Many doctors consider providing medical services in residential premises when beginning their careers or expanding a practice. This raises specific questions: is a medical practice at home permitted at all? What premises-related requirements apply? Is a home-based physiotherapy practice governed by the same rules as a healthcare provider?
The answer is that it depends on the form of the activity and the scope of services.
Below, I discuss the key legal requirements to consider when planning a practice in residential premises, whether it is a medical, psychology, physiotherapy, speech therapy or dental practice.
A medical practice at home – is it lawful?
As a rule, a medical practice in residential premises is permitted if it satisfies the requirements of the following Polish legislation:
- the Act on Medical Activity,
- the Regulation on detailed requirements for the premises and equipment of an entity performing medical activities,
- building law,
- sanitary legislation.
The form of the activity matters greatly. Different requirements apply to an individual medical practice and a healthcare provider.
If you are unsure when an activity becomes a healthcare provider within the meaning of the legislation, it is worth clarifying this first.
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The requirements for a professional practice are somewhat less extensive than those for a healthcare provider, but specified sanitary and premises-related standards still apply.
What premises-related requirements apply to a medical practice at home?
If you are planning a medical practice at home, the principal requirements concern:
- separating a room used exclusively for the activity,
- providing access to running water,
- ensuring surfaces can be disinfected,
- protecting the patient’s privacy,
- meeting technical and sanitary conditions.
In practice, the residential area must not ‘merge’ with the area used for health services. The sanitary authorities pay particular attention to a clear separation between residential and medical use.
If the activity is conducted by a healthcare provider, appropriate documentation and an entry in the relevant register will also be required. It is worth checking in advance how registration works and the formal duties it entails.
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A psychology practice at home – what premises-related requirements apply?
Many assume that a psychology practice in residential premises is not subject to the same requirements as medical activity. This depends on the scope of the services.
If the activity is not a health service within the meaning of the Act on Medical Activity, the provisions for healthcare providers do not apply. The following remain relevant:
- sanitary legislation,
- building legislation,
- health and safety rules.
A psychology practice at home raises many practical questions about the premises. The key issues are a room used exclusively for providing the services, confidentiality of conversations and consistency between the actual use and the use specified under building legislation.
If the activity is conducted by a healthcare provider, the Act on Medical Activity and the requirements for the premises and equipment of entities performing medical activities apply.
A physiotherapy practice in a house or flat
As a rule, a home-based physiotherapy practice constitutes medical activity if the physiotherapist provides health services within the meaning of the Act on Medical Activity.
Under Article 2 of the Act, medical activity consists in providing health services: actions intended to preserve, save, restore or improve health. As part of treatment and rehabilitation, physiotherapy services fall within this definition. In addition, under the Polish Act of 25 September 2015 on the Profession of Physiotherapist, physiotherapists practise a medical profession and provide health services independently as part of medical activity.
This means that the following are subject to the Act on Medical Activity and the requirements for premises and equipment:
- a physiotherapy practice in a house;
- a physiotherapy practice in a flat.
This applies where the practice is operated as a professional practice or by a healthcare provider.
Premises-related requirements in practice
For an individual physiotherapy practice, the premises should:
- be separated from the residential area,
- provide sufficient space for treatments to be performed safely,
- have access to running water,
- allow surfaces and equipment to be disinfected,
- meet the sanitary requirements in the secondary legislation.
Where the activity is conducted by a healthcare provider, the Regulation of the Polish Minister of Health on detailed requirements for premises and equipment applies. It specifies, amongst other things:
- minimum sanitary and hygiene conditions,
- requirements for utility systems,
- the organisation of rooms,
- adaptation to the type of services provided.
Change of use
Operating a physiotherapy practice in a flat may also require notification of a change of use under Polish building law if the way in which the premises are used affects fire safety, sanitary and hygiene conditions or the building’s structure.
The following must therefore be assessed in each case:
- the scale of the activity,
- the volume of patient traffic,
- the scope of the services provided.
A dental practice – premises-related requirements
A dental practice is subject to the most stringent premises-related requirements of the examples discussed. This is due to the services involved and the need to provide:
- appropriate ventilation,
- clean and dirty zones,
- a sterilisation area,
- water and drainage systems,
- compliance with epidemiological requirements.
In practice, a dental practice can be operated in a flat, but the premises must be adapted to the technical and sanitary legislation with particular care.
A speech therapy practice – premises-related requirements
The requirements for a speech therapy practice depend on whether the activity constitutes a health service.
If the speech therapist operates through a healthcare provider, the Act on Medical Activity applies. If the work is educational and therapeutic outside the healthcare system, the requirements may be narrower.
In every case, it is important to:
- separate a dedicated room,
- ensure the safety of patients, who are often children,
- ensure that the premises’ use complies with building legislation.
Change of use
For a medical, physiotherapy or psychology practice in residential premises, a change of use within the meaning of Polish building law may be crucial.
If the scope of activity changes fire-safety or sanitary conditions, or affects the structure of the building, notification or permission may be required.
This issue is frequently overlooked when the activity is being planned.
Summary
A specialist practice at home is possible, but requires a precise analysis of:
- the form of the activity,
- the scope of services,
- sanitary requirements,
- building legislation,
- the Act on Medical Activity.
If you plan to begin operating in residential premises and want to analyse the process step by step, see the articles in the establishing healthcare facilities category.
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Legal basis and sources
- Polish Act of 15 April 2011 on Medical Activity
https://isap.sejm.gov.pl/isap.nsf/DocDetails.xsp?id=WDU20111120654 - Regulation of the Polish Minister of Health on detailed requirements for the premises and equipment of entities performing medical activities
https://isap.sejm.gov.pl/isap.nsf/DocDetails.xsp?id=WDU20220000402 - Polish Building Law Act https://isap.sejm.gov.pl/isap.nsf/DocDetails.xsp?id=wdu19940890414
