AAGBI released the first ‘Independent Practice’ guideline in 2008,  intending to provide advice and guidance to consultants involved in independent practice. Working in an independent hospital provides different challenges to working within an NHS hospital, regardless of the funding for the individual patient involved. Since 2008 there has been a rapid growth in NHS-funded patients within the independent sector. The term ‘private practice’ is probably better replaced by ‘independent practice’ to more accurately reflect current activity. Now many anaesthetists find themselves delivering clinical care in independent hospitals funded from a variety of sources – NHS, private medical insurance and patient self-pay.

The change in demographics of patients undergoing treatment in independent hospitals, in combination with increased regulation, brings new challenges and opportunities to anaesthetic practice. Pre-operative assessment and optimisation, and the anaesthetist as ‘peri-operative physician’, are areas that are currently often poorly addressed and remunerated within independent hospitals.