How to choose a functional medicine clinic in the UK

A disclosure, and why this page exists

I am Dr Andrew Greenland and Greenland Medical is my practice, so I am not a neutral party. I have written this anyway because people searching for a functional medicine clinic in London or elsewhere in the UK are choosing between clinics that look similar on the surface and are very different underneath, and almost nothing written for them explains the difference. Where another model would serve you better than mine, this page says so.

I have not named other clinics. Not because there is anything wrong with them, but because a fair comparison would need re-checking every time a price list changed, and because the useful comparison is between models rather than businesses. Once you understand the models, you can place any clinic you are considering into the right column yourself.

The distinction that matters most: who you actually see

'Functional medicine' is not a protected title in the UK. Anyone can use it, and the clinics that do range from a single nutritional therapist working from home to multi-practitioner businesses with doctors, nutritionists and health coaches. The training behind the term also varies. The Institute for Functional Medicine in the United States certifies practitioners from several professions, including doctors, nutritional therapists and others; other bodies offer shorter courses; and some practitioners have no formal training in it at all.

The practical consequence is that the most useful question to ask any clinic is not what conditions it treats but who will assess you, what they are qualified and regulated to do, and who interprets the test results. There are three broad models.

• Doctor-led. A GMC-registered medical doctor takes the history, orders and interprets the tests, can prescribe, and can recognise and refer serious disease. Costs more per hour. Regulated by the GMC and, where the provider is an organisation, by the Care Quality Commission.
• Nutritional-therapist-led. A nutritional therapist, usually registered with BANT and the CNHC, takes the history and builds a diet, lifestyle and supplement plan. Cannot make a medical diagnosis or prescribe. Often excellent at the detailed dietary work a doctor has less time for. Costs less per hour. Regulation is voluntary.
• Team-based. Doctors and nutritional therapists in one clinic, usually sold as a package in which the doctor sets the direction and the therapist does the follow-through. The most expensive model, and for some problems the most complete.

None of these is wrong. They suit different problems and different budgets, and the rest of this guide is organised around that.

The three models side by side

The price bands are wide on purpose, and they will drift. Calculate the hourly cost rather than reading the headline: a £450 consultation of an hour and a £900 consultation of two hours are the same rate, and a package price only means something once you know how many hours it contains and with whom.

When to pick each

Pick a nutritional-therapist-led clinic when

• Your GP or a specialist has already excluded serious disease, and the work ahead is dietary and lifestyle change with someone who has the time and training to do it thoroughly
• You want frequent, lower-cost follow-up and a coaching relationship over months
• Your budget does not stretch to doctor-led care, and you would rather have a good nutritional therapist than no support at all

Be clear-eyed about the limits. A nutritional therapist cannot make a medical diagnosis, cannot prescribe, and should not be the person interpreting an abnormal thyroid antibody, an autoimmune screen or a raised inflammatory marker in isolation. The good ones know this and refer; ask how they handle it.

Pick a team-based clinic when

• You want a doctor setting the direction and a nutritional therapist doing the follow-through, and you are happy for those to be two different people
• You want frequent contact without paying a doctor’s hourly rate for all of it
• You are comfortable with a package price of two to three thousand pounds before testing, and you will use all the appointments it contains

Ask how much of the package is actually with the doctor, and whether the doctor reviews the test results personally or delegates that.

Pick a doctor-led clinic when

• The problem is one where recognising serious disease matters, and a medical view of the whole case is part of what you are paying for
• You want one person to hold the case from history to test interpretation to plan, without hand-offs
• You may need prescribing, or letters to your GP or a specialist that carry medical weight
• You want a specific medical programme, such as the Bredesen Protocol for cognitive decline, delivered by a doctor trained in it

Within the doctor-led model there is a further distinction worth knowing: a doctor who does only private functional medicine, and one who also practises conventionally. I still work at consultant level in an NHS hospital, and I think that is the single most useful thing I bring, because it keeps the pattern recognition for serious disease sharp. Others will reasonably disagree. Ask.

The honest limits of my own model

Greenland Medical is a sole practice. I see every patient myself, in Twickenham and Richmond in south west London, and online. That has real advantages, set out above, and it has real limits, which you should weigh.

• Capacity. One doctor sees fewer people than a team. Appointments are long and there are not many of them.
• No in-house nutritional therapist. Where someone needs weekly dietary coaching, I refer to colleagues I trust rather than pretending to offer it. If that is the main thing you need, another model will serve you better and cost you less.
• Location. In-person appointments mean south west London. Much of the work can be done online, but some of it, such as physical examination and the active stand test for postural tachycardia, cannot.
• Cost. A two- or three-hour consultation with a doctor is several hours of medical time, and it is priced that way. The fees page sets out the numbers in full, and what is and is not included.

My particular focus is cognitive decline and the Bredesen Protocol, with complex fatigue, tick-borne and biotoxin illness, and hormonal health alongside. If your problem is elsewhere, I will say so on the discovery call rather than take on work someone else would do better.

Questions to ask any clinic before you book

These apply to every functional medicine clinic in the country, including mine. A clinic that cannot answer them plainly is telling you something.

1. Who will take my history, and what register are they on? Ask for the GMC, BANT or CNHC number and look it up. It takes two minutes.
2. Who interprets the test results, and are they medically qualified to do so?
3. Which tests do you not use, and why? A clinic that cannot name any is selling everything. Mine will tell you that IgG food sensitivity panels, unvalidated Lyme tests and hair analysis are not worth your money, and why.
4. What will testing cost, and will I get a written estimate before anything is ordered?
5. What outcome do you realistically expect for someone like me? Be wary of any answer that sounds like a guarantee, particularly for cognitive decline, autoimmunity or Lyme disease. UK advertising rules exist precisely because those promises get made.
6. What happens if you find something serious? A clinic without a clear answer is one to avoid.
7. Will you write to my GP? If not, ask why not.
8. Is the practitioner also selling the supplements? Not disqualifying, but worth knowing when a plan arrives with a long list of them.

About the writer

I am a practising hospital doctor at consultant level in West London, a certified functional medicine practitioner, and trained in the Bredesen Protocol for cognitive decline. Greenland Medical is my private practice, based at The Maris Practice in Twickenham with a second consulting location in Richmond, and online. A discovery call costs nothing, takes about fifteen minutes, and is the fastest way to find out whether my model is the right one for you. If it is not, I will say so.