A physiotherapy clinic does not just pay for one piece of software. The typical stack includes a practice management system, a separate exercise prescription tool (Physitrack or Rehab My Patient), Healthcode for private medical insurance billing (Bupa, AXA Health, WPA and others), and accounting software. Per-practitioner pricing on most platforms means costs scale with headcount. This article lays out the real monthly and five-year numbers based on current public pricing and UK-specific requirements, then compares it to the one-off cost of a bespoke system you own outright.
Most UK physiotherapy clinics run at least four separate tools. The practice management system (notes, booking, invoicing) is the core, but exercise prescription is almost always a separate subscription because none of the major PMS platforms include a full video library and adherence tracking as standard without extra cost. Private medical insurance billing adds Healthcode (the electronic platform used by Bupa, AXA Health, Aviva, WPA, Vitality and others), either natively or via 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 is a realistic monthly breakdown for a typical single-site clinic with 3 clinicians, based on current public pricing from vendor sites and 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: core plus built-in exercise prescription (no separate sub), full insurance billing flows (Healthcode where you are registered), patient portal, advanced reporting (utilisation, DNA rate, revenue per clinician, commissioner PROMs) | £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.
Speak to us about physiotherapy software · +44 7494 618 651 · Mon to Fri, 9am to 6pm
ESRE's live physiotherapy demo shows a unified system with appointments, clinical notes, built-in exercise prescription, invoicing and insurance billing flows, and patient portal, all from the same records, with no per-clinician fees. 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.
Speak to us about physiotherapy software · +44 7494 618 651 · Mon to Fri, 9am to 6pm