How to start up an osteopaths

Customer sitting on bench receiving back massage from osteopath

If you're a trained and qualified osteopath you might decide to set up your own clinic. You'll find all you need to start up and run your own osteopath business in our practical guide.

Research your target market

Estimating demand

You'll need to find out if there is enough demand in your area for your osteopathic clinic. According to the General Osteopathic Council (GOsC) there is anecdotal evidence that suggests that some areas of the UK are oversupplied with osteopaths, whereas numbers in others are very low. You can use the searchable register on the GOsC website to find out how many osteopaths are currently practising in your area - all osteopaths must be registered with the GOsC, so the register gives an accurate picture of the number of practitioners.

At 1 September 2018 the register listed 5357 registered osteopaths, with:

  • 4584 in England
  • 156 in Scotland
  • 141 in Wales
  • 25 in Northern Ireland

The remaining 451 were outside the UK.

The total number of registered osteopaths divides almost equally between male and female practitioners, and between them they see about 30,000 patients a day, an average of around six each a day.

A certain proportion of your patients will be referred to you by GP practices, so you may find it useful to talk to GPs in your area as they may be able to give you an idea of the number of patients they currently refer for osteopathic treatment. (Although at the moment it's rare for patients to have their osteopathic treatment funded by the NHS, many GPs are aware of the benefits of osteopathy and will refer patients, even though the patient will have to pay for the treatment themselves or through their private medical insurance.)

However, the main source of patients is those that self-refer - that is they do not go through a GP or specialist. Unless you have already worked in an osteopathic clinic in the area that your own clinic will be situated, you may find it difficult to assess the level of demand from this type of patient. It is possible that osteopaths with established clinics in your area will be prepared to give you some guidance with this and the statistics provided on the GOsC website may also be useful.


Try to assess the level of competition in your area. Your competitors will include:

  • other osteopathic clinics
  • other private practitioners - such as physiotherapists, chiropractors, masseurs and so on - who treat the same complaints as you do
  • private hospitals
  • GP practices with in-house physiotherapists or osteopaths
  • a clinic attached to an authorised osteopathic training school. All of the eleven training schools (ten in England, one in Wales) have clinics where students train and that offer osteopathic treatment at a reduced rate

If you intend to specialise, for example by only treating sportspeople, you are likely to find that the number of direct competitors will be reduced, although the size of your potential client base is also likely to be smaller.

Your patients

Patients tend to fall into the following categories:

  • those that are covered by health insurance companies - private health insurance accounts for around 10% of payments for osteopathic treatment. The majority of these patients will be referred to you by a GP as this is often a requirement of insurance companies
  • those that are referred by a GP and who will pay for the treatment themselves
  • those that self-refer. These patients may be covered by insurance (some companies do not require a GP referral) or may be paying out of their own pockets
  • those that are referred to you by a GP and are paid for by the NHS

You're likely to find that the vast majority of your patients (over 80%) are self-funded.

Why will patients choose you

You need to make sure that enough clients come to your practice so it's important to develop an effective advertising strategy to bring your clinic to the attention of patients that self-refer without first visiting a health professional (likely to be the majority of your patient base). It's also a good idea to build relationships with those health professionals and organisations who will refer patients to you or can give patients information about your clinic so they can self-refer. These will include:

  • local GPs, consultants and rehabilitation departments in local hospitals (both NHS and private)
  • large corporations. These are becoming increasingly aware that musculo-skeletal problems are very common and cost a great deal to industry in terms of days lost. Businesses located in your area may decide to offer their employees free osteopathic treatment to try to minimise the days lost through these types of complaints. Alternatively, businesses may engage an osteopath or similar professional to teach their employees how to prevent problems - by improving their posture for example
  • nursing homes and retirement homes
  • sports clubs
  • leisure centres

As some of your patients will be referred by a GP, it makes sense to build relationships with the GP practices in your area. You could contact them in person and give them a brochure detailing exactly what you can offer and what prices you charge. The NHS Choices website includes details of osteopathy clinics registered to provide NHS services to patients in England and this is used by GPs and patients when deciding which provider to use.

Research current trends, plus legal and tax issues

Establish your patient profile

Your market

Osteopathic treatment is effective for people of all ages, from babies to the very elderly and unless you intend to specialise in treating a certain type of person, you are likely to have patients of both genders from a broad age spectrum. You are likely to see patients with a variety of complaints, including:

  • back pain, such as scoliosis, hip, groin and pelvic pain, sciatica, muscle and ligament injuries
  • neck pain
  • shoulder injuries
  • whiplash injuries
  • sports injuries
  • infantile colic, sleeplessness, feeding problems and so on

Generally, your patients will fall into these categories:

  • those that have been referred to you by a GP or or other healthcare professional and are either covered by health insurance, will pay out of their own pockets or have the cost of their treatment covered by the company that they work for
  • those that are referred to you by a GP and are paid for by the NHS
  • those that have self-referred. These patients may be covered by insurance (some companies do not require a GP referral) or they may be paying out of their own pockets

According to the General Osteopathic Council in 2018, about 30,000 patients will seek treatment by an osteopath every working day. Over 80% of the treatments are self-funded, with around 10% paid for by insurance companies.

