Clinic management software that keeps patients on their treatment plan
Cliniko, TM3, WriteUpp, Pabau and Semble suit most private clinics. None of their sites lists a way to follow a course of treatment from first assessment to discharge, and that's often where a build earns its keep. A first release with the four core features typically costs £3,750–£5,250 and goes live within a month.
£495 for a working prototype in 5 days. It comes off the build.
Next First Gear slot: w/c 19 Oct · 2 of 3 builds booked this month
Is custom worth it for you?
Three questions, and a straight answer.
What clinic management software does, and who offers it
The rows are the jobs a private clinic hands to its software; the columns are five products UK physios, chiropractors, osteopaths, aesthetic clinics and private GPs buy. Mark each row your clinic needs. Where your current product already says yes to all of them, stay put. Where it doesn't, the estimate below prices the gap.
| Feature | Cliniko | WriteUpp | TM3 | Pabau | Semble | Your clinic |
|---|---|---|---|---|---|---|
| First release | ||||||
| Patient records and notesCase history, notes from your own templates, letters to GPs or insurers | Yes | Yes | Yes | Yes | Yes | |
| Diary and online bookingClinician and room diaries, with patients booking the right appointment type | Yes | Yes | Yes | Yes | Yes | |
| Treatment plansPlanned visits, re-assessments and outcome scores, with anyone who drops off flagged | Manual recalls | Not listed | Not listed | Not listed | Not listed | |
| Invoices and card paymentsSelf-pay, deposits at booking and payment on the day | Yes | Yes | Yes | Yes | Yes | |
| Text and email remindersReminders, confirmations and rebooking links | Yes | Yes | Add-on | Yes | Yes | |
| Intake and consent formsSent before the first visit, signed on a phone, filed to the record | Yes | Yes | Yes | Yes | Yes | |
| Insurer billingClaims to private insurers through Healthcode, with any excess billed to the patient | Not listed | Yes | Yes | Partner | Yes | |
| VAT by treatmentExempt clinical care and standard-rated cosmetic work or retail on one invoice | Not listed | Not listed | Not listed | Tax settings | Not listed | |
| Phase two | ||||||
| Packages and membershipsPrepaid courses with sessions counted down, and monthly plans | Not listed | Not listed | Better+ | Yes | Not listed | |
| Waiting listA cancelled slot offered to the next suitable patient | Yes | Yes | Better+ | Yes | Not listed | |
| Patient portalPatients see their plan, invoices and exercise sheets, and rebook | Not listed | Not listed | Yes | Yes | Yes | |
| Stock and retailProducts used in treatment and sold at the desk, with batch numbers | Not listed | Not listed | Yes | Yes | Not listed | |
| Several sitesShared patient record, rooms per site, one finance view | Yes | Not listed | Yes | Enterprise | Yes | |
| Clinic reportsPlan completion, missed appointments and revenue by clinician | Yes | Yes | Yes | Yes | Yes | |
From each product's own site, checked Oct 2026: Cliniko, WriteUpp, TM3, Pabau, Semble. Better+ means TM3's Better plan and up; Enterprise is Pabau's plan for 16 or more users. Add-on means a paid extra and Partner means a third-party integration. A dash means the vendor's own pages don't list it, not that the product can't do it.
Next: the tools it connects to ↓What I’d build first, and what waits
The first release covers a patient’s journey through the clinic: their record and notes, the diary they book into, the treatment plan they’re on and the invoice at the end of each visit. Those four are ticked for you. Reminders, intake forms, insurer claims and VAT by treatment can join them in the first month if your clinic relies on them now. Packages, a waiting list, the patient portal, stock, a second site and reporting make up phase two, priced separately.
Treatment plans, the part off-the-shelf leaves to you
A chiropractor recommends twelve visits over eight weeks with a re-examination at visit six. A physio books a block of six sessions and a review. In most clinic software those are just appointments; Cliniko’s own guide suggests setting up a series of recalls and ticking them off by hand. In the system I’d build, the plan is a record of its own. Every visit counts towards it, re-assessments land in the diary on the right date, and outcome scores sit beside the notes. Anyone who has slipped off their plan appears on a list for reception to call.
How it differs by clinic
- Physio, chiropractic and osteopathy. Plans and outcome scores, insurer authorisations with a session limit, exercise programmes sent from the record.
- Aesthetics. Consent and photos before every treatment, product batch numbers on the record, packages, and VAT that changes with the purpose of the treatment.
- Private GP and consultant practices. Referral letters, results and prescriptions filed to the patient, with insured and self-pay patients billed differently.
What AI can do here
- Write up the visit. The clinician dictates, a draft SOAP note appears, and nothing is saved until they’ve read and signed it.
