The portfolio career isn't a plan B. For a growing number of GPs, it's the deliberate construction of a working life that's more sustainable, more interesting, and — often — more lucrative than any single contract.
The principle is simple: instead of working 8 sessions at one practice, you work 4–5 clinical sessions and fill the rest with non-clinical income streams that use your medical expertise differently. Here are the specific options, with realistic numbers.
The building blocks
Appraisal work
What it is: Conducting annual GP appraisals for your local area. Appraisers are trained and commissioned by their NHSE regional team.
How to get started: Apply to your regional appraiser recruitment when vacancies are advertised (usually via the NHSE appraisal lead). You'll need to complete appraiser training (free, usually 2–3 days). Most areas require you to have been a GP for at least 5 years.
What it pays: £350–£500 per appraisal. An experienced appraiser doing 20–30 appraisals per year earns £7,000–£15,000. Appraisals can often be scheduled around your clinical sessions with reasonable flexibility.
Medical education and training
What it is: Clinical/educational supervisor for GP trainees, medical school teaching, postgraduate education delivery, examiner roles.
How to get started: Become a training practice (your practice needs to meet HEE standards). Complete the GP educator training programme. For examining: apply to the RCGP for SCA/AKT examiner roles, or to universities for OSCE examiner positions.
What it pays: Training practice payments contribute to practice income, and the personal educational supervisor supplement is modest (~£1,000–£3,000/year). Medical school teaching sessions: £200–£500/session. RCGP examiner fees: £250–£400/day. A GP dedicating 1–2 sessions/week to education can earn £15,000–£30,000/year from combined education roles.
Expert witness and medicolegal
What it is: Providing expert GP opinions for clinical negligence litigation, personal injury cases, and regulatory proceedings.
How to get started: Complete expert witness training (Bond Solon, Cardiff University, or similar). Register with expert witness directories and medicolegal agencies. Build a reputation through consistent, high-quality reports.
What it pays: £150–£350/hour for report writing and case review. A typical GP negligence report takes 8–15 hours and pays £1,500–£4,000. Court attendance: £300–£500/hour. An established expert witness doing 2–3 reports per month earns £30,000–£80,000/year on top of clinical income. Ramp-up takes 1–2 years as you build your referral network.
Health technology advisory
What it is: Clinical advisory boards, product validation, user research, and clinical governance for health tech companies.
How to get started: Build visibility — write about health tech, attend industry events, maintain a LinkedIn presence that signals "practising clinician who understands technology." Companies find advisors through networks, not advertisements.
What it pays: Advisory board sessions: £500–£2,000/half-day. Ongoing advisory retainers: £1,000–£5,000/month. Equity in early-stage companies: variable (sometimes worthless, occasionally life-changing). A GP with 2–3 advisory relationships can earn £10,000–£40,000/year from ad hoc advisory work.
Occupational health
What it is: Fitness-for-work assessments, sickness absence management, health surveillance for employers.
How to get started: The Diploma in Occupational Medicine (DOccMed) is the standard qualification, though some OH providers hire GPs for basic assessments without it. Register with OH providers or offer services directly to local employers.
What it pays: Sessional OH work: £500–£800/session. A GP doing 2 OH sessions/week earns £50,000–£80,000/year from OH alone.
Medical writing and content
What it is: Writing for medical publishers, pharmaceutical companies, health tech companies, patient-facing organisations, or your own platform.
How to get started: Start a blog, contribute to GP publications (Pulse, BJGP, GPonline), or approach medical communications agencies. A portfolio of published writing is your calling card.
What it pays: Freelance medical article: £200–£800. Pharmaceutical medical writing (CME, manuscripts): £1,000–£5,000 per project. Regular content contracts: £500–£3,000/month. Medical writing alone rarely replaces clinical income but combines well with other streams.
CQC inspection
What it is: Serving as a specialist adviser on CQC inspection teams for GP practices and other primary care providers.
How to get started: Apply directly to CQC when specialist adviser vacancies are advertised. You'll need significant GP experience and an understanding of clinical governance.
What it pays: £300–£400/day. Inspections typically involve 1 day of preparation, 1–2 days of inspection, and half a day of report writing. Volume depends on your availability and CQC's schedule.
GMC/tribunal work
What it is: Serving on GMC fitness-to-practise panels, medical practitioners tribunal service (MPTS) panels, or as a clinical assessor.
How to get started: Apply when panel member vacancies are advertised (GMC website). Training is provided. These roles value seniority, clinical breadth, and an understanding of professional standards.
What it pays: Varies by role and commitment, typically £300–£500/day for panel sitting.
Constructing the portfolio
The key insight: don't try to build everything at once. Start with one non-clinical stream alongside your clinical work. Get it established and earning reliably before adding the next.
A realistic build trajectory:
Year 1: Add appraiser training + 10 appraisals. Net addition: ~£4,000–£5,000.
Year 2: Add 1 session of medical education or begin expert witness training. Net addition: ~£10,000–£20,000.
Year 3: Reduce clinical sessions by 1–2, add a second non-clinical stream (medtech advisory, OH, writing). Net income maintained or increased with better variety.
Year 5+: Mature portfolio with 4–5 clinical sessions and 3–4 non-clinical streams. Total income: competitive with full-time partnership, significantly better work-life balance.
The common mistakes
Spreading too thin too early. Three non-clinical activities each done poorly pay less and stress more than one done well.
Underpricing yourself. GPs consistently undercharge for non-clinical work. Your clinical expertise has market value — price accordingly and don't accept rates that imply your time is worth less than a consultation.
Neglecting the clinical anchor. Most non-clinical roles value "practising clinician" status. Dropping clinical work entirely reduces your credibility and your options. Maintain enough clinical sessions to stay current and registered.
Ignoring the admin overhead. Multiple income streams mean multiple contracts, multiple invoices, multiple tax complexities. Budget time (or an accountant) for this.
iatroX is built by a GP running exactly this kind of portfolio — clinical practice + medtech founder + postgraduate education. AI clinical search and CPD tracking for UK GPs.