A six-practitioner private clinic pays for software twice: once for the PMS, priced by practitioner band (Cliniko lists $45 to $195 per month by band; WriteUpp from £19.95 per user; Jane £29 to £55 per month; Pabau's Starter is £50 per month then quote-only; Semble is reported from around £119), and again for the satellite stack bolted around it. Calendly, DocuSign and Dropbox each take a per-seat fee and each becomes a separate US processor holding patient-adjacent data: bookings, consent forms, referral letters. After the NHS and Palantir row, "where does UK health data actually live" is a question patients now ask out loud.
What the satellite stack around your PMS costs
Calendly Teams lists at $16 per seat per month (the vendor prices in dollars); DocuSign's UK Standard plan lists at £20 per user per month with a cap of 100 envelopes per user per year. For a six-practitioner clinic that is roughly £75 a month for booking and £60 for three e-signing seats before anyone shares a file. Keep the PMS; this table is about everything around it.
| Capability | US SaaS stack | On Node (flat, hourly billed) |
|---|---|---|
| Patient & class bookings | Calendly Teams: 6 x $16 (~£75/mo) | Cal.com (Small): £21 |
| Consent forms & treatment plans | DocuSign UK Standard: 3 x £20 = £60, capped at 100 envelopes/user/year | DocuSeal (Small): £25, unlimited envelopes |
| Policies, training records & inter-site files | Dropbox or Drive, per seat | Nextcloud (Medium): £45 |
| DBS, indemnity & CQC evidence archive | Filing cabinets and shared drives | Paperless-ngx (Small): £25 |
| Identity, SSO & audit | Spread across the above | Included with your apps: £0 |
| Indicative total | ~£135+/mo, rising with every hire | £116 flat, headcount-free |
The Node column is a sum of app rates and nothing else: no platform fee, no per-practitioner line. Hire a seventh practitioner and the left column grows; the right column does not move. To be explicit about scope: none of this replaces your PMS, and we will not pretend it does. Ask for a like-for-like figure for your clinic.
What your clinic runs on Node
Nextcloud, EspoCRM, DocuSeal and n8n deploy self-serve, in minutes, from the signup portal; the rest are managed setup, deployed and connected by our engineers.
Bookings: Cal.com (managed setup) (Small, £21/month equivalent): patient appointments, class slots and room diaries without a per-seat fee for every receptionist and associate. Cal.com's own site markets healthcare scheduling as a core use case.
Consent & treatment plans: DocuSeal (self-serve) (Small, £25): consent forms, treatment plans and new-patient paperwork signed with unlimited envelopes, against DocuSign's 100-envelopes-per-user-per-year cap. Documenso is the alternative if you prefer its signing flow.
Files & policies: Nextcloud (self-serve) (Medium, £45): policies, training records and inter-site shares with expiring password-protected links instead of email attachments. ZGT, a Dutch hospital, runs Nextcloud on-premises according to the vendor's published case study, and Nextcloud's own blog documents a collaboration with Harvard Medical School.
Enquiry pipeline: EspoCRM (self-serve) (Small, £25): enquiries, consultations and follow-ups for private and aesthetics clinics. It is a sales pipeline, not a patient record, and we will keep saying so.
Compliance archive: Paperless-ngx (managed setup) (Small, £25): DBS checks, indemnity certificates and CQC evidence scanned, OCRed and findable at inspection time.
Website analytics: Matomo (managed setup) (Small, £22) or Umami (Small, £21): which condition pages someone reads is sensitive browsing data; analyse it on your own tenant, not a US ad-tech platform.
Healthtech: Bring Your Own App with the private registry and right-sizing: run your own patient-data services on UK-owned hardware and call UK-hosted models through the AI gateway, with no US AI provider in the processor chain.
Article 9 data deserves a shorter processor chain
Health data is special-category data under UK GDPR Article 9, and patient-adjacent data (bookings against a condition, consent forms, condition-page analytics) deserves the same caution. Every US SaaS tool in the satellite stack is another Article 28 processor and another international transfer to assess. Your Node tenant is a network-isolated private network on hardware we own in UK data centres, under UK jurisdiction, which ends the transfer analysis for this layer of your stack. A UK GDPR Article 28 DPA is standard. To be equally clear about what this is not: we do not hold NHS DSPT or DTAC, we are not a clinical system, and CQC registration and clinical governance remain entirely yours.
AI on clinic material, without a US provider in the chain
Drafting patient letters, summarising policies, first-pass responses to enquiries: useful AI work on exactly the material that must not go into a consumer chatbot. The AI gateway labels every model UK-hosted or partner-routed; UK-hosted models run on GPUs we own, so prompt content never leaves our infrastructure. Metered per token in GBP on the same hourly invoice: see the model catalogue.
Keep the PMS, move the satellites
Deploy Nextcloud, EspoCRM, DocuSeal or n8n yourself in minutes with £25 of free credit, or tell an engineer what surrounds your PMS today for a flat hourly-billed figure.
Frequently asked questions
Is this a replacement for our practice management system?
No, and we will say so before you ask. Node is not a clinical PMS or EHR and does not replace Semble, Cliniko, Jane or your dental software; clinical records stay in a clinical system built and assured for that job. What we replace is the satellite stack around it: the US booking, e-signing, file-sharing and analytics tools that each become a separate processor holding patient-adjacent data.
Do you hold NHS DSPT or DTAC?
No. We do not hold NHS DSPT or DTAC accreditation, and if your NHS or ICB contract requires them, that assessment applies to your product and organisation, not to generic hosting underneath it. What we provide is UK-owned infrastructure, a UK GDPR Article 28 data processing agreement as standard, and single sign-on with audit, which supports the paperwork you complete.
Where does CQC registration fit?
Entirely with you. CQC registration, clinical governance and safeguarding duties belong to the provider and cannot be transferred to an infrastructure supplier. Our role is narrower and honest: the non-clinical tools around your practice run in a network-isolated UK tenant, behind your own single sign-on, so a leaver loses every app at once and admin actions are audited.
How does the billing work?
Everything is billed hourly against a published rate card with no minimum term and no contract; the monthly figures on this page are equivalents for comparison. Stop an app and the meter stops. Nothing on the bill counts practitioners or seats, which is the axis your PMS and Calendly both charge on.
Why does website analytics matter for a clinic?
Because which condition pages a visitor reads is sensitive browsing data. Send it to a US analytics vendor and you have added another processor to your chain for exactly the data your patients least expect to travel. Matomo or Umami on your own UK tenant keeps that analysis in-house, on hardware we own.
We are a healthtech startup, not a clinic. What is on offer?
Bring Your Own App: your containers in a private UK tenant with the registry, right-sizing and single sign-on handled, plus the AI gateway for UK-hosted models. That means you can run patient-data services and call models with no US AI provider anywhere in the processor chain, which is a due-diligence answer your NHS and insurer prospects will actually accept.