For patients that are referred to you by a GP as NHS patients, you will be paid by the Clinical Commissioning Group (CCG) or Health Board the GP belongs to, rather than by the GP.


Osteopathic treatment can be very effective for animals that are suffering from musculo-skeletal problems and if you are appropriately qualified, you may treat all sorts of animals, such as horses, dogs, cats and farm animals.

Discounts and special offers

You are likely to find that you will have to offer discounts on your normal fees to secure work from health insurance companies. The fees you'll receive for NHS work are typically set against a national tariff or a locally decided rate.

You may also offer discounts to regular customers or patients who will need a long course of treatment.

Decide what services to offer

The services you offer will depend on the type of clinic you intend to run. The size of your premises and the amount of money you have available for starting up may dictate the extent of the services you are initially able to offer.

Osteopathic treatment can be effective for a number of different complaints, such as:

  • postural problems brought about by pregnancy, driving or work
  • back pain
  • repetitive strain injuries
  • sports injuries
  • arthritis
  • infantile colic or sleeplessness

As well as treating your patients' complaints, you are also likely to provide information which will help recovery and prevent further problems in the future. This may include specific exercise programs, orthotics or general guides to improve posture and reduce pain. You may decide to offer cranial osteopathy, which can be used to treat various complaints, including ear infections, asthma, sinus problems and dental work stresses.

Aside from osteopathic treatment, you may decide to offer related services like acupuncture that could broaden the appeal of your clinic.

If you are suitably qualified, you may also offer an animal treatment service, as osteopathy is just as effective on animals as it is for humans.

Opening hours

When deciding on the opening hours for your clinic, bear in mind that it will be difficult or impossible for some of your patients to attend your clinic in normal working hours. You may decide to open on weekends or late in the evenings for a couple of days a week to accommodate these patients. You may also decide to offer home visits.

The right image

It is important for the financial well-being of your business as well as for the safety of your patients that the clinic is run in a professional manner. Patients will be put off by shabby premises and there may be health and safety implications if equipment is poorly maintained. Prominently display your qualifications so that patients are reassured of your professional competence.

Standards of patient care

The General Osteopathic Council (GOsC) publishes Osteopathic Practice Standards which outlines the required standards to make sure that patients receive high quality care and are protected from harm. You can download this publication from the GOsC's website.

Pricing policy

Getting your fees right is an important part of making sure the clinic gets off to a good start. If you have previously worked in a clinic in the area where your own business will be located, you will already have a good idea of the level of fees that people are prepared to pay.

If you are not sure of how much to charge, you could telephone established clinics in your area or look online at their websites. You may decide to charge less than the going rate to try to attract more patients. Alternatively, you may feel that you can charge more than the going rate, for example if you are very experienced or highly qualified. According the General Osteopathic Council, fees range from £35 to £50 for a 30-40 minute session. The initial consultation fee is usually higher than the fee for subsequent visits - the average fee is £48 for the initial consultation and £42 for subsequent sessions. Bear in mind that fees can vary depending on the location of the clinic and the experience of the practitioner.


The majority of your patients will pay you out of their own pockets - some will then claim the fees back from their insurance company. Some patients covered by insurance companies will pass the claim forms to you after treatment has been completed and you will have to collect your fees from the insurance company. If you have any NHS patients, your fees for these will be paid by the Clinical Commissioning Group (CCG) or Health Board in whose area the referring GP practices.

It will be best for your cash flow if you can charge your patients at the completion of each treatment, rather than at the end of a course of treatments, particularly with long treatments. You should make your payment terms clear to the patient before treatment begins.


You are likely to find that you will have to offer discounts on your normal fees to secure work from health insurance companies. The fees you'll receive for NHS work are typically set against a national tariff or a locally decided rate.

You may also offer discounts to regular customers or patients who will need a long course of treatment.

Promote your business

It is likely that you will choose to advertise your clinic so as to attract as many patients as possible. You may advertise your clinic in the following ways:

  • through a listing on the General Osteopathic Council (GOsC) website - as a registered osteopath, your details will automatically be included in the online GOsC database
  • through a listing on a professional association website, such as the Institute of Osteopathy (iO)
  • through 'Any Qualified Provider' registration, which means your details will appear on the NHS Choices website
  • taking an advert on or similar directory. It's a good idea to include information that will give prospective patients a clear idea of the complaints that you can treat - most people will be aware that you can treat back pain but some may be unaware that osteopathy can also be used to address things like changing posture during pregnancy
  • having a brochure printed which details your services and prices. You could then distribute this to local GPs, consultants, rehabilitation departments in NHS and private hospitals, local businesses, sports clubs, leisure centres and anywhere else that may generate business. You may find that putting a few of these in unrelated businesses that have a high throughput of customers, such as fish and chip shops, may also attract patients
  • advertising in newspapers
  • setting up your own website
  • providing an excellent service. One of the best ways of generating more business (particularly self-referrals) is through word-of-mouth recommendation

Buy an existing business

You might decide to buy an osteopath business rather than start your own venture from scratch. Buying a going concern can mean that the products, customers, regular sales, staff, premises and equipment are already in place.

But buying a business can be a hazardous, expensive process unless you have the right skills and experience on your team, including legal and financial know-how. Establish the genuine trading and financial position, so that the price you pay for the business is not too high.

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