The ABCs of PNPs

As we step into 2026, the South African healthcare landscape is shifting more than ever toward decentralized, community-based care. For many Registered Professional Nurses (RNs), the dream of independence could be a reality. Based on the guidelines from the Society of Private Nurse Practitioners (SPNP) and current regulatory standards, here is everything you need to know about transitioning into private practice.

The ABCs of Private Practice

If you are moving from the ward to the boardroom, remember these three pillars:

• A – Authority: Your practice is built on your SANC (South African Nursing Council) registration. Ensure your registration (Annual Practicing Certificate) is current and reflects your specific competencies. In 2026, specializing (e.g., as a Nurse Specialist) is no longer just a "bonus"—it may soon be a requirement for specialized billing and recognition by medical aids.

• B – Billing & PCNS (BHF): To get paid, you need a PCNS (Practice Code Numbering System) number from the Board of Healthcare Funders (BHF). Without this, your patients cannot claim from medical aids, which can severely limit your client base.

• C – Compliance & Coverage: Private practice means you are the primary point of accountability. This includes maintaining Professional Indemnity Insurance (essential for protection against malpractice claims) and adhering to SANC’s ethical rules regarding Scope of Practice and Acts or Omissions.

The "Hit List": Essential Considerations for 2026

Before you hang your shingle, work through this checklist derived from SPNP’s best practices:

1. Define Your Territory: Conduct a "Community Needs Analysis." Are you offering home-based wound care, primary health, or specialized midwifery? Don’t try to be everything to everyone; specialize or define your focus areas to stand out.

2. Statutory Clean-Up: You must be an Registered Professional Nurse to practice privately. Enrolled Nurses and Auxiliaries may not practice independently and must work under the supervision of a Registered Nurse.

3. The Paper Trail: Register your business entity (Sole Proprietor or Pty (Ltd) through the CIPC and open a dedicated business bank account. Mixing personal and business finances is a recipe for a 2026 tax headache.

4. Prescribing & Dispensing Rights: If you plan to prescribe or dispense medication, you must comply with the Medicines & Related Substances Act.  Strict limitations apply to obtaining a Section 22C Dispensing license. A  Section 22A permit from the Department of Health is required to hold stock of S0, 1 & 2 medications for use in your practice.

5. The "Buddy" System: Private practice can be isolating. SPNP recommends finding a colleague to "share call" with. Having a backup for weekends or illness ensures your patients receive continuous care and you avoid burnout.  Being an active member of the SPNP provides you with a network of similar minded nurses and experienced practitioners as a support network.

Pros and Cons: A Reality Check

Pros	Cons
Autonomy: You are the boss; you set the standards of care.	Financial Risk: No patients = no pay. There is no "guaranteed" monthly salary.
Flexibility: Greater control over your schedule and work-life balance.	Admin Overload: You are the nurse, the accountant, and the secretary until you scale.
Personal Growth: Opportunity to build a brand and specialize in a niche you love.	Overhead Costs: Rent, equipment, and insurance premiums are all your responsibility.  Professional Indemnity & Personal sickness insurance should be non-negotiable.

Value-Add: Navigating the 2026 Market

• NHI Readiness: As National Health Insurance (NHI) continues to evolve, consider forming or joining a Group Practice. SPNP notes that multidisciplinary groups or nurse-led partnerships may find it easier to integrate into the proposed NHI systems than solo practitioners.