- Spot who’s likely to drop off. Gaps between visits and cancelled re-assessments put a patient on reception’s call list before the plan stalls.
- Draft the letter. A discharge summary to the GP or a progress report for an insurer, drafted from the notes for the clinician to edit.
Notes are sent only to AI providers your clinic has a data processing agreement with. I quote each AI feature on its own, between £1.5k and £5k, after the core system has bedded in.
What it should talk to
Tick your accounts package, card terminal and the apps clinicians already use for exercises or prescriptions. Each link is priced into the first release.
Moving your patients across
What I bring over. Patients and contacts, clinical notes with their dates and authors, letters and attachments, appointments booked for the weeks ahead, unpaid invoices, package balances and the plans patients are partway through. It’s all included in the import price.
How it runs. Everything goes into a test copy of the new system first. A clinician checks a handful of patients they know well, including one mid-plan and one with an insurer claim open, against the old one, and each mismatch is corrected before launch. Go-live goes on a quiet afternoon, and the old account stays open until your last export is safely stored.
What your current system lets you take
From each vendor's own help pages and terms, checked Oct 2026. Where they don't say, I've written the question I'd put to their support.
I'm on Cliniko
- An admin exports each kind of data as CSV, with the date range set to any time for everything. Patient attachments come out as ZIP files, a folder per patient. Each export can be downloaded for two weeks.
- There's no notice period. After you cancel, admins keep read-only access and Cliniko holds the data for at least a year, so you can still export.
- I'd ask Cliniko whether treatment notes come out in bulk, and in what format, before planning the move.
I'm on WriteUpp
- The terms tell you to run an export with WriteUpp's own tools before cancelling. Only the site administrator can cancel, in Settings, and a phone call or email doesn't count.
- Access lasts until midnight before your next payment date. Everything is deleted 45 days after cancellation and can't be recovered.
- I'd ask which records the export tools cover, notes, letters and attachments included, and run the export while you're still paying.
I'm on TM3
- TM3 says it has tools for exporting data on request, but doesn't publish the formats.
- I'd ask support for patients, notes, appointments, invoices and insurer claims as CSV, with letters and documents as files, plus how long that takes and when they delete the data. Check your contract for the notice period first.
I'm on Pabau
- Clients, appointments and invoices export from Pabau's reports. Medical forms don't: they come out one client card at a time.
- Pabau will run a full export for £450 + VAT, usually within five business days. The free route needs 30 days' notice to cancel, and the export runs on your last day.
- I'd ask what the full export contains for consent forms and before-and-after photos, and in what format.
I'm on Semble
- When you close the account, Semble prepares 17 JSON files covering patients, appointments, invoices and medical records, with CSV copies and a folder of the original documents, sent over SFTP.
- The first export is free, later ones £99 + VAT. You have 30 days to download it.
Your subscription against a build
I've assumed four clinicians at one site on TM3 Better. TM3 charges for every login, so add reception staff to the count if you're on TM3; Cliniko and WriteUpp Group don't charge for them.
£220 a month list price
What a subscription can't give you
- Every patient's course of treatment visible at a glance, so a missed re-assessment gets a phone call the same week.
- Insurer, self-pay and package patients billed from one record, with the VAT on each line set by what the treatment is for.
- Adding a clinician or a second site changes nothing on the software bill.
- Notes, letters and outcome scores sit in a database you own, so leaving a supplier never means a paid export.
The build is the middle of your estimate (£4,500), paid up front. The first month's hosting is free, so the plan starts in month two, and one plan covers every site. Subscription prices are published list prices (the table below says how each vendor treats VAT) and leave out set-up fees and price rises.
What clinic software costs
Published prices from each vendor's pricing page, checked Oct 2026. VAT is shown as each vendor states it.
| Product | Price | Worth knowing |
|---|---|---|
| Cliniko | One monthly price for the clinic: £29 for one practitioner, £59 for 2 to 5, £89 for 6 to 8, £129 for 9 to 12, £199 for 13 to 25, £259 for 26 to 200. | Every feature, with unlimited reception users and locations. Texts are 5p each. The page doesn't say whether prices include VAT. |
| TM3 | £39 (Good), £55 (Better) or £70 (Best) per user a month. | Healthcode on every plan; Connect for Insurance is £10 a licence extra. Packages and waiting lists start on Better, Xero through a £30 integration hub. |
| WriteUpp | Group from £45.95 for practices with two or more clinicians. Users 3 to 10 add £15 each, 11 to 25 add £12 each. | The pricing page gives no period, but WriteUpp's terms bill monthly in advance. Non-clinical users are unlimited. AI scribe £23.95 per user extra. |
| Pabau | Quote-based, by number of users and charged per location; up to 20% off when you pay yearly. | The whole platform on every plan, including packages, stock and consent forms. Only Enterprise (16+ users) covers several sites in one price. |
| Semble | Quote-based. No public price list. | Aimed at private practices, clinics and occupational health. Insurer claims through Healthcode, card payments through Semble Pay, and Xero. |
When off-the-shelf is enough
A clinic with a few clinicians, self-paying patients and standard appointments will spend less on Cliniko, WriteUpp or TM3 than on any build, and be running within days. Stay with a subscription also if:
- you’re opening a new clinic and don’t yet know which services will sell;
- your plans are short and patients rebook themselves without prompting;
- the software you have does everything on the list above and staff like it.
