For Clinicians · Sutton Coldfield

Welcome to the Practicing Privileges Application

Start your journey into private practice at The Vesey. Please complete this detailed application form — our Registered Manager and General Manager will follow up with you directly.

Before you begin — please ensure you have the following to hand: GMC/NMC/professional registration number, your Responsible Officer's details, contact details for two referees, and your professional indemnity insurance information.

Personal Details

Title *

Full Name *

Date of Birth *

Email Address *

Address *

Post Code *

Job Title / Specialty *

Qualifications *

Professional Registration Number *

Sub-specialisms

Biography

Professional Website (URL)

Substantive Employer

Employer Name *

Employer Address

Responsible Officer

Name *

Email *

Telephone

Proposed Sessions & Procedures

Proposed Session at The Vesey *

List of Procedures You Wish to Carry Out *

Professional Memberships

References

Please provide the email addresses of two professional referees. References will be contacted directly.

Reference 1 Email *

Reference 2 Email *

Financial Interests Declaration

Do you or any member of your direct family have a financial interest in any hospital or healthcare facility at which you hold practising privileges or have referring rights? *

YES NO

Do you or any member of your direct family have a financial interest in any equipment at a hospital or healthcare facility at which you hold practising privileges or have referring rights? *

YES NO

Regulatory Declarations

Have you been convicted in the UK of any offence or been convicted elsewhere of any offence which, if committed in the UK, would constitute an offence, if the offence relates to the conduct required in carrying on a regulated activity? *

YES NO

Have you ever been erased, removed or struck-off a register of professionals maintained by a regulator of healthcare or social work professionals? *

YES NO

Are you aware of any investigation by a regulatory body or the potential of an investigation? Are you aware of any patient complaints that may lead to an investigation? *

YES NO

Insurers (tick all applicable)

Please indicate which health insurers you are registered with:

Other insurers not listed

Right to Work in the UK

We are legally required to verify every applicant's right to work in the UK before privileges or employment can begin. British and Irish citizens can prove this with a valid passport (uploaded below). All other nationals should provide a Home Office online right-to-work share code, which you can generate at gov.uk/prove-right-to-work, together with your date of birth.

Nationality

Right-to-work share code (if applicable)

Document Uploads

Please upload clear copies (PDF, JPG or PNG). Photo ID and proof of address are used for identity and right-to-work checks; clinicians must also provide professional indemnity.

Passport (photo page)

Driving licence

Proof of address (utility bill, dated within 3 months)

Professional indemnity certificate (clinicians)

Trouble uploading? You can also email documents to RECEPTION@THEVESEY.CO.UK with your full name in the subject line.

Required Fees & Subscriptions

Medesk Account (required)
All Practitioners must have an active Medesk account. This is chargeable at £18 per month.

Medesk Subscription →

Enhanced DBS Check (required)
All Practitioners must have an enhanced DBS Check. This is chargeable at £53.70.

Pay DBS Fee →

Room Rental Agreement Application

GoCardless Application — Please complete the room rental agreement via GoCardless before commencing practice.
This is an agreement between The Vesey Private Hospital Ltd and the applicant to rent consulting rooms at Unit 3, The Courtyard, Sutton Coldfield, B75 7BU. Agreed Rate: £20 per hour.

GoCardless — Room Rental Application →

Room Rental Terms & Conditions

HOURLY BOOKINGS — These will be on an ad hoc basis. The minimum length for ad hoc bookings is thirty minutes. Payment will be made via BACS following an invoice via email. All hourly bookings are made using our online system or via email request. Standard rate for all room bookings is £20 p/h.

MONTHLY BOOKINGS — Payment is collected four weekly in advance by BACS transfer. Failure to pay in advance may result in cancellation of room bookings within the subsequent four weeks.

