Independent Nurse: Professional - Going it alone.

Becoming self-employed can be a scary prospect but, as Julie Griffiths discovers, nurses have a lot to gain.

Gone are the days when the only option for nurses working in primary care was employment by a GP practice or PCT. With opportunities increasing all the time, a growing number of entrepreneurial nurses are choosing to work for themselves in order to reap the benefits of greater flexibility, autonomy and, in many cases, enhanced job satisfaction and pay.

Despite the usual downsides of self-employment - such as the lack of sick and holiday pay, and forfeiture of the NHS pension - it can provide career progression and a viable alternative to permanent employment, particularly in the current climate of job insecurity.

The options for nurses are varied, ranging from joining a partnership to becoming a locum or setting up in private practice. Opportunities highlighted by the RCN in its guidance for would-be nurse entrepreneurs include working as an expert witness; setting up a care home; developing a nursing agency and providing complementary therapies or a counselling service.

Becoming a partner or independent contractor

Rather than remaining salaried employees, practice nurses can opt for independent contractor status, just like GPs. Independent contractors are self-employed but enter into a contract for services with another party.

This gives them discretion and freedom in how they run their practices, an autonomy that carries with it the administrative and financial responsibility for running the business, providing premises, staff and equipment. It also means they are accountable for the clinical services provided.

Nurses can become independent contractors by joining an existing partnership with GP colleagues. Alternatively, they could set up their own practice under PMS, a route first taken 10 years ago, by pioneering nurse Catherine Baraniak.

Setting up and running a practice gives nurses greater flexibility to run services as they see fit; a larger share of practice profits; and the opportunity to challenge themselves and develop professionally.

However, Ms Baraniak urges nurses to be clear about what they are taking on. 'There's a lot of naivety,' she explains. 'Some nurses are clued-up about budgets and have been helping to run practices, but others are going into it with very limited knowledge.'

To secure a contract under PMS, nurses must convince their PCT that they have a thorough understanding of national policy, as well as …