A build pays off when plans are long and patients drift off them unnoticed, when insurer, package and cosmetic billing sit side by side, or when per-user fees climb with every clinician you hire.
Open-source software you could run instead
You could also host free software and change it yourself. I haven't found a maintained open-source system built for UK private clinics, and none bills insurers through Healthcode, but these three cover parts of the job. Each was checked Oct 2026.
- OpenEMR GPL-3.0
Good for: A full electronic record with scheduling, charting, billing and a patient portal, and a large community.
Missing for you: Written for US medical practices: its billing and forms assume US insurers, and it's heavy for a five-person physio clinic.
- Medplum Apache-2.0
Good for: A FHIR back end, logins and audit trail to build a clinic system on.
Missing for you: Foundations only. The screens, booking and invoicing all have to be built.
- Easy!Appointments GPL-3.0
Good for: Online booking against each clinician's diary, with Google Calendar sync.
Missing for you: Booking only: no notes, plans, invoices or insurer claims.
If open source suits you better, I can host it, connect it to your accounts package and build the treatment plans and UK billing it lacks.
Your plan, to keep or send
Your picks, split into a first release and a second phase, each with a price range. Email it to yourself or send it to me.
First release
The first month after kickoff
- Patient records and notes
- Diary and online booking
- Treatment plans
- Invoices and card payments
Phase two
About a month, after the first release is in use
Nothing picked yet
- First release estimate
- £3,750–£5,250
- Phase two estimate
- None picked
- After launch
- Cruise, £199/mo
Estimates, not quotes: First Gear ends with a fixed price for the first release.
How the estimate works
Each phase starts at £1,500 for what every system needs: logins, hosting, backups and your data imported. Each feature and connection adds £250 to £1,000 depending on its size, and the range is 15% either side of the total. The break-even uses the middle of both phases.
A week at reception, before and after
An illustration of a four-clinician physio and chiropractic clinic, not any one clinic’s records.
| Before | After | |
|---|---|---|
| Monday | The practice manager prints a recall report and works out who has fallen off their plan. | Patients who missed a planned visit are already on reception’s call list. |
| Wednesday | An insured patient reaches the session limit and nobody notices until the claim is rejected. | The record warns at the second-to-last authorised session, with the insurer’s details. |
| Thursday | An aesthetics patient buys a skincare product after a filler review; VAT on the invoice is worked out by hand. | Each invoice line carries the VAT treatment set for that service or product. |
| Friday | Outcome scores live in a spreadsheet beside the notes. | Scores are charted on the record and shown to the patient at re-assessment. |
The rules your system has to follow
- Health data. Clinical notes are special category data under Article 9 of UK GDPR. Processing for medical diagnosis or treatment is allowed when done by or under a professional bound by confidentiality, and the Data Protection Act 2018, Schedule 1 sets the health and social care condition. Your clinic also pays the ICO data protection fee unless it’s exempt.
- How long to keep records. UK GDPR’s storage limitation principle says keep them no longer than needed. Agree a period for each kind of record with your professional body or indemnity provider; the system then flags records due for review.
- CQC registration. The CQC’s guidance on treatment of disease, disorder or injury says physiotherapists running a standalone service don’t need to register for it, interventions purely for cosmetic purposes aren’t part of it, and treatment by a listed professional such as a doctor or nurse is. Chiropractic and osteopathy, and teams mixing professions, need checking against that page or with the CQC. Under regulation 17, a registered provider keeps an accurate, complete and contemporaneous record of each patient’s care and treatment.
- VAT. HMRC’s VAT Notice 701/57 exempts care by a registered health professional when it’s within their profession and its main purpose is to protect, maintain or restore health. Cosmetic work done purely for appearance is standard-rated (section 4.4), so one aesthetics invoice can hold both. Your accountant decides which treatments fall where; the system applies their decision line by line.
