Opening a New Clinic

Dr Anna Hemming shares her experience and advice on establishing your own aesthetic premises

In 2019 I decided to develop my clinical practice and find premises of my own. For the past 11 years I had been working from CQC-registered medical practices, but my dream was to open my own clinic. The project was eventually started after returning from living in the US and having my children, who were one and four-years-old.

Creating a business plan The first thing I did was write our business plan with the help of my husband, who is the managing director of a large multinational company. We calculated the cash flow forecast, income statement, projected revenue and cost of goods for the next two years. We also estimated the cost of staff, introducing them when most appropriate, facilities, marketing and equipment lease. The plan took into account the renovation and set-up costs, although we had a separate renovation cost tracker to monitor carefully. Through speaking to others who had done a renovation before, as well as visiting other colleagues’ clinics, we gained a good insight into the cost of setting up a clinic from an empty shell. While working as a GP for my regular income, I had been saving all of my aesthetic profits for the last 10 years to finance the project. I chose to invest a £160,000 director’s loan, while also taking earnings from the business from July 2019. Of course other methods of financing are available through such things as external investments and bank loans. One of the benefits of having a good business plan was the ability to use it to project the size of the premises I would need. It became apparent that we would outgrow a two to three room clinic within a 10-year lease, so we instead starting looking for a building with space for five or more rooms.

Location Purchasing in London was not really an option, so I decided to rent my first premises. I hope to one day purchase the building, but I am taking small steps!

Before Finding a suitable property took six to eight months. First I chose my area; after exploring central London and local towns, I eventually settled on Twickenham, which is much closer to home. Working in this area would allow me to see all of my current patients, drawing in from the different locations I practised in which included Richmond, Teddington and Wimbledon. One really useful step I took and something I’d recommend other practitioners do is I employed a local planning consultant to review the premises I saw. He investigated the likelihood that I would be able to change the use of a building in various locations to a D1 medical lease with the council. 1 I felt this was important as I wanted to create a medical clinic, and not convert a retail space. The advice was valuable and helped me to change track on one of the first sites I found. Several sites later, after visiting a previous bank and prime retail shops, I revisited an office tucked away in a mews building in Twickenham. I fell in love with the building for a number of reasons. The location was ideal – just a five-minute walk from two stations, near a large car park, but with three spaces of its own outside. It also had the scope to make five rooms and have some staff space. The building is also just off the high street; central yet tucked away, has a private entrance consideration for welcoming and treating aesthetic patients. The challenge was that it needed total refurbishment. We had to build walls to create new rooms, put in new electrics, plumbing

After

and great light – ideal and an important

Before

After

My top 10 tips for opening a new clinic

1. Research everything in detail before you go ahead 2. Apply for change of use with the council for a D1 property 1 3. Call the Valuation Office Agency to challenge rates if you change use of the building – we are doing this at the moment – there’s no guarantee, but it could help 2 4. Reach out to others and visit their new clinics 5. Have a clear goal of what your clinic will be like, envisaging the patient flow and how you want to deliver your services 6. Understand your market, who is your patient, what services you are going to provide 7. Understand the devices and machines for specific higher energy circuits that need to go into the design early 8. Ask friends/colleagues for contacts and help with contractors 9. Apply for trade accounts for everything 10.You do not need to go with a project managed service if you can do it yourself

and clinical cabinetry. We also decided to put in a floating floor for sound proofing, in order to allow for patient confidentiality, which is of course an important point to consider when opening a medical clinic. We decided to take on the project management ourselves, which meant more work, but allowed us to get the clinic to exactly how we wanted it. I have found having a clinic outside of central London invaluable. There are many patients in the area who used to travel into central London for treatment who are now finding me, especially in the current climate when people are working from home and need general medical advice. When the time comes I have a list of new patients for our non-medical aesthetic services.

Branding I had to set up a limited company with the new clinic’s name. Before deciding, I had a shortlist of potential names. Upon research, however, we found that many aesthetic clinics sounded similar to others. I wanted to make it personable, yet allow for brand growth so, after much consideration, eventually chose Thames Skin Clinic. With a love of water from rowing and living close to the river, it seemed like a good option and has the flexibility to grow a brand with multiple locations. I would recommend others bear clinic growth and name similarities in mind before making a decision! Next was designing my wordmark and logo. I worked with some branding professionals on this, with the aim for it to be an evolving part of my clinic’s story since starting in medical aesthetics in 2008. We created mood boards, with our target patients in mind. We eventually chose a navy blue and white colour scheme, which fits with the clinic name, and I love the bridge in the A we created in ‘THAMES’ (Figure 1), further representing the river. I also started getting quotes for the website build. I had created the last three websites I’ve used but wanted a different feel and a bespoke site. If you’re not in a position to make it completely bespoke just yet, I would recommend using website builders such as Wordpress or Wix, which I have used in the past and allow for a good level of personalisation. I also knew that I would be working really hard with the day job, refurbishment and preparing our own home renovation, so outsourcing was the best option for me.

Figure 1: The Thames Skin Clinic logo, demonstrating the bridge in A linking to the clinic name

Design Designing the clinic was a great experience. With such an iconic building, it became very clear how we should use it. It has been developed into five clinic rooms, a patient lounge separate from the reception and a staff kitchen, meeting room, patient restroom and staff restroom with shower. We invested in clinic flooring and bespoke cabinets with inbuilt sinks, which give a very professional finish. If you’re not sure where to start I would highly recommend using Pinterest for layout and décor ideas, which really helps you envisage how things should look. There I built boards for clinic rooms and furniture, which really helped. I also spent a lot of time visiting furniture shops and taking pictures of things I liked to further build mood boards. You will soon start noticing themes and your ideas will come together! I set up trade accounts everywhere I could, including BoConcept for the patient lounge, clinic chairs, shelves and lights. Trade accounts vary in that for some you will need to spend a certain amount to get a good discount (on average 30%), while for others you’ll only get a 5% discount but, of course, every little bit helps! The medical couches were designed by Avalon in Wiltshire, where I visited with textile samples to choose the right couches and fabrics. I worked with Sussex Signs to design the internal and external clinic signs. These needed to be eye catching but very subtle at the same time. Our clinic music is powered by Sonos which can be controlled in every room from our tablets, as can our door entry system and CCTV cameras.

Summary We were lucky to have a lot of personal renovating experience and detailed technological insight into certain aspects such as sound proofing, so the project overall was not as daunting as it might have been. It was, however, a huge task, especially with the fact my husband changed jobs two months in and was away from home all week, meaning I juggled the project with working and looking after two small children. For anyone considering opening a new clinic, I would advise that speaking to other people is key. I spoke to friends in all kinds of related spaces, from commercial conveyancing to recruitment and talent. Their insight and advice was invaluable. Over the months, everything pulled together and I moved into the building earlier this year. It is a tranquil medical space with natural softness and a calm, relaxing spa feel.

Dr Anna Hemming has more than 12 years’ experience in medical aesthetics. She is the owner and medical director of Thames Skin Clinic in Twickenham and associate doctor at Cranley Clinic on Harley Street. Dr Hemming is a GP who has worked at Buckingham Palace and spent five years as an army doctor. Qual: MBChB, BSc, DFFP, MRCGP

REFERENCES

1. Gov.uk, The Town and Country Planning (Use Classes) Order 1987 <http://www.legislation.gov.uk/uksi/1987/764/schedule/ made> 2. Gov.uk, Valuation Office Agency <https://www.gov.uk/ government/organisations/valuation-office-agency>