeing them?
Sometimes everything is stable. But that reassurance usually comes from continuity rather than assumption. Without that relationship, the threshold for comfortable prescribing is naturally higher - not because of reluctance, but because professional responsibility requires it.
Chronic care on a pay-as-you-go basis can absolutely work. It simply requires more deliberate scheduling, clearer prescribing boundaries and an understanding that prescription or letter requests involve clinician time and professional responsibility. For that reason, they carry a cost - sometimes a prescribing fee, and occasionally the need for a further consultation if your GP feels a review is clinically appropriate.
Making Expectations Clear in Pay-As-You-Go Care
As we became more involved in supporting patients with ongoing conditions, it became clear that simplicity and consistency matter. Chronic care can absolutely be managed on a pay-as-you-go basis, but it works best when expectations are clear from the outset.
Prescribing safely is not simply issuing medication. It involves professional responsibility, periodic reassessment and ensuring that monitoring remains appropriate. Even when things feel stable, good medicine benefits from sensible review points.
For that reason, we generally limit prescriptions issued on a pay-as-you-go basis to a maximum of three months at a time. This reflects standard safe prescribing practice and helps ensure treatment remains appropriate, monitoring is up to date, and both patient and clinician remain comfortable with the plan.
Alongside that, if we have not reviewed you within roughly three months and you require a prescription, letter or ongoing clinical input, we will usually ask for a consultation before proceeding. Often this can simply a 15 minute phone or video review, but occasionally a more in-depth appointment is clinically appropriate.
Prescription and letter requests also involve clinician time, record review and professional accountability. As such, they may carry a prescribing fee or, where review is required, a consultation cost. Being transparent about this helps patients understand where they stand and provides clarity around the likely costs when private care becomes part of managing a longer-term condition.
Membership naturally removes much of this friction because regular contact and continuity are already built into the structure. But pay-as-you-go remains entirely valid when expectations are understood.
The key is simply clarity, so that care remains safe, predictable, transparent and fair for everyone involved
Final Thoughts
Private GP care is not about replacing the NHS. It is about access when you need it, time when complexity demands it, and continuity when care becomes ongoing.
Pay-as-you-go works extremely well for one-off or occasional needs. When care becomes ongoing, continuity and a relationship with your GP often make things simpler, safer and more straightforward.
Neither model is inherently better. They simply suit different patterns of use.
And if you are unsure which fits you best, that is always a conversation worth having.
If you’d like to understand more about our membership model and the value of relationship-based care, you can read more here.