The software holds the records and follows the settings your advisers pick. Whether the clinic complies is for you, your accountant and the regulator.
Is my data safe?
Reception sees diaries, contact details and invoices. Clinicians see the notes of patients they treat. Notes can’t be quietly changed: an edit after signing is added as an amendment with a name and time, and every time a record is opened, that’s logged too. Clinical notes and patient details are encrypted, hosted within the UK or EU, with a nightly copy kept at a second location.
Will reception use it?
Reception lives in three screens: today’s diary, the patient’s plan and the till. I lay those out for the five minutes between patients when the phone is also ringing. During First Gear your receptionist books, checks in and takes payment for a few real appointments on the prototype, and I change anything that holds up the queue at the desk.
Other ways to solve it
| Option | Cost | Best for | Where it breaks |
|---|---|---|---|
| Clinic software | A monthly fee for the clinic or per user | Clinics with short courses and mostly self-pay patients | Treatment plans run on recalls and memory, and per-user fees grow with the team |
| Custom build | £495 for First Gear, a fixed price for the build, hosting from £79 a month or on your own server | Clinics with long plans, insurer and package billing, or several sites | Paid for before it saves anything, and each later addition is another phase |
| Open source (OpenEMR, Medplum) | Nothing for the code; a server plus the hours to install, secure and update it | Clinics with technical help who want full control | US-centred billing, no Healthcode, and treatment plans still need building |
| Booking app plus paper notes | A small monthly fee | A single practitioner starting out | Notes in filing cabinets, no plan tracking, and invoices typed separately |
Four guarantees, in writing.
They're written into the terms you accept when you pay.
Every build also comes with a 30-day fix guarantee. If something I built doesn't work as the plan describes, I fix it free.
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See it first
You click through a working prototype before you commit to the build, and you keep it either way.
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Fixed price
You pay the price in the build plan. New ideas go into a later phase with its own fixed price. Nothing is billed by the hour.
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On time
If I miss the go-live date in your build plan because of a delay on my side, you get 3 months of Cruise free (£597). If your data, feedback or sign-off is late, the date moves by the same number of days.
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Yours to keep
Code, data and accounts are in your name from day one. Export your data or cancel a plan whenever you like, and ask for a full handover pack.
You'll talk to me
I've built software for over ten years and started ByteGears in 2020. The person on your kickoff call is the person who writes the code. Recent work includes quoting automation for a renewable-energy installer and a cask whisky auction platform with ID and anti-money-laundering checks.
Questions about a clinic build
Which clinic management software is best in the UK?
It depends on who pays. Physio, chiropractic and osteopathy clinics billing insurers tend to pick TM3 or WriteUpp, which both connect to Healthcode. Cliniko charges one price for the whole clinic, which suits a growing team. Pabau is built around aesthetics, with packages, stock and consent on every plan, and Semble aims at private practices, clinics and occupational health. The matrix in step 1 shows what each vendor's own pages list.
Can it track chiropractic treatment plans and patient progress?
Yes, that's the part I build first. A plan records the visits you've recommended over the coming weeks, the re-examination dates and the outcome score you use, and every visit is counted against it. Reception sees who has missed a planned visit or gone two weeks without booking, and the patient's scores are charted visit by visit so you can show them how they're getting on.
Does my clinic need to register with the CQC?
It depends on who treats patients and what for. A clinic where a doctor or nurse treats patients is usually in scope; a physiotherapist running a standalone service usually isn't; purely cosmetic work falls outside the treatment activity. Chiropractic, osteopathy and mixed teams need checking. The CQC's scope guidance linked on this page sets out the tests, and the CQC decides each case.
How does clinic billing software handle insurers and self-pay together?
Each appointment carries who pays: the patient, an insurer with an authorisation number, or a prepaid package. Insurer claims go through Healthcode, any excess goes on a separate patient invoice, and package sessions count down without an invoice at all. Payments then post to Xero or QuickBooks each day.
Can patients check themselves in when they arrive?
Yes. A tablet at reception or a QR code in the waiting room marks them as arrived, shows the clinician they're here, and asks for any form still unsigned.
What does it cost, and what happens after launch?
Step 3 prices your picks against your subscription. First Gear is £495 for a working prototype in five days, taken off the build. Most builds come in between £2k and £10k at a fixed price, paid 50/50. Anything that breaks in the first 30 days I fix free, the first month's hosting is included, and then you choose Idle £79, Cruise £199 or Overdrive £449 a month, or host it yourself.
Let's get the gears turning.
Send me your plan. If First Gear is the right start, I'll reply with a payment link that holds your slot. If an off-the-shelf product would serve you better, I'll name it.
