A physiotherapy clinic does not just pay for one piece of software. Most clinics run four things. A practice management system. A separate exercise tool, such as Physitrack or Rehab My Patient. Healthcode, to bill Bupa, AXA Health, WPA and others. Accounting software. Per-practitioner pricing on most platforms means costs scale with headcount. This article gives the real monthly figures, and the five-year total. It uses the prices each vendor publishes, and what a UK clinic must have. It then compares that with the single cost of a system you own.
Most UK physiotherapy clinics run at least four separate tools. The practice management system holds the notes, the bookings and the invoices. Exercise prescription is almost always a second subscription. No main platform includes a full video library, and a record of what the patient did, without charging more. Insurance billing adds Healthcode. Bupa, AXA Health, Aviva, WPA and Vitality all use it. Your system reaches it directly, or through a bridge. Accounting is usually Xero or similar.
Per-practitioner pricing on the PMS and exercise tools means the bill rises with every associate or locum. Here are the real monthly figures for one clinic with 3 clinicians. They come from the published prices, and from UK comparisons.
| Component | Typical monthly cost | Notes / examples |
|---|---|---|
| Practice management (PMS) | £45-£120 (for 3 clinicians) | Cliniko tiered, WriteUpp ~£15/user + fees, TM3/PPS quote-based, Jane/Nookal/Pabau per practitioner or location. Varies widely. |
| Exercise prescription | £35-£60 (for 3 clinicians) | Physitrack £19.49 + VAT per practitioner per month. Rehab My Patient from ~£11-£20 per practitioner depending on plan. Almost always a separate sub. |
| Healthcode / insurance billing | 0.3% per successful claim or small sub + PPR registration | Major insurers (Bupa, AXA Health, Aviva, WPA, Vitality) require or strongly prefer Healthcode electronic billing. Some PMS (WriteUpp, PPS, Nookal) have native support; others use bridges or manual. Providers must register via Healthcode PPR. |
| Accounting | £25-£45 (practice total) | Xero, QuickBooks, Sage. Often the only flat practice-wide cost. |
| Total monthly (3-clinician example) | £150-£400+ | Depends on exact vendors and PMI volume. Scales with headcount. |
| Five-year total | £9,000-£24,000+ | Plus setup, migration, training, and any price rises. You own nothing at the end. |
Each tool holds a slice of the data. Clinical notes and appointments in the PMS. Exercise plans and adherence in Physitrack or Rehab My Patient. Claims and remittances in Healthcode or a bridge. Financials in Xero. Reconciling them is manual work or fragile integrations that can break on updates.
VAT note: Services provided by an HCPC-registered physiotherapist are generally exempt from VAT as a supply of medical care (HMRC VAT Notice 701/57). Confirm your exact position with your accountant.
ESRE builds physiotherapy clinic systems for a one-off fee. No per-clinician subscriptions. No separate exercise tool. No Healthcode bridge fees. You own the code and the data outright. Hosted on UK servers with full audit trails and retention logic built in.
| System scope | Typical one-off cost | Replaces |
|---|---|---|
| Core: booking/self-referral, clinical notes (your templates + body charts + outcome measures), treatment plans, basic invoicing, reporting | £10,000-£18,000 | PMS subscription + manual workarounds |
| Full: everything in the core build, and more. Exercise prescription inside it, with no second subscription. Full insurance billing, through Healthcode where you are registered. A patient portal. Deeper reports, covering use of time, missed appointments, income for each clinician, and the PROMs a commissioner asks for | £18,000-£35,000 | Full subscription stack (PMS + exercise + billing friction + accounting workarounds) |
| Multi-site: full system across 2-6 sites with centralised records, cross-site reporting, and shared patient history | £30,000-£65,000 | Multiplied per-site subscriptions |
A clinic paying £300/month across tools spends £18,000 over five years and owns nothing. A bespoke system at £25,000 pays for itself in under three years and belongs to you permanently. After year three, every month is pure savings. The higher upfront cost is the real trade-off; ownership, exact fit, and no ongoing per-clinician fees are the return.
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The pattern in this article repeats in every clinic. Notes in one product. Exercises in another. Insurance billing in a third. Nobody sells all three together.
Each vendor declared a patient, an appointment and a treatment once, in the shape its own market needed. A video library and an adherence record sit outside that shape, so a second company built them, with its own idea of a patient. You then pay twice, and match the two by hand.
We build the other way. Every clinic we build for shares one foundation, which already holds a patient, an appointment, a clinical note, an exercise plan and an invoice. Your own system sits on top. The exercise plan and the note are the same record, so there is no second bill and nothing to match.
We explain that in bespoke software for a whole sector. We set out the full cost, including your own time, in what does it cost to own and run your own systems.
The live ESRE physiotherapy demonstration shows one system. Appointments, clinical notes, exercise prescription, invoicing, insurance billing and a patient portal. All of it runs from the same records, with no fee for each clinician. Sign in as owner, physio, receptionist, manager or patient. It is a working system, not screenshots. Open the physiotherapy software hub for the demo link and full details.
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