The Vesey Private Hospital Ltd agrees to:

Offer a clean, safe, confidential environment for the practitioner and client to work in. Notify the practitioner of any correspondence to them and keep it safe and confidential until collected.
Give at least 24 hours notice wherever possible of building closures.
Give three months notice if rooms are no longer being used for rental purposes.
Deal with any complaints and grievances regarding facilities in line with The Vesey Private Hospital Ltd complaints policy.

The Practitioner agrees to:

Respect all furniture and fittings and leave the rooms in a clean and tidy condition, suitable for the next user. No food is permitted in the rooms (drinks are permitted).
Inform The Vesey Private Hospital Ltd if they need to cancel an ad hoc booking. At least 24 hours notice is needed otherwise The Vesey Private Hospital Ltd will still charge for the room.
Provide their own resources and do their own administration.
Pay all invoices when they fall due. Failure to do so will result in termination of this agreement.
Be fully responsible for the health and safety of their clients/course participants.
Provide up to date professional indemnity insurance and evidence of professional body membership, qualifications etc. and maintain insurance for the duration of this agreement.
Indemnify The Vesey Private Hospital Ltd from any liability, loss or damage arising from the practitioner's activities.
Operate within the General Terms and Conditions of Room Rental.

General Terms and Conditions

You must maintain the appropriate certification, qualifications and up to date professional liability insurance. You should always conduct yourself in a professional manner whilst using the rooms and the building. The rooms must only be used during the hours that have been agreed and booked. Please vacate the room as soon as your slot has finished. Other therapists may be using the room and running over the allocated time slot is not permitted.

A £100 deposit is required for the key fob. The Vesey Private Hospital Ltd, a company registered in England and Wales (reg no 13989980). Registered office: Unit 3, The Courtyard, Sutton Coldfield, B75 7BU.

Billing, Invoicing & Reconciliation — SOP

Invoice Requirements

Each invoice must contain: date and time of consultation/procedure; type of activity (Consultation/Procedure); rate of pay; an identifier to reconcile the patient against Medesk records (Initials/NHS number/hospital number); clinician name or full company details (if corporate entity); address; email; telephone; bank details including sort code and account number.

Submission

Following the end of each calendar month, and no later than the 14th of the subsequent month, a single invoice should be submitted for clinical services, electronically in Word or PDF format, to: invoices@thevesey.co.uk — and not include any cc'd persons. Invoices not in this format will be rejected. Invoices in Excel spreadsheet format will be rejected.

Invoices should only be sent once. Sending invoices multiple times or statements will result in delays.

Invoices Must NOT Contain

Patient identifiable information such as patient name or address. Deduction amounts of room rental at source — a separate invoice from The Vesey to individual clinicians will be generated for room rental.

Payment Schedule

Once approved, invoices are scheduled on payment runs twice monthly on the 2nd or 4th Friday of each month. Approved invoices should be settled within a 28-day window from approval.

Queries

For invoice queries: invoices@thevesey.co.uk (include invoice number as subject). All queries responded to within 48 hours via email only.

Escalation

For any payment delays: Ben.royal@thevesey.co.uk

Declaration & Consent

Before commencing private patient activity within The Vesey, Practitioners MUST:

Undertake and consent to DBS check (chargeable at £53.70 as of September 2024)
Agree to all terms and conditions
Disclose all private practice fees and procedures information in line with CMA requirements
Accept and agree to abide by the terms of the Practising Privileges Policy

All Medical Professionals with practising privileges may have profile details published on The Vesey website to comply with CMA requirements.

BY SUBMITTING THIS FORM, I confirm that the information supplied is an accurate record of my current medical practice and accurately reflects any personal and professional details. I agree to abide by the Practising Privileges Policy and all terms and conditions of The Vesey Private Hospital Ltd. *

Once submitted, our Registered Manager and General Manager will review your application and contact you within 5 working days. For queries contact reception@thevesey.co.uk or call 0121 387 3727.

Application Received — Thank You

Your practicing privileges application has been submitted successfully. Our Registered Manager and General Manager will be in touch within 5 working days.

In the meantime, please ensure you have completed your DBS fee payment and Medesk subscription using the links above.