A large number of physiotherapists set up their own businesses or work in private clinics. Most of these deal with musculoskeletal conditions such as back pain, neck pain and knee injuries. A smaller number specialise in sports injuries, neurological problems and women’s health amongst other fields.

A formal referral from a doctor is not required to book an appointment with a private physiotherapist. However, physiotherapists strongly prefer to keep a patient’s doctor informed about ongoing treatment.

Self Referral For Physiotherapy

Private Physiotherapy Cost

The first assessment session lasts from 30 minutes to an hour and subsequent appointments are often 30 minutes. Costs for 30 minutes vary from around £25 in some areas to £75 or over £100 in areas such as London. Specialised treatment may cost towards the upper end of this range or higher. Payment can be private or via health insurance with companies such as AXA PPP, BUPA, Pru Health or Norwich Union. Check your eligibility for physiotherapy treatment with your insurer before you book an appointment.

Private physiotherapists target the core problem underlying the patient’s symptoms as quickly as possible. A treatment episode typically consists of three to five treatment sessions. A larger number of sessions or a longer term review may be necessary for more complex cases.

Many private physiotherapy clinics develop expertise in managing post-surgery orthopaedic cases. This includes knee replacement, hip replacement, shoulder operations, discectomy and laminectomy. They will have a close relationship with the local orthopaedic surgeons doing private work.

Private Physiotherapy Waiting Times

Waiting times for private physiotherapy are often under a week so your rehabilitation will not be delayed. The cost of physiotherapy is a small part of the costs of a private joint replacement or other orthopaedic operation. This makes private therapy a good investment to get the best out of a new joint or recover after a shoulder or back operation.

Many clinics offer a wide range of services and aim to be a “one-stop shop” for health and spiritual needs.

They may offer traditional services such as:

  • Massage therapy
  • Chiropody
  • Exercise physiology
  • Podiatry
  • Osteopathy
  • Chiropractic

Cognitive therapy may be offered by clinical psychologists for psychological problems and phobias or for pain management.

Alternative therapies provided may include:

  • Acupuncture
  • Aromatherapy
  • Homeopathy
  • Natural healing

Private clinics are usually able to provide an assessment appointment within 48 hours of a call to book.

NHS Physiotherapy

NHS Hospital

Most physiotherapists working in the NHS practice as inpatient therapists on the wards. They manage surgical, obstetric, medical, elderly or orthopaedic inpatients. Outpatient departments exist in most hospitals however. These deal with the work of the unit and with musculoskeletal conditions like seen in the private sector.

Cases seen in major hospital unit tend to be more chronic that in a private clinic as they are often secondary referrals. This means they are referrals from other physiotherapists or from hospital consultants. To come via this route with its waiting times a patient needs to have had their problem for a much longer period than a typical recent injury. Cases might include chronic back pain, neck pain from whiplash injury, post-surgery and osteoarthritis.

Rheumatology, the medical specialty covering over 100 types of arthritis, is becoming increasingly important. This is due to the ageing population. Hospital physiotherapy units may specialise in managing these conditions. They include rheumatoid arthritis (RA), osteoarthritis (OA), ankylosing spondylitis (AS) and psoriatic arthritis.

Treatments may include hydrotherapy in a pool close to blood heat to allow exercise for weak and painful joints. Exercise regimes, monitoring of conditions and joint protection advice are also important. The close proximity of rheumatology consultants means expert advice is readily available.

In this way NHS units tend to deal with cases than are more chronic and resistant to standard therapy approaches. NHS physiotherapy departments develop expertise in managing chronic musculoskeletal, rheumatological and chronic pain conditions. These make up a very significant proportion of healthcare time and costs.

NHS physiotherapy units often specialise in complex cases related to the work of the hospital unit. A consultant led hand surgery unit will backed by a dedicated physiotherapy and occupational therapy team. They will have experience in splinting and in the rehabilitation of complex hand injuries. This expertise and equipment is beyond most musculoskeletal physiotherapists in a private clinic. It would be rarely available and very expensive.

NHS Physiotherapy Referral

You need a referral for most NHS physiotherapy units but some, especially in Scotland, allow self-referral. Payment is not required. In some areas an NHS referral occurs through the Choose and Book system and you receive a docket authorising treatment at a private clinic of your choice. You will not have to pay for this but the clinic must be an authorised provider by the NHS locality.

NHS Waiting Times for Physiotherapy

Waiting times for NHS physiotherapy are always longer than for private treatment. This is due to the large areas of potential referral and the need to prioritise the work of the hospital over outside referrals. The shortest waits are under a week, with a typical average of 6-8 weeks, although this varies greatly with specialty and area. The longest waits can be in the 30-40 week range.


  1. NHS Choices: Physiotherapy
  2. Physiotherapy – Accessing Physiotherapy 
  3. The Health Professions Council – Physiotherapy Standards of Efficiency (2008)